Many women will reach for the fake tan and ensure their nails are painted beautifully however many will still have hang-ups over particular parts of their bodies – perhaps the veins in the hands stand out too much or their feet look too bony.

Although dermal fillers are most well known for use on the face, many women are now turning to them to ensure that all parts of the body look smooth and plump to give them a better beach body.

Injectable fillers can be used to plump out most areas on the body. Aside from the face, the most popular areas are the feet (to plump them out and stop them looking bony), the hands (to plump them out and make them look more youthful) and the knees (to pad out droppy looking knees). Other areas where these fillers can be used are in the armpit creases, the crepey skin area on the chest/decolletage, and the inner side of the upper arm.

The injectable filler is the same concoction as that used on the face – a hyaluronic based acid. These fillers are said to help stimulate the skin’s natural collage helping to improve firmness.

For those who would prefer not to have an ‘alien’ substance in their bodies, fat transfers can also be used to much the same effect. The body’s own fat cells can be extracted and injected into specific areas to help fill, smooth and sculpt. Some of the most popular areas include the bottom and thighs to help minimse the look of cellulite, the breasts, and the bottom area. However the fat transfer option is significantly more expensive than the injectable filler option.

Some cosmetic surgeons are not enthused about this new fad for injecting filler in large quantities into the body. For the face, around 1-3 ml is normally used; for the body, much larger quantities are generally required. Even small amounts of filler can cause lumps or granulomas (big bumps) under the skin so larger injections mean there is the possible risk of the skin taking on a really uneven, lumpy look – a look which is usually far worse than the original “problem”.

There are also currently no long-term studies on the effects of having large quantities of filler injected into the body therefore potential patients need to be aware before having the fillers injected.

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Naturally there are downsides to this form of cosmetic procedure. There can be swelling after the dermal filler injections, there is the possibility of allergic reaction to the filler itself and the dermal fillers need to be topped up as they wear off.

Restylane

Restylane is made of hyaluronic acid, a naturally occurring substance in the skin. Restylane was the first dermal filler to use non-animal hyaluronic acid. Before Restylane, facial fillers were made of animal products such as bovine collagen, silicone or body fat. Hyaluronic acid is a good choice for dermal filler because it is a substance that occurs naturally in the body therefore the incidence of allergic reaction is very low.

Restylane is approved by the FDA for lasting up to 18 months. It is currently the world’s leading dermal filler having been used over 10 million times since it’s inception in 2004. Restylane is most commonly used for the hollows under the eyes, lines around the nose and mouth, and in the lips.

Perlane

Perlane is made by the same company who manufacture Restylane and is also made of hyaluronic acid. However it is only FDA approved to last for up to 6 months. A relative newcomer to the dermal filler market, Perlane has only been in use since 2007.

Juvederm

Juvederm is made of hyaluronic acid and is from the same manufacturers who make Botox. Juvederm is very popular for deeper wrinkles such as for plumping out crows feet and the lines between the nose and the mouth.

Prevelle Silk

Prevelle Silk is made of hyaluronic acid and also incorporates lidocaine, a local anaesthetic to help numb the injection site. This makes it a good filler for use in sensitive areas such as the lips, however it should be noted that some discomfort will still be experienced from the injection despite the numbing sensation.

Radiesse

Radiesse is made of calcium-based microspheres and claims to promote collage reproduction which helps plump the skin out, however this claim is probably not as good as it sounds. The body will naturally produce collagen to wall of foreign substances therefore all dermal fillers will actually see the body producing collagen.

Evolence

Evolence is another relative newcomer to the dermal filler market having been around since 2008. Evolence is made from porcine collagen (from pigs). Porcine collagen is very similar to human collagen hence it’s usage. There is no risk of catching pig diseases from having these dermal filler injections.

Dysport

Touted as a safer and better alternative to Botox, Dysport has only recently been released into the cosmetic market. Dysport uses the same active ingredient as Botox however it is claimed to act more quickly than Botox and also has a much lower risk of the toxin spreading to other areas of the body. Dysport is also priced lower than Botox.

However Botox has 20 years of research and use behind it whilst Dysport is very new therefore little is known about long-term effects ofusing Dysport.

So which filler is best? The answer is there is no one best filler. If you are planning on getting facial fillers it is best to talk through the options with your cosmetic practitioner to discuss what the best dermal filler for you is.

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The first of the modern generation of fillers came on to the market in the early 1980s with the collagen fillers, Zyderm and Zyplast. Collagen was revolutionary at the time in that the products could be taken off a package on the shelf and (usually) safely injected into the face to fill out wrinkles, lips and facial contours. Collagen fillers however, revolutionary as they were, were far from perfect. The collagen was derived from Cow’s hide and consequently was associated with a 1 in 20 chance of an allergic reaction therefore everyone had to have a skin test carried out two weeks prior to having the treatment. Even that wasn’t full proof however and some patients who had a negative skin test still went on to have an allergic reaction when the full treatment dose was administered. Other problems with collagen included a limited duration of action, with the results generally lasting only 8-12 weeks at a time. There was also a theoretical possibility of the transmission of disease from cow’s to humans.

In the mid-1990s Swedish company Q-Med launched the first ever hyaluronic acid based dermal filler: Restylane. Hyaluronic acid is a glycoprotein present in normal skin and joints. It is manufactured by genetically engineering bacteria to produce it and because of the non-animal source there is a much lower risk of allergic reaction (approximately 1 in 2000) therefore it can be injected without the need for a skin test. Best of all it lasts longer than collagen, approximately 3-4 months between injections.

Since Q-Med introduced their hyaluronic acid filler to the market there have been many other companies who have jumped on the hyaluronic acid band wagon, producing more refined and technically advanced versions of the gel. New brands of hyaluronic acid such as Teosyal and Juvederm Ultra which are manufactured to give a smoother result and have increased cross linking between molecules. The increased cross linking means that the molecules are more stable making them more difficult for the body to break down and therefore causing the results to last longer. Treatments with Teosyal or Juvederm ultra typically last in the 8-12 month range – a vast improvement from previous products.

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A new product is currently going through the clinical trial process which may revolutionise the way that patients encourage collagen production. TOKI is a drink made with Hijiki seaweed extracts, collagen peptides and a number of other key ‘youth-enhancing’ ingredients.

During one of the initial trials, 32 women between the ages of 35 and 65 drank TOKI regularly over an 8 week period. During the trial, each woman’s blood collagen levels were tested and it was found that the overall blood collagen levels increased – blood collagen helps improve the outer layer of the skin.

The manufacturers of TOKI claim that results will be seen within as little as 45 days. The product itself has been released for sale in the form of a powder which is diluted into water, ready for drinking. It is claimed that drinking the liquid allows for quick absorption of the key ingredients into the bloodstream, and if drunk on a regular basis the drink will help reduce the appearance of fine lines and wrinkles, and help skin look tighter, smoother and therefore younger.

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‘Radiesse’ was developed by BioForm Medical in 2002 for use in facial reconstructive surgery, but now the calcium based microsphere technology has been approved for other applications.

The new treatment is longer lasting as it not only fills in facial folds and depressions like existing ‘wrinkle fillers’, but also increases the bodies capacity to produce collagen. Collagen provides body to facial tissues.

The drug was also approved for use on HIV positive candidates who suffer from significant facial fat loss (or lipoatrophy).

http://www.fda.gov/fdac/features/2004/204_beauty.html

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