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Introduction

Collagen injections give your skin a plumper, smoother appearance. Although collagen is the best known filler, there are many other substances doctors can use to plump up your skin, including fat from your own body and synthetic materials. Below you will find a detailed explanation of how collagen works, followed by a list of other injectable fillers your doctor may recommend.

Collagen

To understand collagen, you should first understand your skin.

Skin consists of three layers: the epidermis, dermis, and subcutaneous tissue (hypodermis). The upper-most layer, known as the epidermis, controls the loss of water from cells and tissue. Without this protective barrier, the body would quickly dehydrate.

Just below the epidermis lies the second layer, the dermis. The dermis, although it contains blood vessels, nerves and hair follicles, is primarily made up of a protein called "collagen." This protein forms a network of fibers that provides a framework for the growth of cells and blood vessels. Because it is the primary component of the dermis, collagen acts as the support structure for the skin. The hypodermis is a layer of fat and connective tissue that contains larger blood vessels and nerves. It also hosts sweat glands, fat, and collagen cells. The hypodermis is responsible for conserving your body's heat and protecting your vital inner organs.

Why Do Lines Appear on Skin?

In young skin, the collagen framework is intact and the skin remains moisturized and elastic. It's resilient to the many facial expressions we adopt as well as everyday environmental exposure. But, over time, the support structure weakens and the skin loses its elasticity. The skin begins to lose its tone as the collagen support wears down. Every time you smile, frown or squint, you put stress on the collagen in your skin. The effect of these facial expressions is cumulative and facial lines begin to appear.

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How Do Collagen Injections Work?

Collagen injections replenish the skin's natural collagen. The natural beauty of your skin is enhanced as the contour of the support structure is restored.

Zyderm and Zyplast are collagen products gotten from cows that replace the collagen your skin loses over time. Zyderm and Zyplast collagen are placed just beneath the skin, in the dermis where the body readily accepts it as its own.

CosmoDerm and CosmoPlast are bioengineered human collagen products that are used for similar indications as Zyderm and Zyplast but have the advantage of not requiring a skin test prior to the first treatment.

Collagen should be injected into your skin only by a trained health care professional.

Other Injectable Fillers

  • Artecoll is a synthetic filler material. Because it's synthetic, you are at higher risk of having an allergic reaction to it than if you got an injection of collagen or fat, but it lasts much longer than those options.
  • Autologen is an injection of your own collagen, extracted from another place on your body. There's no risk of allergic reaction; however, the results are only temporary.
  • Dermalogen is collagen extracted from deceased human donors. This is also a temporary fix, but your body should not reject it.
  • Fascia injections use a specific type of connective tissue harvested either from your own body or from a deceased human donor. It can be implanted surgically or injected. The main drawback is that within a year of injection, your body will reabsorb the fascia and you'll be back at square one.
  • Fat from your own thighs or abdomen can be also be injected. There's no risk of allergic reaction and you may achieve permanent results. This can also be implanted surgically.
  • HylaForm is a material created from a natural body substance known as hyaluronic acid. There's no risk of infection, but you will need repeated treatments to maintain the result as it's only a temporary fix.
  • Restylane is a clear gel that also contains hyaluronic acid. It is only a temporary fix, as your body will absorb it within about six months of the injection.

What Can I Expect From Collagen Injections or Other Fillers?

Before getting a collagen injection, you should expect to receive a small injection of local anesthesia to numb the area being treated. There is a possibility of slight bruising, and you may experience puffiness, redness, and tenderness around the treated site.

It's important to discuss with your doctor exactly what you can expect from each treatment. Together, you can prioritize which facial areas you wish to be treated and discuss how many treatments you may need and the estimated cost. It's important to know that one treatment may not remove every line on your face.

Depending on the substance injected, you may need continued treatments to maintain the smoothing effect.

How Many Collagen or Filler Injections Will I Need?

That depends on which product you use. Just like natural collagen, collagen replacements begin to lose form and will eventually wear down. Treatment may require collagen injections two to four times a year to maintain the smoothing effects. Hylaform and Restylane are also eventually reabsorbed by the body requiring repeated treatment. Synthetic materials, such as Artecoll, last longer but carry a higher risk of allergic reaction. Fat, depending on how it is used, can sometimes achieve permanent results.

How Do I Find Out if Injections Are Right for Me?

You and your doctor will discuss your medical history and the areas you want treated with injectable fillers. Injections are not appropriate for certain lines and scars or when certain medical conditions are present. It is very important to discuss and understand what filler injections can do for you.

If you and your doctor decide injections are appropriate, your doctor may start with a skin test in your forearm to determine if you are sensitive to the substance being used. You must watch the area very carefully over a four-week period. Most men and women tested show no reaction to the skin test and can have injections.

Why Aren't Creams Containing Collagen Enough to Smooth Out Lines?

Collagen creams work only on the skin surface. A moisturizer with or without collagen cannot penetrate the skin and is not designed to be absorbed. No moisturizer can undo the cumulative effect of collagen loss. Creams primarily slow the rate of water loss from the skin and help keep the skin supple.

WebMD Medical Reference

SOURCES:

FDA: "Wrinkle Relief: Injectable Cosmetic Fillers."

American Academy of Dermatology: "Cosmetic Procedures: Fillers."

Reviewed by Michael J. Wheatley, MD on June 12, 2012

Last Editorial Review: 6/12/2012

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Reviewed on 6/12/2012
References
SOURCES:

FDA: "Wrinkle Relief: Injectable Cosmetic Fillers."

American Academy of Dermatology: "Cosmetic Procedures: Fillers."

Reviewed by Michael J. Wheatley, MD on June 12, 2012

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