William Callaghan. MD (botulinum-toxin Surgery)
Facial Fillers and “Toxin” Injectables
Facial fillers and injectables are used to reduce the many signs of the aging face, or correct minor deformities. Botox (cosmetic) is usually used for elimination of wrinkles of the forehead, glabella (between eyebrows), “crows feet”(sides of eyes), under the eyes, and around the mouth. Botox has been found to have many other uses, but here we will discuss only its aesthetic uses.
These procedures are temporary and require repeated uses for maintenance.
It is important to note that injectable fillers, and Botox, is not meant to repair but temporarily improve.
There are many different types. Even permanent ones, but one must be very cautious when using anything permanent as there is a risk of permanent deformity and infection.
Botulinum Toxin Type A
Injectable toxins works by paralyzing the underlying muscle causing the skin wrinkle while muscles are paralyzed, the lines and wrinkles become less apparent. This toxin can cause botulism when consumed in large amounts which can be fatal.
Botox is the most well-known and most-often prescribed of this type of injectable, but there are two others — Xeomin and Dysport.
While Botox, Xeomin and Dysport are considered quite safe, they carry a "black box" warning from the FDA due to a rare side effect in which the injected material spreads and causes potentially serious swallowing and breathing problems.
Hyaluronic Acid-Based Injectables (Fillers)
These types of fillers work by temporarily filling in creases, wrinkles and depressions in the skin and by generally adding volume to thinning skin. One such class of injectables is known as hyaluronic acid-based injectables.
Hyaluronic acid is a naturally occurring substance in the connective tissues of the body. As we age, our body's supply of hyaluronic acid decreases. By injecting this substance into the face, a plastic surgeon is able to replenish stores of hyaluronic acid and temporarily rejuvenate the appearance of the face.
Hyaluronic acid-based fillers include Juvederm, Juvederm Voluma, Restylane, Perlane and Belotero. They are typically used to treat nasolabial folds (the creases that run from the sides of the nose to the corners of the mouth), marionette lines, under-eye hollows and wrinkles around the mouth. They can also be used to temporarily plump up thinning lips.
Collagen and Collagen Boosters
Another type of filler works by increasing the skin's stores of collagen. Collagen is a naturally occurring substance in the human body that is responsible for maintaining the skin's integrity. As the skin ages, collagen breaks down, leading to wrinkles, lines and folds. Collagen injections help replace the skin's dwindling supply of collagen, causing the skin to appear more supple, and rejuvenated.
Radiesse is another injectable that helps boost collagen. It contains microspheres of a naturally occurring mineral known as calcium hydroxylapatite in a water-based gel. In addition to adding volume to the skin when initially injected, it also stimulates the body to produce more collagen, creating longer-lasting results.
Some facial injectables contain synthetic materials to help bring a youthful appearance to the face. Bellafill contains microspheres of a substance called polymehtylmethacrylate (PMMA), which are suspended in bovine (cow) collagen. It is used to treat smile lines, thin lips, acne scars and other facial lines.
Bellafill's unique feature is that the PMMA microspheres are not absorbed by the body, making Bellafill the only injectable to produce permanent results.
Sculptra is another injectable that contains synthetic material. Specifically, it contains microparticles of poly-L-lactic acid, a biocompatible, biodegradable polymer. Sculptra is used to treat nasolabial folds and other facial wrinkles. Unlike Bellafill, it is absorbed by the body; therefore, its results are temporary.
Autologous Injectables involve the use of one's own body tissues to rejuvenate facial appearance (i.e. fat transfer). When performing fat transfer, a surgeon removes fat cells from the stomach, buttocks or thighs and re-injects them into the face. Fat fillers are used to add volume to sunken cheeks, fill in facial lines and enhance lips.
Laviv is an injectable that is made from one's own skin cells. The cells are taken from behind the ear and sent to a lab, where more cells are grown and placed in a solution
Vampire injections, also known as vampire facelift and Dracula therapy, are made from one's own blood. The surgeon first removes blood. He or she then processes it to separate out the platelet-rich plasma (PRP). The PRP is re-injected into the face, where it provokes collagen production and gives the face a fresher, more youthful appearance.