Evolution of Dermal Fillers

In La Jolla

By Nasrin Mani, M.D.

Dermal fillers aren’t anything new and have been used for over a hundred years. As early as the 1890s, doctors were using transplanted fat as a facial filler.

In the mid 1900s, doctors began using paraffin as filler in the skin until the tissue in the targeted area became inflamed. Safety concerns further prevented it from being used widely. In the 1940s, the use of highly refined injectable silicone was used as a dermal filler. However, the material was never approved for use as in this way. Though it became popular among prostitutes, entertainers, and the transgender community for its quick, dramatic results, complications ranged from asymmetry to the formulation of painful, disfiguring granulomas to painful death that took from days to months to occur. States began outlawing the injection of silicone in 1975, and a nationwide ban soon followed.

The last 25 years have seen the rise of many new dermal fillers. The first major success was with bovine collagen for injection. It began to be used in the 1970s and was approved in 1981. Despite numerous shortcomings, it became the industry standard for many years until the development of human derived collagen fillers.

For more than two decades, collagen has been the preferred filler for many cosmetic surgeons. However, today collagen-based dermal fillers are on the decline because of the skepticism surrounding the origins of its donor tissue. Plus, collagen-based fillers require skin allergy testing and are relatively short-lived compared to the next generation of fillers. As the popularity of these compounds has declined, many manufacturers have stopped making them, so there are limited options for this type of filler.

The popularity of non-animal hyaluronic acid (HA) dermal fillers such as Juvéderm and Restylane has grown dramatically in recent years because they do not require allergy testing, give great-looking results, and last longer than their collagen predecessors. Radiesse is very popular because of its very long-lived results, though it is not as flexible as other fillers. The most unique filler is Sculptra, injectable poly-l-lactic acid, which is not itself a filler, but stimulates your body to produce its own filler, collagen.

What will the world of dermal fillers look like in the future?  Change is certainly underway. Although fillers that indirectly stimulate fibroblast production are holding sway, direct injection of fibroblasts with Human Dermal Fibroblasts (HDFs) may be a trend.

To find out how dermal fillers can revitalize your skin, please contact our experienced San Diego skin specialists for a personal consultation.

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