More recently, bovine collagen was the gold standard of...

More recently, bovine collagen was the gold standard of safe fillers. A small percentage of individuals are allergic to bovine collagen so a test dose was needed before treatment. Collagen was safe and pretty effective but only lasted a very short time and therefore was expensive and impractical for all but those with the deepest pockets.

• Collagen was improved with the introduction of Cosmoplast and Cosmoderm, which were made from human collagens (much lower likelihood of allergy). These offered no additional benefit in terms of longevity so when Restylane hit the market, it was essentially over for these Collagen products.
• Restylane and the recently released Perlane are hyaluronic acid based fillers. This is a sugar gel that occurs naturally in the body. Restylane and Perlane are made by Medicis. Juvederm, a competing hyaluronic acid filler, is marketed by Allergan.
  • These products last approximately 9 to 14 months in the body (somewhat less in the lips) and in sufficient volume are capable of results that cannot be achieved with surgery.
  • While treatment is expensive, these services can be comfortably performed during an office visit with almost no down time.
  • The hyaluronic fillers are so effective and versatile that it is almost not worth discussing the other FDA approved fillers. These hyaluronic fillers are so good that not only will they dominate the filler market but they will take the place of surgery in many cases.