Initially fillers were viewed as relatively inert materials, such as collagen, that were injected, immediately plumped up the area to be filled, and gradually were absorbed. These type of fillers still exist, as exemplified by the hyaluronic acid fillers (Restylane and Juvederm). However, a new type of filler has emerged, a filler that works by stimulating the body to make more collagen in the area where the material has been injected.
Currently there are at least three fillers that fill this role. The first of these is Radiesse. Radiesse is a calcium based filler which was first introduced as a traditional filler. However, subsequent studies showed that much of the injected material was absorbed, and the prolonged effect seen was due at least partially to the production of new collagen in the area. In our hands, Radiesse has been essentially problem free.However, there is a much stronger collagen stimulator available now.
Sculptra has always been recognized as achieving its effect by inducing the body to produce new collagen. Sculptra consists of tiny particles of poly-L-lactic acid, the same material that is used in absorbable sutures. The Sculptra is suspended in liquid and when injected, the area appears filled, similar to the immediate filling seen in other fillers. However, the liquid is absorbed within 24 hours, and the filling effect vanishes. The filler particles gradually stimulate the formation of new collagen, and it takes at least a month before results can be seen. The final result may not be seen until two to three months.
The last of the fillers that induce new collagen formation is a permanent filler called Artefill or Artesense.This is a powerful long lasting stimulator that can last upto 10 years. More about this in a later post.