Filling? Plumping? Volumising? Stimulating?

The evolution of the humble dermal filler...

The American Society for Aesthetic A surgical operation (ASAPS) reported in its plastic cosmetic surgery predictions for 2006 which; "the growth and popularity of cosmetic fillers will sharply increase as products are nevertheless evolve and new players to enter the market. "

We last reviewed the expanding UK dermal filler marketplace here we are at June 2004, and since then the number of products available has indeed increased even much more; more interesting however is usually to note that the way they are used has created from simple "filling" to new state-of-the-art "volumetric" things.

So who are the new kids on the block? And, what's hot in the application of dermal fillers?

Types of your Dermal Fillers:

It is agreed of the experts that ideally a usual dermal filler product should invariably be biocompatible (compatible with console tissues), non-toxic, non-immunogenic, (not provoke an immunity mechanism response), and non-migratory, (i. mirielle. not move to other parts of the body). Hence, numerous kinds natural and man-made or synthetic materials have been developed eventually for injection into they likewise have.

In general, as well as classifying dermal fillers based on their temporary (resorbable) and permanent (non-resorbable) qualities, take a look at also split the shortlist UK available products big on six main groups depending on their primary composition.

These secure:

The Collagens, each and every single from human or animal origins - Zyderm®, Zyplast®, Cymetra®, Artecoll® and Evolence(TM).
The Hyaluronic Acids - Restylane®, Juvederm®, Hydrafill®, Hylaform®, Dermalive®, Dermdeep®, Matridur®, Matridex® Esthé lis®, Reviderm® Intra, Puragen(TM) and Teosyal.
The Polyacrylamides up to Aquamid(TM), Bio-Alcamid(TM), Outline® and Evolution®.
The Poly-L-Lactic Acids - Sculptra®.
The Polyvinyl Alcohols up to Bioinblue(TM).
And, the Lime Hydroxylapatites - Radiesse(TM).

Many practitioners are understandably wary about by using a permanent filler product, on most reasons, including worries about complications in consequence of patient reaction, and the care that the patient better not like the resulting "permanent" swelling. However, patient criteria pertaining to the dermal filler product, not necessarily cost, has always been heavily influenced by what steps that a filler product last and retain the sought-after correction.

So, to makeup this middle ground, a fake "semi-permanent" (resorbable) filler work on has arisen, comprising those goods that contain a biodegradable rucksack substance, such as hyaluronic acid, plus microspheres (small balls clothes like) of another substance which provide structure to the static correction, which the natural physique will bond around, ensuing a more permanent and tough effect. Examples of these semi-permanent products include: Radiesse(TM) (Calcium Hydroxylapatite (CaHA) microspheres), Matridex® and Reviderm® Intra (Dextran microspheres), Dermalive® and Dermdeep® (Acrylic Hydrogel microspheres).

As effortlessly as filling or volumising gels and creams, a new breed going through "stimulators", which includes the semi-permanent ones on top of, has also become built which through their injection stimulate the body's production of new bovine collagen meaning natural added volume and correction eventually. Unlike the products such as that of those with a hyaluronic acid base which gives easy results, and with the microspheres longer lasting results, there are products with no immediate volumising effect, yet are created to cause a foreign basis reaction (collagen production) over time to search for the long lasting effects; tips includeSculptra® and Isolagen®, (although in fact categorised as an autologous cell therapy and not have to a cosmetic filler).

With the transitional phase of so called "baby-boomers", made worse disposable income, increased media exposure and consumer awareness via TV programmes quickly 10 Years Younger, the necessity of quick, minimally invasive treatments will emulate the emphasis on non-animal, permanent, natural and safe makeup filler products.

Recent Unusual Launches:

Sculptra® (Formerly New-Fill® )

Sculptra® - previously identified as New-Fill® - was originally launched in the uk in 2000. It was re-branded within the new name Sculptra® in 2004 and is now in popularity in the uk and Europe.

It holds tiny beads of an artificial (non-animal and non-human) material called Poly-L-Lactic acid (PLLA). PLLA is broken down from your very own body to lactic acid - a potent substance found systems.

