Soft tissue fillers are products that are designed to "fill in" facial indentations made by fine lines and wrinkles. The treatment smoothes the skin and gives the patient a more youthful appearance.

There are several different types of soft tissue fillers available. With fat injections, doctors take fat from another area of the body, process it, and then inject it into the new site. According to the American Society for Aesthetic Plastic Surgery, about 99,439 fat injections were performed in 2004. The effect is temporary because the body eventually breaks down the fat. Results last from several months to about a year.

Collagen is derived from a patient's own tissues or from purified cow collagen. It is injected into the skin to add volume to an area. Last year, 785,448 collagen injections were done in the U.S. Treatment lasts up to six months.

Hyaluronic acid (Hylaform(r) and Restylane) is a natural substance found in living organisms. It is produced in a laboratory and injected into fine lines and wrinkles. It can also be used to increase fullness in the lips. In 2004, 882,469 hyaluronic acid injections were performed in the U.S. The treatment lasts from several months to a year.

Calcium hydroxylapatite (Radiance) is a newer soft tissue filler. It's a synthetic version of a natural substance found in bone and teeth. Last year, 69,439 procedures were done in the U.S. The treatment is more expensive than collagen or hyaluronic acid, but lasts much longer. Results with calcium hydroxylapatite last for two years or more.

Sculptra(tm)

Another soft tissue filler is Sculptra(tm) (injectable poly-L-lactic acid). Sculptra is a synthetic material that has been safely used to make dissolvable sutures and soft tissue implants. In August 2004, the FDA approved Sculptra for loss of fat in the face (lipoatrophy, or facial wasting) associated with antitretroviral therapy in HIV patients. Facial fat loss gives a sunken appearance to the cheeks, eyes and temples. When injected into the skin, Sculptra makes the skin thicker and restores volume and shape to the target area.

Some physicians are now using Sculptra on an off-label basis for cosmetic purposes in non-HIV patients (the filler has not been approved for this purpose yet). The treatment appears to be safe and can last for two or more years.

Patients who are considering Sculptra should understand the risks associated with the injections. According to the manufacturer, some people experience redness, swelling, pain or bruising after an injection. The side effects usually go away within a few hours, but can last for up to 17 days. Another potential side effect is the development of small bumps under the skin of the target area. About 19 percent of patients receiving Sculptra experience this problem. The bumps are not always visible and sometimes go away on their own. In some cases, however, the bumps are visible and may cause redness or color change in the affected area of skin. Since Sculptra is so long-lasting, experts recommend patients seek treatment from physicians experienced in its use to reduce the risk of unintentional bumps or improper placement of the filler.

SOURCES

American Society for Aesthetic Plastic Surgery, http://www.surgery.org