Wrinkle Smoothers and Fillers: A Quick Rundown from Dr. Amy Wechsler
Wondering what injectable muscle relaxers, like Botox, and fillers, like laViv, which has recently become available, can do for you? If you're considering a facelift, these products may make it postponable, if not completely unnecessary. And fillers can vastly improve the appearance of scars too. There's a menu of safe choices -- natural and synthetic, semipermanent and permanent -- and new injectable materials are coming on the market every year.
Muscle Relaxers
How They Work: Paralyze tiny muscles to stop the expressive movements that etch-in frown lines, crow's feet, neck bands, and brow furrows.
What Gets Injected: Botulinum toxin A or B.
Brand Names: Botox Cosmetic, Reloxin (Dysport), Myobloc.
Cost: About $400 per area, but prices vary considerably.
Lasting Power: May take a week or so to take full effect. Lasts 3 to 6 months; less and less needed over time to maintain smoothing effect.
Extra Tips: Have repeat maintenance injections before benefit disappears to maintain skin smoothness. Myobloc (Botulinum B) is not often used for cosmetic reasons.
Wrinkle Fillers
About a dozen fillers have become available since collagen debuted in the 80's. They differ in everything from materials, cost and lasting power to the types of problems they correct.
How They Work: They plump up deep creases, fine lines, sunken areas and/or and some types of scars.
An experienced physician -- usually a dermatologists or cosmetic surgeon will make a recommendation for the specific filler -- or a combination -- will improve scars or take years off your face or both. Like any procedure, a second opinion may be worthwhile. And keep in mind, cheaper is not always better. You're not only buying the filler, you're paying for the doctor's expertise, artistry, and skill. It's smart to know in advance what you're getting into.
1. Autologous Cellular Product
Brand Name: laViv (A bioengineered injectable made from your own skin cells -- not to be confused with stem cell transplants, which are experimental.)
Cost: $3,000-$3,500 (typically includes the entire process, including skin cell retrieval, lab processing, and injection)
Lasting Power: Just approved in May, laViv lasts at least a year and the material can be banked for future use.
Extra Tips: Since it may take three to four months for your amped up cells to produce new collagen, start the process well in advance of your high school reunion. Not the best choice for areas where serious volumizing, as in cheek hollows, is needed.
2. Hyaluronic Acid
Brand Names: Restylane, Perlane, Hylaform, Juvederm, Hydrelle, Prevelle, Elevess, Captique.
Cost: $500–$850 and up.
Lasting Power: 6 months or longer.
Extra Tips: Try to avoid aspirin, NSAIDs, ginkgo, vitamin E, or any other blood thinner for 2 weeks prior to injection.
3. Collagen (Cow or Human)
Brand Names: Zyderm, Zyplast, CosmoDerm, CosmoPlast, Fascian, Cymetra.
Cost: $400 and up.
Lasting Power: From 2 weeks to 6 months.
Extra Tips: Skin testing for allergy essential when bovine collagen is used. To prevent bumps, massage filled areas for a few minutes several times a day for 24 hours.
4. Synthetic Fillers
Brand Names: Radiesse (the heaviest filler used "off label" to fill deep creases and shallows).
Cost: $650 and up.
Lasting Power: 2 years or longer.
Extra Tips: Plumping is immediate and stimulates collagen growth to maintain the improvement.
5. Polylactic Acid
Brand Name: Sculptra
Cost: $1,000 and up.
Lasting Power: Up to 2 years.
Extra Tips: Filling results of may not be apparent for 10–12 weeks or more. Several treatments are usually needed for plumping shallow contours.
6. PMMA (Polymethylmethacrylate)
Brand Name: Artefill
Cost: $500 and up.
Lasting Power: Forever. It's said to be permanent.
Extra Tips: Multiple treatments done several weeks apart may be needed. Mircospheres of PMMA in the gel prompt skin to produce collagen production do not degrade and are not absorbed by your body. Removal if you're unhappy with the results is difficult.
