A more youthful and rested look with no anesthesia and no need to go under the knife? Small wonder that in 2011, non-surgical procedures like injections of Botox and dermal fillers accounted for 82 percent of all cosmetic procedures performed and 37 percent of all spending on plastic surgery, according to the American Society for Aesthetic Plastic Surgery, which includes Canadian doctors. It’s a trend that will likely continue as more of us consider anti-aging alternatives that fall between a facelift and a wrinkle cream. A recent survey of more than 800 Canadian women by Leger Marketing found that one in four was open to getting an injectable treatment, and 34 percent considered injectables to be an everyday procedure akin to teeth whitening and hair colouring.
How fillers work
Second in popularity to Botox in non-invasive anti-aging procedures, fillers add volume to the face, usually by filling in wrinkles and lines, and sometimes by plumping up areas of the face that have lost fat pads (such as the cheeks, under-eye area and temples), causing the skin to sink and sag, explains Calgary dermatologist Dr. John Arlette.
Most patients who see Vancouver dermatologist Dr. Frances Jang for dermal fillers start treatments in their 30s, 40s or 50s, but patients range in age from their 20s (usually for lip plumping or, occasionally, filling smile lines) even up to their mid-80s.
The subtle improvement that dermal fillers can provide is a selling point for many. “Patients say they don’t want to look dramatically different,” says Jang. Treatment takes as little as 20 minutes, and in some cases you get immediate results.
First-generation dermal fillers, introduced in the early to mid-1980s, were made of animal collagen. They had to be topped up every three months and required a patch test first because they caused allergic reactions in about three percent of patients.
Since 2000, those fillers have given way to a range of new formulations. Some contain lidocaine to make treatment more comfortable. And some doctors now inject with cannulas (tubes with a blunt tip) rather than needles, an innovation that, along with lidocaine, has “reduced pain and discomfort by 90 percent or more,” according to Toronto dermatologist Dr. Benjamin Barankin.
Here’s a cheat sheet on various options:
Hyaluronic acid (HA) fillers (brand names include Juvéderm and Restylane)
By far the most commonly used fillers, these can plump thin lips and hollowed under-eyes; fill facial wrinkles, acne and post-surgery scars; and fill creases such as smile lines (nasolabial folds) and “marionette” lines (which run from the mouth to chin). “They can also be used on their own or in conjunction with Botox to soften the lines between the eyebrows,” says Arlette. HA naturally occurs in the middle layer of your skin, keeping it plump and elastic. Although HA fillers are synthetically produced, the substance is nearly identical to the HA we produce naturally. The fillers come in various formulations so doctors can target specific areas. More viscous (thicker) versions, such as Juvéderm Voluma, recontour the face, and lift and sculpt cheekbones, chin, temples and even the nose.
Made of tiny calcium-based crystals suspended in a water-based gel, it is used in the mid-face area, often for deep smile lines and marionette lines. The beads initially plump up the target areas, but also stimulate your body to produce its own collagen for a longer-term effect.
Originally used to treat gaunt-faced HIV patients, Sculptra is best for patients whose faces are thin and saggy, but who don’t want, or aren’t ready for, a facelift. Sculptra is a “stimulatory filler,” meaning it encourages skin to produce its own collagen over time. It is made of poly-L-lactic acid—the same material used in dissolvable stitches.
Platelet-rich plasma therapy (for example, The Selphyl System)
Platelet-rich plasma therapy is less commonly used than the ones mentioned above. Introduced in 2009, it treats wrinkles, crow’s feet, scars, and neck and under-eye crepiness. Doctors draw your own blood into a test tube and put it through a centrifuge to separate the platelets and fibrin from the blood cells. They then inject the platelets into your skin to trigger the growth of collagen and cells.
Autologous fat transfer
Also less commonly used, autologous fat transfer is a technique that has been around since the 1980s. Doctors extract fat from your thighs, buttocks or flanks, process it and then inject it as a filler.
When to steer clear
Health Canada advises postponing a dermal filler treatment if you have inflamed or infected skin, or pimples, cysts, rashes or hives. Avoid the procedure altogether if you have a bleeding disorder, a tendency to excessive scarring or a history of severe allergies, particularly those marked by anaphylactic shock.
SOURCE: Besth Health Magazine
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