If time has etched your face and neck with more telltale wrinkles than you care to see, you may have been thinking about "having something done." Yet if you're like many women, you're hesitant to consider plastic surgery. Maybe you're also not eager to try Botox and its newer cousin, Dysport, both of which work by immobilizing muscles with botulinum toxin. If so, an injectable filler could be just what you want. The typical improvement rate is 80%. A dermatologist can perform any of these procedures with a syringe in the office. You'll get local anesthesia and be on your way in about an hour. Just be sure to stay out of the sun for a week or two. Here are the specifics about the top five fillers:
Restylane: In December of 2003, this treatment became the first to get FDA approval. The suggested age range for patients is 35 to 60. Restylane works by supplementing your body's own supply of hyaluronic acid, a substance that keeps your skin supple but typically decreases over the years. Results last six to eight months. However, swelling is pretty much a given for the first few days. You may also have pain at the site of the injection and some patients report getting headaches and flu-like symptoms. The cost ranges from $350 to $800.
Juvederm: Also a form of hyaluronic acid, this volumizer was approved by the FDA in June of 2006.Juvederm Ultra is for moderate creases and Juvederm Ultra Plus works for deeper grooves. Injections last up to nine months and side effects such as redness, tenderness, and swelling are rare. If they do occur, they usually resolve within a matter of days. Like Restylane, this product is recommended for people 35 to 60 years old. The cost ranges from $800 to $1300.
ArteFill: In October 2006, ArteFill became the only permanent dermal filler approved by the FDA. Results last for years and patients of any age are good candidates for the procedure. The intended use is for wrinkles around the mouth. Reputable dermatologists strongly discourage "off-label" treatments for lip augmentation. ArteFill is a gel made of synthetic microspheres suspended in purified collagen from cows. It has a local anesthetic right in the mix. The microspheres stimulate your body to make more of its own collagen. After a few weeks the ratio is about 80% natural and 20% bovine. You'll need an allergy test a few weeks before your appointment. Side effects can include redness, swelling, lumpiness, pain, or sensitivity at the injection site. ArteFill treatments cost about $1,000.
Radiesse: FDA-approved in 2009, this is a gel containing a compound of carbon, hydrogen, oxygen, glycerin, and sterile water. After the injection, your body makes a film of connective tissue around the microspheres that result. You won't see the full effect for about a week but the treatment lasts up to two years. Any swelling usually goes down in a day or two. You might need some pain medication for a while. Rarely, a patient develops nodules that require steroids or surgery. The cost for Radiesse ranges from $650 to $800.
Sculptra: A European import, this filler was originally approved by the FDA for people with the facial wasting typical of HIV/Aids. In 2009, the agency approved Sculptra for the general public. You'll need three to six treatments before you see any improvement but the final firming will last nearly two years. The product is a synthetic version of polylactic acid, a substance naturally produced in the body during exercise. A similar product has been safely used as suture material in the human body for over 30 years. Sculptra works by gradually thickening your skin and the product eventually dissolves. Tenderness and redness can last a couple of weeks. The cost for each Sculptra treatment ranges from $450 to $550.
A final word to the wise: Make sure your dermatologist is board-certified and has a terrific track record of successful results with minimal side effects for the treatment you choose. If he or she offers to perform an "off-label" procedure or says that a physician's assistant will do the honors, those are red flags that should tell you to find another doctor and fast!
Does anything really work? Let us know what you think?
Sondra Forsyth, Senior Editor at ThirdAge, is a National Magazine Award winner. She writes for major magazines and is the author or co-author of eleven books. She was Executive Editor at "Ladies’ Home Journal," Features Editor at "Cosmopolitan," and Articles Editor at "Bride’s." A former ballerina, she is the Artistic Director of Ballet Ambassadors, an arts-in-education company in New York City.