Injectable Fillers

What's Involved

Fat Injections: Before

A doctor injects a substance into wrinkles or creases to add volume or plump them up and make them less noticeable. In 2004, more than 1.85 million Americans smoothed wrinkles with injectables, according to the American Society for Aesthetic Plastic Surgery.

Fat Injections: After

While they are considered nonsurgical, these injections are medical procedures. They should be done by a qualified physician in an appropriate facility. A wide variety of injectable fillers are available. You may also wish to consider Botox.

Is It Right for You?

Substance/Name: Hyaluronan (Hyaluronic acid, Restylane, Hylaform) What it is: Considered by many to be the "next big thing" after Botox because it is longer lasting, hyaluronan is a compound found in connective tissue of animals -- for instance, the combs of chickens. After processing, the substance is made into a viscous gel. In December 2003, the product Restylane, a synthetic form of hyaluronan, was approved by the FDA for wrinkle treatments. It has been used for wrinkle treatments in Europe for the past six years. Injection areas: Wrinkles around nose and chin, forehead wrinkles, smile lines, and lips Results: Expected to last six months to a year Average cost*: Expected to be about $650 per procedure Back to work: No downtime Possible reactions: Swelling, redness, and tenderness Other: Does not require an allergy skin test

Substance/Name: Fat Injections What it is: Fat transfer from one part of the body to another Injection areas: Lines around nose and chin, crow's feet, lips, frown lines, and facial recontouring Results: Highly variable (lasts months to years) Average cost*: $1,282 per procedure Back to work: Minor: One to four days; extensive: seven to 14 days Possible reactions: Swelling, bruising, and lumpiness Other: Requires a "donor site" (e.g., thighs, abdomen, buttocks); this procedure often accompanies liposuction.

Substance/Name: Bovine-based collagen (Zyderm, Zyplast) What it is: This substance is derived from purified bovine (cow) collagen, a natural protein that provides structural support to skin, muscle, tendons, and bone. Injection areas: Lines around nose and chin, crow's feet, frown lines, and lips Results: Lasts up to six months Average cost*: $399 per procedure Back to work: No downtime Possible reactions: Slight bruising and allergic reactions Other: Requires an allergy skin test and at least a one-month wait before injections

Substance/Name: Human-based collagen (CosmoDerm, Cosmoplast) What it is: This substance is derived from human collagen, a natural protein that provides support to skin, muscle, tendons, and bone. Injection areas: Lines around nose and chin, crow's feet, frown lines, and lips Results: Lasts up to six months Average cost*: $450 per procedure Back to work: No downtime Possible reactions: Swelling, redness, and bruising Other: Does not require an allergy skin test

Substance/Name: Calcium hydroxyl-lapatite/Radiance What it is: This substance is a synthetic form of material found in bone and teeth. Injection areas: Lines around nose and chin, crow's feet, frown lines, and lips Results: Lasts two years, possibly longer Average cost: $1,500 per procedure Back to work: No downtime Possible reactions: Swelling, redness, bruising, and lumpiness Other: Does not require an allergy skin test

*Source: American Society for Aesthetic Plastic Surgery, 2002. Costs are for surgeon's fees and do not include a charge for facility or other miscellaneous costs, if any. Costs of injections are usually charged per vial of filler.

What Real Women Say

Patricia, 70s, New York

In 2003, Patricia had injections of Radiance and bovine collagen to fill out the nasolabial folds (which run from the nose down toward the mouth) and lines from the sides of the chin toward the jaw. The Radiance procedure took only half an hour. An anesthetic cream prevented pain. "It was excellent. I went back to work as a volunteer the next day," she says. Patricia pays about $400 per vial of collagen, and she needs two vials per visit every few months. The Radiance, which lasts much longer, costs about $2,500. (Patricia received a significant discount of about $1,000 as a trial patient.)

"I think this is the future of cosmetic improvements," she says. "I didn't want to do anything drastic. I'm not trying to look like a young girl. For me this is a marvelous thing. I'm able to wear brighter colors now. It's taken some years off my face. It's a very natural look."

Karen, 43, Miami, Florida

"I have a long face and I wanted to fill it out," says Karen. So in the summer of 2003, when she underwent liposuction of her thighs and lower back, she decided to also include fat transfer to her face. The doctor injected her own fat into her cheeks, mouth area, and temples. "At first, I swelled up like a pig and thought I was deformed!" Karen says. But her doctor told her to be patient. After a few days, the swelling started to subside. "For a while, I had a round, fat face," Karen says. Then her new look settled in. "You can see a difference in photos. I look fuller," she says, sounding pleased. Karen paid $1,800 for the fat injections, plus $2,500 for the liposuction.

To Learn More: Visit the Public Site section of the American Society for Aesthetic Plastic Surgery's Web site. Or call their toll-free referral line at 1-888-ASAPS-11.

Check out the Learn section of BeautySurg.com, the "cosmetic surgery supersite."

For physician referrals, call the American Society of Plastic Surgeons referral service at 1-888-4PLASTIC or visit them online. Click on "Learn About Procedures" to find out more.