Overview

The umbrella term ‘Dermal Filler’ here refers to collagen, Restylane, Hydrafill or Radiesse. Dermal Fillers generally aim to replace that part of the skin that naturally wanes over time. The two primary components of skin structure and integrity are collagen and hyaluronan (‘Restylane’ or ‘Hydrafill’). These components are situated in the dermis, beneath the top layer of the skin, the epidermis. A reasonable analogy to a house could be made: the bricks would be collagen and the mortar the hyaluronan. In structural terms neither could be said to be more important than the other, as with a house.

Radiesse is medically known as Calcium Hydroxyapatite, the naturally occurring soft component found anatomically as the soft inner part of our bones. It has been used in orthopaedic medicine for more than 25 years, and  has been very popular in North America in dermatology for more than 10 years.

Over years the dermis thins progressively. You can see for yourself with the naked eye when comparing a 25 year old’s skin with that of an 85 year old’s skin. Older skin appears papery (thinner) and wrinkled (loss of dermal supporting structures, integrity and actual volume). Under the microscope these changes are starkly appreciated.

The Client’s Experience

Before treatment can start with collagen you would need a pre-treatment test dose, typically sited inconspicuously on the underside of the forearm and re-examined 4 weeks later. With Restylane, Hydrafill and Radiesse you do not need a test dose and treatment can be undertaken on the day of request.

You may like to use anaesthetic creams [delete:(placed 1-2 hours beforehand and kept covered with cling film)] but most often clients find this is not necessary. However, when enhancing the lips, a local anaesthetic is recommended to completely anaesthetise the lips because of their increased sensitivity. All these products are injectable treatments.

What are they?

Collagen was one of the first dermal fillers, having been used extensively since the 1970’s Restylane and hydrafill (hyaluronans) have gained more popularity in the past 20 years because of their slightly better safety record and no need for a pre-treatment skin test. Radiesse is rapidly gaining popularity, not just because of its frequently dramatic results for more prominent facial wrinkles, but also because it lasts up to three times longer than Collagen/ Restylane/ Hydrafill

Uses

All facial wrinkles, especially lower face, including

Safety

Restylane, Hydrafill, and Radiesse dermal fillers are used most because of their excellent safety record. For a few hours afterwards some people have redness. Lumpiness on rare occasion may be noticed initially but this is unusual and will improve..

Results

Patient 1 - Full face                     Before     After 6 months     After touchup

Patient 2 - Glabella                     Before     After 6 months     After touchup

Patient 3 - Nasolabials                     Before     After 6 months     After touchup

Patient 4 - Lips                     Before     After 6 months     After touchup

Patient 5 - Lips                     Before     After

Patient 6 - Lips                     Before     After                       Patient 7 - Nasolabial                     Before     After                       Patient 8 - Nasolabial                     Before     After 22 months     Post injection 36 months                 Patient 9 - Lip lines                     Before     After                       Patient 10 - Jowl Sulcus                     Before     After

Pros

Cons

The Future

Collagen, Hydrafill and Restylane last for 3-9 months, whereas Radiesse’s benefits may last up to two years. All of these products can be repeated as often as you like. There is no worry about accumalation because they are gradually removed by the body’s natural turnover mechanisms.

Cost

Restylane and Perlane	from £250 per syringe
Radiesse	£450 for 1.3 ml syringe
	£395 for second syringe
Hydrafill	from £250 per syringe
Collagen	£290 per 1.0 ml syringe

One ml is usually enough for one of the following: nasolabial lines (from nose to the corners of the mouth),marionette lines (lower chin to corners of the mouth), forehead lines, and lips.