The manufacturer, Sanofi-Aventis, claims that the product can certainly help cause new collagen production in addition to mechanically filling depressions. The object itself is not permanent marriage ceremony effects can be permanent. Sculptra® is therefore used more thereby sculpting agent and organize stimulator, rather than like in a wrinkle filler. It also has an FDA approval of treatment for HIV-induced facial lipodystrophy, (sunken features for fat loss).

Radiesse(TM) (Formerly Radiance(TM))

We inspected Radiance(TM) (Calcium Hydroxylapatite) inside your feature article on dermal fillers back in June 2004 entitled - Filling the gap. The product was just being marketed as Radiance(TM), however when they get home of 2004 Bioform Medical, the US manufacturers re-branded it as Radiesse(TM).

Radiesse(TM) is basically no permanent filler. It is an enduring, resorbable filler - by means of effect claimed to most up-to-date approximately 2 years depending on patient and the area treated. Once injected on the skin, the smooth and spherical CaHA particles get a 'scaffold' which a person's own tissue grows between say. The gel carrier dissolves within just just months and over plenty of, the CaHA particles gradually respite and are completely metabolised from your very own body, leaving only the fresh collagen structure.

Esthelis®

Esthé lis® fantastic monophasic double crosslinked hyaluronic acid created in Switzerland simply by Anteis, and promoted in the uk by Aston Biomed Ltd. (In Denmark, Austria, Switzerland, Russia, and Italy it is promoted as Belotero. )

Esthé lis® continues to be designed from biofermentation hyaluronic acid, a substance naturally around our body; which the manufacturers claim makes it as well as completely biocompatible, as well as wholly biodegradable. It is created using Cohesive Polydensified Matrix (CPM) discovery, a unique process which supplies Esthé lis® hyaluronic acidity unusual elasticity; (this technology improves its "mono-phasic" nature). Esthé lis® therefore guarantees a considerably better result from early on in hours after the injection and older the initial months, simply by increased volume and wrinkle filling distinct from "biphasic" products.

Esthé lis® Basic is aimed in to volume enhancement treatments and can be used for deep furrows, lip augmentation, facial outlines, naso-labial pipes, glabellar lines and the correction of facial depressions. At this time whilst Esthé lis® Soft is designed for treating superficial wrinkles and can be used for perioral wrinkles, lip commissures, crow's legs, and forehead wrinkles.

Evolence(TM)

Launched in the UK at the outset of 2005, EVOLENCE(TM) is a perpetual, porcine (derived from pigs) collagen-based skin filler; which the makers claim will last at least 12 some time. Manufactured by ColBar LifeScience and distributed in the uk by Clover Leaf Medical Ltd, EVOLENCE(TM) is made out of highly purified, cross-linked porcine bovine collagen dispersed in phosphate buffered saline scenario.

The manufacturer's state it is additionally EVOLENCE(TM), unlike bovine (cow) prepared fillers, is able to mimic the properties of the natural collagen located in the skin and therefore, while some treatment for allergies is theoretically possible, this can be very rare so pre-testing is not necessary before treatment with EVOLENCE(TM).

Puragen(TM)

Puragen(TM), launched by Mentor Corporation in the uk in October 2005, fantastic Non-animal Hyaluronic Acid (NaHA) dermal filler consists of bacterial fermentation.

It is generated using their breakthrough discovery called DXL(TM). The patented DXL(TM) process double cross-links hyaluron chemical substances, providing greater resistance to give degradation than single cross-linked tubes available. DXL(TM) therefore increases the resistance of Puragen(TM) to breaking up as the doubled network of molecules turn up useful info absorbed by the body as quickly, giving Puragen(TM) a longer lasting ability depending on manufacturers. They also state that Puragen(TM) is the usual dermal filler product which relies upon double cross-link chemistry, definitely particle size, to maintain it last longer.

Puragen(TM) qualifies as a CE-marked Section III medical device in Europe towards correction of facial creases, folds, and lip growth; with FDA approval in the state currently pending.

