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I've Got You Under My Skin

By James Barber M.D.
Cosmetic Surgery Expert
Updated: September 10, 2008
"FILL'ER UP!" Historically, that statement would most likely be associated with a person who was in the close proximity of a gas pump or a beer tap. More recently, is has been shouted again and again at plastic surgeon's offices across the globe. Injectable materials and fillers have been a staple in facial rejuvenation for years, but a recent expansion of options has led to a boom in these procedures.

For years, the standard was bovine collagen known to doctors as Zyderm and Zyplast. The material was easy to inject into small lines, but since it came from non-human sources, a sensitivity test was required two to four weeks before the actual procedure could take place. This was to minimize the risk of allergies or other reactions to the collagen.

More recently, doctors have begun using Cosmoderm and Cosmoplast, human collagens which are grown in laboratories. Like the bovine collagen, these materials last for four to six months once placed. Their advantage lies in the fact that they need not undergo any sensitivity testing before placement.

The newest injectable is Alloderm, a cadaver A-cellular dermal mix. No testing is required for this soft material as its inflammatory response is minimal. Alloderm has a natural feel once implanted, and early patient studies show that Alloderm establishes more permanent results than bovine collagen.
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More permanent fillers can be used in certain situations, but often the patient must live with a less natural look or feel. Gortex, an expanded polytetraflouroethylene, was approved in 1993 for facial aesthetic surgery. Gortex is fairly biocompatible but has a somewhat unnatural feel. It has also shown a higher instance of infection and extrusion than other fillers because of cell reactions around the Gortex strands.

Softform is a permanent solution for lip augmentation and generally feels more natural than Gortex. Some patients, however, do report a cord-like feeling after surgery.

Finally, there is silicone. This injectable has been used to treat retinal detachment and is currently in clinical trials for cosmetic uses. Silicone will deliver the most natural feel of the permanent fillers, but it comes at a price. A single injection will run $700 or more.

If you are tired of trying to hide lines, wrinkles, or scars and want to feel better about the face you present to the world, fillers can be just the thing. They are a fast, easy, and effective way to erase a few years of wear and tear.

Forever Facts:
- Studies from MIT show that a high-carb breakfast can leave your mid-morning tryptophan levels 4 times higher than if you had eaten a mostly protein early-riser. Since tryptophan is a known sleep-inducing compound, you might want to swap ham and eggs for your cereal next time you have a busy day planned.

- Only 2.5 million people browsed onto doctor's websites in 2001. A year later these same sites saw 7.3 million hits in only three months.

- Don't cut the crust off your kid's PB&J's. German scientists have found that during baking, a powerful anti-oxidant known as pronyl-lysine is produced in bread. The levels of this substance are 8 times greater in the crust.

Words of Wisdom:

"The best index to a person's character is (a) how he treats people who can't do him any good, and (b) how he treats people who can't fight back." -Abigail Van Buren
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