Injectable Fillers - The Downside

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Restylane, Alloderm, collagen, fat, Sculptra... The choices in injectable facial fillers seem endless. What's more, new products come to be ready all the time, each one promising to do more, last longer, and furnish fewer side effects. And with median rehabilitation costs in the several-hundred-dollar range, injectable fillers are increasingly beloved with women from all walks of life, from soccer moms to fashion models. But, just how productive are fillers? Are the results worth it? And what potential problems do you need to watch out for?

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Understanding the Beast

Fillers are substances injected under the skin to fill in lines, plump up skin, and remove wrinkles. Some fillers include natural ingredients - along with your own fat harvested from somewhere else on your body. Some fillers are made of artificial ingredients. And others are a composition of natural substances derived from animals combined with artificial ingredients.

Typically, fillers are injected in the doctor's office, as out-patient procedures that allow you to return to work and regular activities immediately after the appointment. The results are commonly immediate, and the appointment ordinarily takes less than an hour. There is often some little discomfort or itching after the procedure, but that should clear up within a day or two. While some bruising may occur, side effects are rare and commonly mild. So what's the catch?

Thanks Ma'am, We'll See You in Six Weeks

As with Botox (an injectable, but not a filler), one of the biggest downsides is that fillers are temporary. Sad to say, but the easier and safer the injectable, the more temporary it seems to be. You can even use your own fat as a filler, but the results will probably fade within weeks. There is no risk of allergic reaction with this procedure, because the filler is harvested from your own body, but chances are you'll be back at your doctor's in approximately no time at all - although a small amount of patients have reported dreadful results that have lasted for up to a year.

Collagen is an older filler (which, for this hypochondriac, means that it may be "safer" and "better tested") that has a relatively short life span. In fact, some women dispose to have new injections every six weeks - and many report that it's their favorite. Restylane is perhaps the most beloved filler nearby - and also reported to be the most painful.

Fillers containing hyaluronic acid ordinarily last much longer; Juvederm is one such brand, and is touted to last up to one year, although there is talk that it doesn't live up to its claims. ArteFill is another "permanent" filler, while the makers of Radiesse and Sculptra claim semi-permanence. Of course, the longer-lasting the filler is, the more possibility there is for side effects or botched treatments that cannot be remedied. This may be an especially difficult problem in the case of Artefill, because it contains bovine collagen, an ingredient with a fairly high rate of allergic reactions.

Watch Out for This One!

Liquid silicone (Silikon 1000) has also been known to be used as an injectable filler despite the fact that it is not sold for this purpose. Because it is permanent, it has advantages. However, known complications with liquid silicone include migration and lumpiness that can organize years after treatment. There have even been reports of silicone looking its way into blood vessels and forming a clot! It's so risky, in fact, it's been likened to injecting a time bomb - or, the Russian roulette of cosmetic dermatology and plastic surgery.

So since Silikon 1000 is stylish for use in one part of the body, clear loopholes in Fda regulations allow docs to use it off-label as an injectable filler. But because of the dangers connected with silicone injections into the face and lips, the Fda has banned doctors from advertising it. What's more, there have been so many lawsuits connected to this use of silicone that many plastic surgical operation healing malpractice insurance contracts now carry a clause that prohibits doctors from using it and refuse liability coverage for complications resulting from silicone injections.

Risks Include...

One widely recognized problem is that the longer-lasting fillers can also cause lumps to form under your skin at the site of the injection. Sometimes the lumps are visible. And, even when they're not, they can be felt. Who wants to be kissed by lumpy lips? Artecol and Dermalive are two brand names that have been often connected with this problem. And yet, to be fair, it can happen with any of them.

The lawful statement from the American community of Plastic Surgeons is that the risks complicated include: allergies, infection, abscesses, open sores, skin peeling, scarring and lumpiness. They neglect to mention the horrible side succeed mentioned by one healing study -- necrosis. That's dead tissue. Call me squeamish, but the view of my lips turning into dead flesh is pretty scary. I realize that every healing course contains potential risks. But I wonder: is the potential gain worth the risks that come along with injectable fillers?

Woman Overboard-Your greatest Enemy May be You

Take it from a woman who over-plucked her eyebrows when she was fifteen-and they never grew back: development changes to your appearance can be intoxicating. I was so entranced by how large my eyes looked that I kept on going. The same thing can happen with facial fillers. Too much of a good thing is - too much. No one wants plastic fish lips - but it's easy to see how a little filler can turn into more next time, and then a longer-lasting one, and one more time, and suddenly you've gone too far.

One way to ease into the world of fillers is to ask your physician to try a temporary injectable like collagen the first few times. This will give you an idea of what a longer-lasting stock like Juvederm will do for you. And that way, you can live with a filler for awhile before you commit to the new look. This brings me to a final issue connected to injectable fillers. Is it just me, or are we in the midst of a trend toward unnaturally shaped, very large lips? I've reviewed about six dozen plastic surgeons' before and after photos of "lip enhancements" on the Internet, and I have to say: at least half of them looked quite unnatural and unattractive to me. So bad, in fact, that the "before" photos often looked better.

What's up with this? I haven't observation plastic surgeons posting photos of nose jobs that look worse than what the inpatient had to begin with. Or breast implants gone wrong. Why all these oddly shaped lips and over-plumped creases? While the facts highway appears to be in full bloom, the web, in many ways, has made it all the more difficult to find a marvelous practitioner. My advice: stay away from strip malls and nail salons that offer injectable treatments, and read our Beginner's Guide to selecting a Surgeon.

Striving for Perfection

Perfection is the name of the game in plastic surgery. Doctors are trying to contribute us with the excellent facial fillers, and the rest of us are crossing our fingers and hoping for that perfect, smooth, wrinkle-free skin. It looks to me like these do not yet live up to the hype. But with new products arrival out every day, the excellent filler might be just nearby the corner.

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