Teosyal

The Teosyal a small amount of, promoted in the GREAT BRITAIN by Lifestyle Aesthetics, covers three monophasic hyaluronic chemical based products of non-animal location of creation, which are highly biocompatible, offering patients immediate and long-lasting results number preliminary testing. Two dermal filler products have been launched alongside Teosyal Meso - the actual hyaluronic acid based mesotherapy treatment (see below).

Teosyal 27G is a very dense and voluminous implant employed to fill nasolabial folds up, lip augmentation, and facial contouring and Teosyal 30G fills cutaneous fissures quickly marionette or perioral lines and facial lines.

Restylane® Lipp

Launched in The month of january 2006, Restylane® Lipp continues to be specially designed for injecting using the lips for enhancement and personal contouring. It is the cohesive and dynamic grease, and claims to wind up structured to withstand the plethora of mouth movements and subluxes that characterise the teeth and therefore last enhanced. As with the remaining portion of the RESTYLANE® range it is add Non-Animal Stabilised Hyaluronic Acidic (NASHA).

Differing Techniques:

Volumetric

With the continuing rise in consumer fascination with quick, minimally invasive, fake "lunchtime" procedures, which spotlight no down-time but suspect almost surgical standard plans, it is no surprise that manufacturers have evaluated ways of producing products that merely fill wrinkles the long-established way, but add volume and structure to the present crucial facial areas which beginning to sag or sink as a body ages.

Dr David Eccleston, Cosmetic Physician and medical advisor and yet Consulting Room(TM) comments; "The three primary ingredients of ageing skin go photodamage (sun), leading to deal with fine wrinkles, the deeper creases caused by expression, and loss of facial volume due to offer facial fat and money deposited atrophy, leading to sunken cheeks and the head moving downwards in folds up. ".

As discussed inside your January feature article as high as The "Non-Surgical Face Lift" Comes unwanted? - it is in addition to that a new subject of volumising or volumetric techniques emerged alongside the original wrinkle filling procedures. Examples of dermal fillers which used to provide associated with a volumetric approach that is going to facial correction, rather the simple line or anti aging filling, include Sculptra® and Restylane® SubQ, which both of them are injected deeper than most usual products. These can be familiar with add volume to locations which traditionally lose volume as a body ages such as the cheekbones, hollows under the eyes or tear trough as well as chins.

Also, as noted in the least recent Paris IMCAS getting together in January, cosmetic fillers are getting used where once surgery was the single recommended option - specifically, in the new art of non-surgical rhinoplasty and in addition nose jobs. A small number his or her practitioners are experimenting if you use filler products to raise your tip of a sagging nose or recontour any large number of nasal profile to camouflage design for a bump or ridge more than a nose. Whilst surgery is the usual option to permanently affect the structure of the stink, dermal fillers are indeed now seen as an valuable tool for the particular nose better fit the particular through such volumetric options.

Mesotherapy

Hyaluronic acid exists naturally generally living organisms and is a universal aspects of spaces between the biotic of body tissues, the actual extracellular space. It can retain 500 times its volume in water, swelling to plump the actual skin and intensively hydrate it from within. This hydrating property not simply helps the skin to make-up firmer, but also helps with the transport of important nutrients from the bloodstream within a skin cells.

As i know age, the amount of acid hyaluronic in the skin takes away from, as the skin cells lose the incredible to produce it. Several hyaluronic acid based injectable gels and creams has therefore emerged, to be able to cosmetic filler technology, as well as several as an adjunctive product inside an overall filler brand scope, to fill the topic dedicated to rehydration on the epidermis via the micro-injection technique in order to mesotherapy.

Restylane® Vital

RESTYLANE® Vital is something new offering from the Norwegian company Q-Med, aimed this particular new approach to appearing rejuvenation. Like all excellent RESTYLANE® products, RESTYLANE® Vital manufactured Q-Med's patented NASHA (Non-Animal Sits firmly Hyaluronic Acid) gel. It is targeted at a broad range of treatment areas including the face, neck, dé colletage (the area within the neck and breasts) and it is hands; designed to replenish the hyaluronic acid lost through ageing, hence hydrating our bodies and improving its elasticity and tone.

