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believed to have a rate of complications of less than 1%. their own advantages and disadvantages, and generally
Granulomas may develop weeks or even years following do not have any adverse reactions. The optimal filler is
treatment, and can be managed using oral or intralesional determined by the case, cost associated with treatment,
corticosteroids and antibiotics. and the physician’s experience. Research continues to be
conducted on formulations, clinical trials, and comparative
The extent to which volume loss and fat atrophy affect facial studies between fillers. Optimal results in treating dynamic
aging is evident by the large variety of existing intradermal lines and volume loss are achieved with combination therapy.
fillers. Intradermal fillers are not as strictly regulated as It is crucial that patients have realistic expectations as
prescription drugs, as most fillers fall under the category of multiple treatments may be required, and each filler has its
a medical device rather than that of a pharmaceutical agent. limitations. More comparative studies and literature reviews
While intradermal fillers are considered to be inert, many are required to provide the layperson with a summary of the
of them elicit immunogenic reactions and granulomas. In many options and their risks and benefits, thereby allowing
addition, some fillers induce neo-collagenesis. Temporary patients to choose the filler most suitable to their needs.
fillers generally persist for 3-6 months. While permanent
fillers may be advantageous in terms of their longevity, Financial support and sponsorship
a permanent dermatological procedure may eventually The authors would like to thank the Grant for Excellent
become unnatural as it is unable to accommodate the Young Scholars from Xi’an Jiaotong University.
patient’s aesthetic needs over time due to the dynamic
nature of facial aging. Conflicts of interest
There are no conflicts of interest.
Other fillers
Apart from the fillers mentioned above, a combination of REFERENCES
two or more fillers have been shown to be very effective in
facial volumization. A 6-month comparison study examined 1. Luebberding S, Alexiades-Armenakas M. Facial volume augmentation in
the efficacy and safety profiles of plain CaHA and CaHA mixed 2. 2014: overview of different filler options. J Drugs Dermatol 2013;12:1339-44.
Maddern G. The Australian Safety and Efficacy Register of New Interventional
[68]
with lidocaine for the treatment of nasolabial folds. In this Procedures - Surgical (ASERNIP-S) assesses new surgeries. Aust Health Rev
study, 16 patients with moderate-to-deep wrinkle ratings 2004;28:143-4.
were recruited. A visual analog pain scale was used to assess 3. Silvipriya KS, Kumar KK, Bhat AR, Kumar BD, John A, Lakshmanan P. Collagen:
the patients’ pain perception. A blinded injector and an 4. animal sources and biomedical application. J App Pharm Sci 2015;5:123-7.
Ottani V, Raspanti M, Ruggeri A. Collagen structure and functional
independent observer determined the efficacy of treatment implications. Micron 2001;32:251-60.
over a period of 24 weeks. There were no significant adverse 5. Sadick NS, Katz BE, Roy D. A multicenter, 47-month study of safety and
events and very few local adverse events. Both of the groups efficacy of calcium hydroxylapatite for soft tissue augmentation of nasolabial
reported satisfaction with the treatment and much less folds and other areas of the face. Dermatol Surg 2007;33:S122-6; discussion
S126-7.
pain when CaHA was mixed with lidocaine as compared to 6. Baumann L, Kaufman J, Saghari S. Collagen fillers. Dermatol Ther 2006;19:134-
plain CaHA. Intradermal fillers have also been used with 40.
[68]
other anti-aging chemicals including BOTOX®. A study by 7. Nicolle FV. Correction of age- and disease-related contour deficiencies of
the face. Aesthetic Plastic Surg 1985;9:159-62.
Coleman and Carruthers [69] showed that in younger subjects 8. Bailin MD, Bailin PL. Correction of surgical scars, acne scars, and rhytids with
with glabellar frown lines, treatment with BOTOX®- alone zyderm and zyplast implants. J Dermatol Surg Oncol 1988;14:31-3.
did not show positive results, but when combined with 9. Zeide DA. Adverse reactions to collagen implants. Clin Dermatol 1986;4:176-
82.
intradermal fillers such as HA gave an immediate resting 10. Struck H. Immunological investigations of antigenicity and specificity of
result and made it last twice as long. Similarly, melomental soluble collagen fractions. IV. Anaphylaxis and allergy experiments. Eur Surg
folds in the perioral region can be effectively treated with the Res 1976;8:243-9.
combination of BOTOX® to remove the muscular depressor 11. Monstrey SJ, Pitaru S, Hamdi M, Van Landuyt K, Blondeel P, Shiri J, Goldlust A,
action of the lower face and intradermal filler to volumize Shoshani D. A two-stage phase I trial of Evolence30 collagen for soft-tissue
contour correction. Plast Reconstr Surg 2007;120:303-11.
[69]
the mouth corners, giving an overall youthful appearance. 12. Narins RS, Brandt FS, Lorenc ZP, Maas CS, Monheit GD, Smith SR, McIntyre S.
A randomized, multicenter study of the safety and efficacy of Dermicol-P35
CONCLUSION and non-animal-stabilized hyaluronic acid gel for the correction of nasolabial
folds. Dermatol Surg 2007;33:S213-21; discussion S221.
13. Lee JH, Choi YS, Kim SM, Kim YJ, Rhie JW, Jun YJ. Efficacy and safety of
The field of cosmetic dermatology has been expanding porcine collagen filler for nasolabial fold correction in Asians: a prospective
globally. With the ever increasing popularity of nonsurgical multicenter, 12 months follow-up study. J Korean Med Sci 2014;29:S217-21.
enhancement and an increasing number of patients who 14. Brongo S, Moccia LS, Nunziata V, D'Andrea F. Keratoacanthoma arising
after site injection infection of cosmetic collagen filler. Int J Surg Case Rep
have been treated, the demand for fillers continues to 2013;4:429-31.
rise. Research articles, long-term clinical experience, peer 15. Tumerdem B, Aydin A, Kesim SN. An unusual case of self-injected bovine
reviewed publications and regulatory approvals have all fat in liquid form to the face for cosmetic reasons. Aesthetic Plastic Surg
200ss4;28:251-3.
demonstrated the safety and efficacy of various fillers. Fillers 16. Baumann LS, Shamban AT, Lupo MP, Monheit GD, Thomas JA, Murphy
appeal to various age demographics including young adults DK, Walker PS; JUVEDERM vs. ZYPLAST Nasolabial Fold Study Group.
for the enhancement of youthful features, middle-aged Comparison of smooth-gel hyaluronic acid dermal fillers with cross-linked
adults for early prevention and volume restoration, and the bovine collagen: a multicenter, double-masked, randomized, within-subject
study. Dermatol Surgery 2007;33:S128-35.
older individuals for delay and maintenance of age-related 17. Kim BS, Choi JS, Kim JD, Yoon HI, Choi YC, Cho YW. Human collagen isolated
symptoms. All of the injectable fillers discussed above have from adipose tissue. Biotechnol Prog 2012;28:973-80.
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