Cosmetic fillers are materials used by physicians to restore volume and fullness to the skin of the face in order to correct mild, moderate, or severe facial wrinkles and folds. Areas treated include the forehead and around the eyes as well as lines from the nose to the corners of the mouth (nasolabial folds), in addition to other depressions such as acne scars.

Common cosmetic fillers include hyaluronate, a biodegradable and fully biocompatible substance that can provide volume and fullness to the skin. Collagen, derived from animals like cattle, is also used but may produce allergic reactions in some people. An allergy test is needed before treatment with collagen injection. Fat injection, using a patient’s own adipose tissue taken from the abdomen, thighs, or buttocks, can also be used. Other injectable fillers include resorbable suture material (polyglactic acid) and biocompatible calcium hydroxyl appetite microspheres that are suspended in an injectable gel.

Injectable fillers plump up the skin to smooth away facial lines and wrinkles. In contrast, botulinum toxin (Botox) is a drug that relaxes the muscles underlying the wrinkles. One product does not necessarily replace the other product, and often they are used together in different areas of the face to provide the most natural line and wrinkle reduction.

Patients must realize that the corrections from cosmetic fillers usually are not permanent. Some fillers last longer than others, but patients should expect to need repeated treatments every nine to 12 months or, with the longer-acting agents, every few years to maintain the desired results.

Complications from injectable fillers are infrequent and usually minor. Risks include allergic reactions (from collagen), bruising, swelling, puffiness, infection, and lumpiness.

Ask your ophthalmologist (Eye M.D.) about treatment options and decide together which cosmetic filler might be appropriate for you.

(c) 2007 The American Academy of Ophthalmology