RESTYLANE® Vital obtained European CE certification in 2004 to discover the indication of hydration on the epidermis by injections.

Viscontour®

Sanofi Aventis, the creators of Sculptra(TM) (Poly-L-Lactic acid) newly introduced an injectable and topical hyaluronic brand : Viscontour®.

The injection relating to Viscontour® is targeted of your broad range of remedies for areas for skin restorative, helping to hydrate the skin and reduce designs for wrinkles on the dial, neck, dé colletage and hands; used in in conjunction with the topical application yeah Viscontour® (Hyaluronic Acid) Serum.

Teosyal Meso

Launched in manchester in 2005, Teosyal Meso is just one non cross linked hyaluronic acid gel which hydrates and revives the dermis on the epidermis, neck hands and dé colletage.

Elastence®

Elastence®, by Inamed, is a hyaluronic acid product aimed at replacing skin hydration, tone, and elasticity to the skin evidently, neck, dé colletage and backs along at the hands. Treatment using Elastence® is marketed as the Biorevitalisation Treatment Programme.

Juvelift®

Juvelift®, section of the Juvederm® range, is a hyaluronic earned product with vitamins made for micro-injection application evidently, neck, dé colletage and backs along at the hands to replace lost hyaluronic acid and improve skin moisture and elasticity.

Surgilift® Plus

Surgilift® Plus fantastic hyaluronic acid based product from Corneal Group, (see more below of their total recent product launches) made for micro-injection application evidently, neck, dé colletage and backs along at the hands to replace lost hyaluronic acid and improve skin moisture and elasticity.

Although you can get in Europe this product has yet to access UK shores, yet as most is comes from a company that produces Juvederm®, we is expecting to see it's introduction here the coming years.

Future Introductions:

Captique(TM)

In November 2004, Inamed was granted FDA approval to trade Genzyme Corporation's new non-animal stabilised hyaluronic acid dermal filler called Captique(TM) within in the. Designed for the adjustment of moderate to severe facial wrinkles and folds around this valuable nose and mouth and claimed to live up to one generation.

Although currently only found on the internet USA, rumour has it that this product is without a doubt available in the UNITED KINGDOM in 2007.

Cosmoderm® and Cosmoplast®

FDA approved CosmoDerm® and CosmoPlast®, from Inamed, consist of highly purified human-based collagen (type I and type III) that may be contained in phosphate-buffered saline through this 0. 3% lidocaine, a nearby anaesthetic. And, unlike bovine collagen based products they don't require a skin test - empowering same day treatment.

CosmoDerm® must be used to treat fine queues, wrinkles and shallow scars and overcorrection of just one. 5 - 2. 0 times the depth along at the wrinkle is often handled. CosmoPlast® is used to deal with deep lines, furrows actually scars without overcorrection. Adding of CosmoDerm® over CosmoPlast® may performed to eliminate a standard wrinkle or scar with the requirement of overcorrection techniques.

Despite the main benefit of the natural collagen replacement and awful skin test requirement, some people may with aversion to the use of cadaver derived products and also choose an alternative.

Although found on the internet USA this product has yet to access UK shores.

Surgiderm®

Recently launched and very promoted at IMCAS this current year, the Surgiderm® range with a few Corneal Group, is depending on their patented cross-linking process called "3D Acid hyaluronic Matrix Technology", which is claimed to make a tighter, more stable, and greater number of them cross-link structures - allowing greater potential to deal with degradation.

The range covers Surgiderm 18 for fine lines, Surgiderm 24 XP in favor medium depth wrinkles and very enhancing lip contours, Surgiderm 30 for the treatment of deep skin depressions and volume enhancement through injection to deep dermis, and Surgiderm 30 XP which can be used to treat medium as well as deep skin depressions and personal enhance facial volume and how lip contours.

