Fillers that turn back the hands of time

I’ve been an avid golfer since I was 10 years old and now at 40, I look 55. My skin is so dry and leathery with a lot of deep lines. I’ve had collagen injections, but they last only a few months and aside from being pricey, I feel the countless needle marks leave a trail that after the collagen melts, my lines seem to be deeper. I hear that there are new products on the market that are better than collagen. Could you recommend a doctor who has better products than collagen or botox, which I hear is just as short-term as collagen. – Wrinkled Golfer

In a recent dinner party that I attended, one of the guests was a noted cosmetic surgeon. The conversation veered towards the latest in antiaging procedures. Surprisingly, the men were just as interested as the women. One male guest, who spent his younger years basking under the sun and has a lot of deep lines on his forehead and around his eyes, admitted to doing botox for a more youthful appearance. He confessed though that he would rather go for something more permanent than botox as he was tired of going every four to six months for a refill. The doctor explained that the more botox treatments one gets, the longer it takes to refill but still not long enough to just sit back and relax and enjoy a line-free face for a long time. He came out with several possibilities which are more long lasting than botox or collagen.

During the recent annual meeting of the American Academy of Dermatology that he attended, experts said that wrinkle fillers that erase the signs of aging are getting better and better. To begin with, it must be noted that wrinkles result from the loss of three skin components: Collage, hyaluronic acid and elastin. "Today, we can replace two of these components – collagen and hyauloronic acid – that are lost as skin ages," claims Dr. Leslie Baumann, an associate professor at the University of Miami Florida. "While there are no elastin fillers, some products are being developed that may stimulate elastin."

One thing for certain, says the doctor in our midst, "there are a lot more paints on our palates now." Such as, Juvederm, which is already being used in Europe but not yet in the US. It is a new filler composed of a long-lasting gel that, once injected into the skin with an ultra fine needle, lifts and adds volume. This gel is made from hyaluronic acid and can last for 15 months. According to studies, this filler causes less tissue injury, less inflammation, and fewer damaging free radicals compared to other fillers. Free radicals break down hyaluronic acid so the effects of Juvederm may last longer.

Another type of filler is the Sculptra. It is known as a dermal stimulator because it stimulates the skin’s dermis layer to make more collagen. What’s interesting about this filler is that doctors have appealed to the FDA for approval of this product for use as an injectible filler to reconstruct AIDS patients suffering from loss of facial fat that makes them appear ill.

This is a common side effect of some medications used to treat HIV. But Sculptra does not offer immediate gratification. It provides a slow correction as it is injected and gets the skin’s fibroblast cells to make more collagen, the doctor explains. The product takes about a week to work. Currently, patients receive this treatment once a month for four months and the results can last up to two years. European doctors highly recommend Sculptra as really effective even if it requires a series of treatments and takes time for results to be seen.

Then there’s Artecoll, a mixture of small microspheres of a chemical called polymethymethacrylate, or PMMA, and collagen. It augments the tissue under the upper layers of the skin, giving a smooth appearance to wrinkles. "This is already approved in Canada," states Dr. Katz of the Skin and Laser Center of New York. "This is supposed to last three to four years, but a lot of my colleagues have seen reactions." Reactions can include long-lasting granulomas, a solid group of inflammatory cells that sometimes forms a visible lump under the skin.

Another long-lasting injectible filler is Radiesse. It is made of tiny microspheres of calcium hydoxyappetite, the same mineral that makes up bones and teeth.

It is approved for treating vocal chord paralysis, but it is also used as a wrinkle filler, he says. It can last anywhere from two to five years, research programs suggest.

Looking to the future of wrinkle fillers, our doctor says that "the ideal filler is one that doesn’t need skin testing and is long lasting, but not permanent," he says. You wouldn’t want one that lasts longer than three to five years because as people age, our skin thins out and features change, so you would see lumps and bumps and mounds of tissues," he says.

"If someone has huge cheekbones and their face shrinks, they look distorted. Semi-permanent is the way to go."

Deep lines cannot be reversed by a surgical face-lift. Doctors recommend fillers for deep lines as they could really make a face wrinkle-free. But the question is what fillers to use to fit one’s budget and lifestyle. The above fillers are probably not yet available here. But our doctor friend says that there are the equivalent long-lasting fillers here under different names that are already used in Europe and the US. For my readers’ information, here are some dermatologists and/or cosmetic surgeons who perform these wonder procedures: Dr. Kathy Nuñez, Globe Bldg., Pioneer St., ground floor; Dr. Nonie Fernandez, Makati Med.; Dr. Benny Herbosa, Makati Med.; Dr. Pierre Clero, 5B Aquarius St., Bel Air 3, Makati; and Dr. Vicki Belo, Connecticut St., Greenhills. Try anyone of them, the effect on you could be magical.

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For your questions, write to Mayenne Carmona, Stargate Media, 6th floor, Jaka Bldg., Ayala Ave., Makati City.