INJECTABLES

Definition: Injectables consist of two groups: cosmetic fillers and cosmetic injectable drugs. These products treat wrinkles and volume loss in the face. Injectables and fillers include a variety of materials, which last for different lengths of time and have different effects and uses. [1]

Overview of Types of Injectables

Provided below is a table of common injectables for referance. Not all providers will offer all of these treatments. Ultimately your doctor will let you know how to best achieve your cosmetic goals based on the area you wish to treat and the severity of the wrinkling or volume loss. [1]

BotoxDynamic Facial Wrinkles, HyperhidrosisPurified Botulinum Toxin4 to 6 months for wrinkles, up to 1 year for hyperhidrosisForehead Lines, Crow’s Feet, Eyebrows, Hyperhidrosis
DysportDynamic Lines and WrinklesAbobotulinum Toxin A4 to 6 monthsForehead Lines, Crow’s Feet, Between the Eyes
CosmodermFine lines, wrinkles, and scarsPurified Human Collagen2 to 3 monthsThroughout face on lines and wrinkles
Evolence Deep Wrinkles and FoldsPorcine Collagen6 monthsNasolabial Folds, Smile Lines, Mouth
RadiesseDeeper Wrinkles, some Acne ScarringCalcium Hydroxylapatatite (CaHA) Particles Suspended in a Hyaluronic Acid GelApprox. 1 yearThroughout the facial area
RestylaneLines in lower face, under eyes, increase lip sizeHyaluronic AcidLips: 3 to 6 months, Other: 6 to 9 monthsLips, underneath the eyes, lines such as frown lines and creases
JuvedermModerate to Deep wrinklingHyaluronic Acid4 to 9 monthsLips, Mouth Wrinkles, Facial lines
SculptraVolume loss in the face. Depressed cheeks.Poly-L-Lactic AcidUp to 2 yearsCheeks, Hollow Eyes, Facial Indents
PerlaneFacial wrinkles, lips, lines and creases on the face (often in conjunction with Restylane)Hyaluronic Acid3 to 6 monthsLips, fines lines around mouth and eyes, face
Captique Deep Wrinkles and Folds, Facial Contouring, Lip AugmentationHyaluronic Acid4 to 6 monthsLips, Mouth and Nose, Between the Eyes, Cheeks

Botox vs Dysport

Botox and Dysport and both made from the same neurotoxic protein (Clostridium botulinim toxin type A) and do the same thing, treat wrinkles and lines of movement. These dynamic wrinkles have been shown to be effectively treated with both Botox & Dysport. Some research indicates Dysport may last a bit longer than Botox, and that it may also spread farther from the injection site. Ulltimately they are very similar and which is right for you should be discussed with your doctor during your consultation.[1]

Restylane vs Juvederm

Both these products are often used for plumping the lips and filling lines and wrinkles. Both last up to 9 months between injections and are made of hyaluronic acid. While there are some differences (such as molecule size and consistency) the decision as to which ought to be used should be made by your doctor. [1]

Human-Based Collagen Fillers

Human-based collagen is used under brand names such as CosmoDerm, CosmoPlast, Cymetra, Autologen, and Fascian to build volume in facial areas including the lip area (such as for lip augmentation), above and below the eyes, crow’s feet, the nasolabial fold area (the grooves from your nose to your mouth), and frown lines.

Human-based collagen fillers are biocompatible and produce results that may last for four or more months. But as collagen treatments continue over time, more and more of the collagen remains, and results may last longer, in some cases forever. It is important to note that the treatment area is typically overfilled initially, because up to 40% of the collagen dissipates within a short time. [2]

Human-Based Collagen Fillers

The brand names of bovine-based collagen fillers include Zyderm and Zyplast. This form of collagen is derived from cows and may be used to add volume to facial areas such as the lip area, above and below the eye, crow’s feet, the nasolabial fold area, and frown lines. Because some people are allergic to bovine-based collagen, your doctor will perform an allergy test.

Results may last for four or more months, but as with human-based collagen, if you continue to have treatments over time, some of the collagen will remain, and results may last a lifetime. Also, ArteFill (described below) uses a bovine collagen product to suspend polymethylmethacrylate (PMMA, a type of plastic) microspheres that lodge into the treatment area after the collagen dissipates, with the goal of providing a more permanent benefit. Since up to 40% of bovine-based collagen soon dissipates, the treatment area is typically overfilled at first.

Both human-based and bovine-based collagen are FDA-approved for cosmetic uses. [2]

Off Label Treatments

In many medical treatment areas, including cosmetic injectables and fillers, you will often hear the term “off-label.” When the FDA approves a substance for medical or cosmetic purposes, it is for a very specific use. That FDA-specific use is printed on the label. But the FDA also allows physicians to use their own judgment. Physicians are allowed to prescribe fillers for newly discovered uses that were not originally included in the FDA-approval specification (although certain controlled drugs such as opiates are excluded from off-label use).

For example, Botox is FDA-approved for cosmetic use for lines between the eyes, but is commonly prescribed off-label for other areas of the face. Sculptra is FDA-approved for certain non-cosmetic uses, but is commonly prescribed for a number of cosmetic uses.

Cosmetic fillers are commonly used off-label, as many new applications are constantly being found. Doctors may also use a combination of fillers customized to fit the facial conditions of each patient. The fact that physicians can prescribe treatments off-label is a good reason to choose a qualified, trained, and experienced dermatologist or a board-certified plastic surgeon who has extensive expertise in the specific treatment you are receiving.

Injectables Costs

There are a wide range of costs for various dermal fillers. Some last longer and are therefore more expensive. Others are used for different purposes and have their own unique price as a result. Many times the price is determined by “units” or “vials” used for the procedure. The price of dermal fillers may also be determined by the area of the country you live in and who you go to for treatment. Certain physicians may charge more because they have more experience performing the treatment. It’s advisable to seek treatment with an experienced physician, as they are the most likely to provide you with a satisfactory result. Price should not be your main consideration when deciding on treatment. [1]

Average Patient Costs 
Average Number of Treatments: 1
National Average Cost Per-Treatment: $604
TreatmentAvg. Cost per treatment ($)
Radiesse475
Restylane508
Juvederm533
Botox575
Dysport600
Perlane675
Sculptra862

References

  1. Dermal Fillers. The Patient’s Guide. http://www.dermalfiller.net/comparison.aspx
  2. http://www.yourplasticsurgeryguide.com/injectables-and-fillers/injectable-fillers.htm