There is a new wrinkle, of sorts, in the cosmetic filler wars. Plastic surgeons are being trained to use a new type of collagen injections to fill in those undesirable creases!

“I look in the mirror and go, oh my gosh, I can’t believe I’m 49,” said Tonya Wilder.

At 49, Tonya Wilder says “parentheses” don’t belong on her face.

“Right in here is the most I guess because when you smile, it’s - so, if we could soften this a little bit,” said Wilder. She wants her nasolabial folds (the line or crease that runs from the corner of the nose to the outer area of the lip) filled in.

And Dr. Rod Rohrich, has a new weapon in the fight against creases. It’s called “Evolence.”

“It stimulates the natural collagen and is gradually replaced over 6-9 months,” said Rohrich.

Evolence promises to fill immediately and last longer, no bruising or swelling. It’s collagen that actually comes from pigs.

“The collagen looks just like type 1 collagen of humans,” said Dr. Rohrich.

Tonya only needs one syringe and within 20 minutes, her wrinkles are less noticeable. Dr. Rohrich says she’s free to go back to work and make plans that night.

“If you feel good about yourself then you have a different attitude. Yeah I think it’s worth it,” said Wilder.

Evolence is an FDA-approved facial filler only for the nasolabial folds. It lasts about six months and varies in price.

With Aquamid being only available in Europe because of the FDA’s lengthy process of approving the drug, the next best facial filler is Juvederm ® because while Artecoll ® is similar to Aquamid ® in that it lasts 10 years it’s only approved to be used in the nasolabial folds. Juvederm can be used to fill in almost anything on the face, including lips, cheek, and other areas of the face.
Is it worth it to fly over to Europe to get Aquamid injected instead of getting Juvederm locally?

The True Cost Of Getting Aquamid
Aquamid is only available in Europe, and is commonly used in London. The airfare to London, cost of the hotel, cost of food, and how long of a stay greatly impacts this cost. A frugal estimate would be $2000-$3000 just to stay in London for 5 days. The actual cost of the procedure can vary, but the average is about the same as a face lift which is $5000.

It’s going to be expensive, above $5000. But, the filler will last up to 10 years.

The True Cost of Getting Juvederm
The average cost of getting Juvederm done is $690. Wherever you live in the United States, it’s easy to find a plastic surgeon or dermatologist within driving distance. Also the filler will last up to two years.

If you were to get new injections every two years, that would cost you $3450. That’s significantly less than one injection of Aquamid.

Over 10 years
Aquamid is the more expensive choice, and it may be FDA approved in the near future as clinical trials started in August of 2006. With Juvederm costing thousands less initially and over time clearly the cost winner is Juvederm.

Juvederm is cheaper, but only a Doctor can tell you which facial filler is right for you.

If  you’re looking for information on Artecoll ® here it is. It lasts up to 10 years and is approved by the FDA strictly for the use of filling in Nasolabial folds only. Those are the “smile lines” to the side of your mouth.

Here is a good before and after photo of a patient using Artecoll. It’s still keeping those wrinkles at bay 8 years after getting it injected!

As with all facial fillers only a Doctor can tell you for sure what’s right for you.

What Is Sculptra and What Can It Do For Me?

Sculptra is a facial injectable that has been used throughout Europe since 1999. Europe is known to have the newest Facial Fillers before the U.S. because of the lengthy testing that the FDA puts all facial injectables through.

It fills in sunken eyes, wrinkled skin folds, hollowed cheeks, and indented chin surfaces.

Sculptra is injected by a doctor into areas of facial fat loss (facial lipoatrophy) in patients with, or receiving treatment for, Human Immunodeficiency Virus (HIV).

Is Sculptra FDA Approved?

Yes, it was approved August 3rd, 2004.

How Long Does Sculptra Last?

Up to two years.

How Much Does Sculptra Cost?

Each syringe costs between $450 and $550. The amount that the plastic surgeon or dermatologist charges you will vary, but don’t expect to pay for just the syringes. It would be irresponsible for me to tell you how much it costs because it depends on how much the Doctor decides to inject, and how much they charge to do the procedure.

However on average the procedure costs between $750 and $1,900 per treatment. There are many ways to finance the procedure, from loans to even getting your insurance to pay for the procedure.

Before and After Photos of Sculptra Patients

I can’t host before and after pictures here due to legal reasons, but I found a ton of before and after pictures here.

What Are The Risks?

Side Effects are usually temporary, and if present will disappear within 3 to 15 days. You may have tenderness, redness, bruising or swelling at the site of the injection. Other side effects may include small bumps under the skin in the treated area which may appear over time. These bumps are not always visible, and often are only detected by pressing on the skin.

Areas that receive a Sculptra injection should be massaged a few times each day for several days after the procedure. Following the procedure an ice pack should be applied for a few minutes at a time to the treatment area to help reduce swelling for the first 24 hours after treatment. To avoid direct contact with the skin place the ice in a cloth. It is also recommend that excessive sun and/or UV lamp exposure be avoided until any visible swelling and redness has subsided. Sculptra has safely been used since 1999 in over 150,000 patients world-wide under the trade name New-Fill.

How Can I Find A Board Certified Plastic Surgeon?

If you’re interested in the procedure and looking for a qualified plastic surgeon in your area use this search tool. This site is great, and it’s fun using their Google Maps ™ surgeon finder.

Board Certification is important, so make sure you research which boards are real and which are fake.

It’s called Aquamid ® and here in America it’s not well known. In Europe however, over 300,000 injections have been performed. It is used to contour the face and create more defined cheek bones. It’s also used for lip augmentation and chin augmentations to name a few. As of this update (September 9th, 2008) Aquamid is not FDA approved, but that doesn’t stop patients in Europe.

