Primary goal: Fill in wrinkles and grooves caused by loss of natural dermal collagen and fat
Technique: The tissue filler is placed into a syringe and injected through a needle into the middle of the dermis in the area of the skin depression. Multiple injections to achieve a layering effect may be used, as well as gentle massage to smooth out any obvious "beading".
Variations: Zyderm and Zyplast are preparations of bovine (cow) collagen, while Dermalogen is of human origin (donor skin from cadaver tissue banks) and Autologen is derived from the patient's own tissues. Fat is obtained by liposuction or direct excision from the patient's own tissues.
Limitations: Collagen of animal origin not only disappears rapidly, but also carries a relatively high chance of stimulating allergy. While Dermalogen is carefully tested for communicable disease, it is from a human donor source, which may not be ideal. Synthetic materials (silicone oil, Teflon paste, Gore-tex, etc.) are used less commonly because of their tendencies to cause chronic inflammation, infection, and extrusion.
Comments: Recently, there has been a surge of interest in injecting fat removed during liposuction into areas of facial depression, such as into furrows between the brows or the grooves between the nose and cheek. The biggest drawback to injecting fat is its highly unpredictable disappearance, ranging from almost none at all to 100%.
A whole new "crop" of tissue fillers will soon be available in the United States. As with all such materials, each has its own set of advantages and disadvantages.