Also on range is the fresh launched Surgilips®, which prior to the introduction of RESTYLANE® Lipp was the sole injectable product available designed specially for treating the penile herpes. Corneal claim that the outcome, as well as looking more natural, last longer at 9 - 12 months normally, compared to less than a year for other hyaluronic acid fillers used in the lips.

Although you can get in Europe this product has yet to access UK shores.

Voluma®

Also recently launched alongside Surgiderm® merely by Corneal Group is Voluma®, create are marketing as simply how much "D. R. E. A BRAND NEW. M. sculpture® ". This system, based on their hyaluronic acid technology is about face volume restoration. Little more is known about it at the time.

REDEFYNE(TM)

Anika Therapeutics Inc, recently received CE Mark approval to push its cosmetic tissue development product, REDEFYNE(TM), in the european countries; American FDA market approval holds pending. The product depends upon hyaluronic acid and happens when lidocaine, a local pain-killer. We have no info yet on any offers to start promoting this in the uk.

Hylanew®

The HylaNew® add some Canadian company Prollenium features the most notable concentration of cross-linked non-animal based acid hyaluronic gel available. It also incorporates Hypromellose (an eye lubricant) making the gel easy to inject this said to cause much less bruising and swelling about the patient.

The range is the term for formulated into three garment. HylaNew® is best useful to fill superficial imperfections like in fine lines, forehead wrinkling, crow's feet, and perioral stripes, and is claimed to keep 6 months. HylaNew Ultra fantastic high viscosity, longer lasting product utilised in smoothing out deeper wrinkles with regard to lip augmentation, and is said to last 9 time period. HylaDex has the same acid hyaluronic base but with the addition of Dextronomer beads, making it the longest lasting one of the many three fillers. The Dextronomer beads stimulate producing the body's own new tissue. HylaDex is used offered medium to deep scale wrinkles and folds and is about chin/cheek augmentation, and is said to last 12-15 time period.

Although only available in Canada along with US FDA market standards pending, this product include some UK clinics.

Summary:

The UK dermal filler deal, estimated to be caliber between £ 15-20 thousand, is still dominated by Q-Med with the tried and trusted brief dermal filler range, Restylane®. Becasue it is UK introduction in 1996, this acid hyaluronic has taken significant market share from Inamed, who promote bovine collagen (Zyderm® and Zyplast® ) key lack of sensitivity testing required for this non-animal derived customer service.

There are now 9 helium actively promoted purely hyaluronic based product lines found on the internet UK, (and counting), highlighting the achievements hyaluronic acid as an safe and effective dermal filler compound, and collectively they account for ranks dermal fillers used the uk. Increasing choice is fragmenting the market to some extent, although the Restylane® brand still appears to own the majority.

Differentiation relating to safety performance may now you need to be noticed in practice definitely high volume, experienced users - hence receive relating to training specialists; costs and marketing or brand support are getting used by suppliers to advertise their brand to centers and practitioners.

In extra, recent national reports commissioned key Chief Medical Officer, Friend Liam Donaldson, on the supply of cosmetic surgery recommendations have recommended that "remodelling course of action using cells or build up i. e. cosmetic fillers" be brought regarding the regulatory framework of a great Healthcare Commission. This is made to come into force in October 2006. This makes sure that like those clinics presently offering laser/IPL or medical operation procedures, those offering dermal fillers will be required by law to wind up registered and annually read through.

We believe this to make certain good news for both practitioners and some tips public, giving peace of mind with the public and continuity of the caliber of filler administration for centers.

Lorna Jackson is Editor along at the Consulting Room? consultingroom. net consultingroom. com/ -the UK's utmost aesthetic website providing evident and unbiased information to the present public on a variety of surgical and non-surgical plastic surgery, combined with a directory of UK & Ireland nicely situated clinics and surgeons. The actual Consulting Room? Shop consultingroomshop. net consultingroomshop. com/ is the first aesthetic income online backed by FACT not FICTION and offers a simple and web store online shopping experience for your latest in at-home, tested skincare, suncare, post plastic cosmetic surgery after care, laser hair laser removal and hair growth instruments, slimming garments and a variety of other aesthetic products.