According to www.responsesource.com:

Aquamid® can be used to enhance and contour the face and create more defined cheekbones. The volume created comes mostly from water (97.5%) cross linked with Polyacrylamide to create a soft and uniform hydro gel that moves naturally with the face. As water is recognised by the body Aquamid® is readily accepted and forms a thin membrane around the implant which helps keep it in place, therefore preventing migration. In comparison to fillers containing micro particles, Aquamid® does not cause a foreign body reaction and will not cause tissue to harden. It simply becomes a soft and stable part of the tissue and remains in natural harmony with the body. Results achieved by Aqaumid® are instant and long lasting.

How long will it last then? It lasts at least four years according to a study published in 2004. 104 patients in the study that received the injections were asked after four years what they thought of the results. 78% said very good and 22% said good.

So what are you to do if you can’t make a trip to London anytime soon to get this filler? Ask any dermatologist or cosmetic surgeon if they have it for off-label use. Sometimes they will bring it back from medical conferences in Europe. You can also wait for the FDA to approve this filler, as they are expected to approve it eventually.

Check out this article about new facial fillers that are on the way.

Let’s forget about political issues and let’s take a look at the real story here.
Did she get plastic surgery done?
It sure looks like it. After all, how else can you age 24 years without looking a day older?

On the right is a before and after picture, of 24 years. Her eyes are just as big, forehead just as smooth, under the eyes just as full, as 24 years ago. I doubt she’s had major plastic surgery done, such as a face lift. The only sign of aging is that her smile has perhaps a few more wrinkles. These all look filled in with some kind of facial filler. If I had to guess as to which facial filler she had done, I’d say Juvederm for the area around her cheeks and under her eyes, and Botox for any wrinkles around the eyes and forehead.

Regardless of any plastic surgery she’s had done, there is also a good possibility that she has had nothing done to her face at all. Is the cold and crisp Alaskan air preserving beauty like some sort of air borne “Fountain of Youth”?
I doubt it.
I’m sure many will disagree with me when I say she has to have been under the needle. How could anyone resist looking young when the cost of facial fillers is so low?
You be the judge.

Here is a pretty good video (although old, November 2006) that shows patients being injected with facial fillers like Juvederm and Sculptra. The results are more natural and subtle than face lifts. Sculptra is reported as lasting up to two years.

If you’re sick and tired of people asking you “Did you get enough sleep? You look so tired!” then facial fillers can help. As people age, their faces ’sink’. Facial fillers will fill them in and restore your natural beauty. Your friends won’t be able to tell that you’ve had plastic surgery, and everyone will think you look great.

Everybody loves top 5’s. What are the five most popular facial fillers? I don’t know.. but here’s my top 5 list anyways.

5) ArteColl ®/ ArteFill ® - This is the first injectable to provide a permanent support solution to fill wrinkles and prevent further wrinkling. (In the United States, ArteColl ® is approved strictly for correction of nasolabial folds.)

4) Sculptra ® - An injectable made of synthetic polylactic acid contained in microspheres, Sculptra ® is the first FDA-approved injectable for the restoration of lost facial volume (correction of lipoatrophy) in people with HIV infection.

3) Radiesse ® (formerly known as Radiance) - This is a synthetic dermal filler made of calcium hydroxyapatite is utilized for the correction of moderate to severe wrinkles and folds. This injectable is a longer-lasting filler because the body forms collagen around the microspheres; adding bulk to the injected areas.

2) Restylane ® - A non-animal, biodegradable gel composed of hyaluronic acid, Restylane ® is a soft tissue filler that adds volume to the skin through tiny injections; smoothing facial folds and wrinkles in areas around the mouth and eyes.

1) Juvederm ™ - Made of a hyaluronic acid gel, Juvederm ™ is a naturally-occurring substance in the skin that contributes to volume and hydration. Juvederm ™ is designed to temporarily correct moderate to severe facial wrinkles and folds.

Image courtesy of fairesplasticsurgery.com

On average Juvederm costs $684. Doctors usually charge per tube. Make sure you ask to see before and after photos, and how many times he or she has done the procedure.

Be sure to read testimonials and become educated on the subject before you get the procedure done.

When you undergo a face lift, your face will look different, and not always in a good way. Take for example actress Jessica Lange. The photo on the left is from 1980, and the photo on the right is from 2005. You can tell in the photo on the right that she has a very surprised look. This is a considered a classic sign of a traditional face lift.

The reason for this is when you get a face lift, your skin is stretched to the top of your face. There are many cases where getting a face lift does not give the surprised look. In fact, many plastic surgeons can give you a face lift without making you look surprised all the time.

A wonderful alternative to face lifts is facial fillers such as Juvederm, Restylane, Radiesse, Pearlane and Sculptra. Each of these fillers are slightly different, and vary in what they are made from, how much they cost, where they are used on the face, and how long they last.

However, all of them are not cheap. They are cheaper than a face lift though. How much is your face worth to you? To many people it is worth the expense. Usually these injections will cost $500-$1000 and have to be performed 2 - 3 times a year. While a face lift can cost around $4000, and easily cost more with added procedures commonly being done at the same time as a face lift.

The best thing about facial fillers is that they build upon the natural beauty that people have. They fill in the gaps that age brings upon us. Some facial fillers, such as Juvederm, have been known to actually stimulate collagen growth.

A perfect example of facial fillers working great is Demi Moore. You can see how facial fillers have given her a natural look. She still looks just as young as she did years ago. That is what is so great about facial fillers. Perhaps face lifts will slowly fade out as more facial fillers come on market.

Johnson and Johnson is even releasing their own wrinkle fighting filler. It was approved by the FDA and has been in use by other countries since 2004. It’s called Evolence and is made from tendons harvested from pigs. It’s unlikey it will make a huge dent against Juvederm and Restylane which are produced in a lab.