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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Made from a mixture of hyularonic acid and collagen, the new biodegradable wrinkle fillers are said to have a reduced risk of allergic reactions because their component parts are absorbed by the body at a slower rate. For some patients, the results from these biodegradable wrinkle fillers may be significantly better than the results they could achieve with the more conventional fillers.

There are plenty of ways that the new fillers can be used – from filling out hollow cheekbones, to augmenting the cheeks and lips, or helping to tighten up sagging skin around the eyes and jaw.

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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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