Dr. Mendoza in the Media

For Immediate Release

Injectable Filler Options for Use in Facial Rejuvenation

When wrinkles appear on the surface of your skin, this is the result of many years of damage to your skin by the underlying muscle. Many of our patients are on a facial rejuvenation programs to address the issues they have with wrinkles, acne scarring, pigmentation and complexion. There are several ways to address these issues.

First, often a comprehensive skin care program using pharmaceutical strength skin care products including hydroxides, Retin A and Hydroquinone. We can often follow up with chemical or glycolic peels and Microdermabrasion to further optimize their results. Botox® works great on wrinkles to paralyze the muscles in the face causing these wrinkles but if the damage is too severe, the skin crease will not smooth out completely. Further, Botox® will not work on scarring caused by acne or trauma.

Fortunately, there are several solutions available for people interested in addressing these issues further to achieve a more vibrant, youthful look. These treatments may be used to fill folds, smooth away lines and even enhance lips, all with virtually no downtime.

COLLAGEN is the most common filler in use today in the United States. Collagen is a protein, produced by people's bodies, that boosts up the outer layer of skin, creating a smooth surface. However, as people age, this natural substance begins to break down, allowing creases to form in the skin. Injectable collagen is a filler derived from highly purified bovine (cow), collagen. It acts similarly to people's natural collagen by plumping up the skin in creases and some types of scarring, as well as filling out the boarder of the lips. People with an allergy to beef, pregnant women, and people with certain autoimmune diseases are not good candidates for this treatment. A small patch test on the forearm is required four weeks before injection into the site to ensure that there is no allergic reaction. The smoothing results of the injections should last from three to six months, depending on how quickly the individual's body breaks down the new collagen. Then the process will need to be repeated. For patients allergic to traditional collagen injections, there is a new type of collagen injection available that is genetically engineered from human cadavers. This is more expensive but there is skin testing required.

FAT TRANSFER involves extracting fat cells from the patient's abdomen, thighs, buttocks or elsewhere and reinjecting them beneath the facial skin. Fat is most often used to fill in "sunken" cheeks or laugh lines between the nose and mouth, to correct skin depressions or indentations, to minimize forehead wrinkles and to enhance the lips. The fat is withdrawn using a syringe with a large-bore needle or a cannula (the same instrument used in liposuction) attached to a syringe. The fat is then prepared and injected into the recipient site with a smaller cannula. Sometimes the procedure may need to be repeated two or three times for optimal results because not all the fat that is transferred will survive.

NEW ON THE HORIZON Recently, there has been a lot of buzz in the news about several alternatives that are being used in other countries and are under currently under FDA investigation.

RESTYLANE, composed of hyaluronic acid, a substance naturally produced by the body, adds volume under the wrinkle, lifts the area up and smoothes it out. The manufacturer claims results last up to one year. Since this injectable is composed of a substance in the body, no allergy skin test is required. The FDA has received results of clinical trials with Restylane, and the manufacturer is awaiting approval for official use in the U.S.

RADIANCE FN is another, more permanent solution. Radiance FN consists of calcium hydroxyapatite suspended in gel (carboxymethylcellulose). Because calcium hydroxyapatite is a normal constituent of bone, it should not elicit a chronic inflammatory immune response, and no allergy testing is required for this treatment. Radiance FN is said to last 3 to 5 years. This product has been successfully used for many years in prosthetic implants for dental, orthopedic and facial surgery. Injection of this treatment in vocal cords, neck and pelvic areas shows that it remains soft without new bone formation when injected into soft tissue. Radiance FN has already been used for cosmetic purposes in Italy for several years and has been gaining an international reputation for itself as a more lasting facial contouring agent.

ARTECOLL® is made of microspheres of PMMA (polymethylmethacrylate), suspended in collagen with a small amount of anesthetic mixed in. Your body absorbs the collagen carrier in one to three months. Your own collagen completely replaces the Artecoll® collagen. Artecoll® collagen absorption and your new collagen formation occur at a similar rate. The PMMA-microspheres serve as a stimulus for collagen formation. Each microsphere is completely surrounded and encapsulated by your own collagen. After completion of the remodeling process (3 to 6 months), the augmentation area consists of about 75% of your own collagen and 25% PMMA microspheres to form a pliable implant. Skin testing is required because it contains collagen. The major drawback is that small cysts can sometimes form that may need to be surgically removed. Clinical trials in the US were finished in September 2001 and it's currently awaiting FDA approval.

Before you embark on any medical procedures, please be sure to check your doctor's credentials and backgrounds. The above procedures are best provided by a board certified plastic surgeon or dermatologist. Be leery of anyone promoting themselves as board certified cosmetic surgeon. There is no board certification for a cosmetic surgeon in the United States, per the American Board of Medical Specialties [www.abms.org]. Your doctor's board certification and training can also be confirmed on the AMA's web site [www.ama-assn.org].

Dr. Mendoza is a Board Certified Plastic Surgeon with offices in Naperville, Chicago (Michigan Avenue) and Oak Lawn. Specializing in cosmetic surgery of the face and of the body, he also offers a wide range of cosmetic surgery options. He can be reached at Chicagoland Plastic Surgery at 630.305.0331 or www.plastic-handsurgery.com

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