Wrinkle fillers that last too long
mellieb on 21 Jan 2007 at 12:00am
One trend in wrinkle fillers like Restylane is that companies are pouring big dollars into developing longer-lasting wrinkle erasers. For instance, Juvederm seeks to differentiate from Restylane by outlasting it's effectiveness. Some docs believe Juvederm can last up to 25-percent longer than Restylane.
But I expect to hear more dermatologists and plastic surgeons sound the warning bell that a wrinkle filler can last too long.
Case in point is the recently US FDA-approved wrinkle filler called ArteFILL. The injection material in ArteFILL lasts upwards of 5 years. That's at least 5 times longer than Juvederm.
Some experts claim that this durability makes it more unlikely for patients to maintain a more natural appearance where facial lines match up with the aging face. Illustrating this point, Dr. Mark Rubin, a dermatologist in Beverly Hills, Calif., and assistant clinical professor of dermatology at the University of California, San Diego tells the Dermatology Times that:
"There are some people - both physicians and patients - who are interested in a product that can be used safely once or twice in their lifetimes, and there are others who have concerns about that idea," Dr. Rubin says. "I can understand both viewpoints. Physicians should discuss both the pros and any perceived cons to a product that promises such longevity."
But does ArteFILL really make the best business sense for doctors and medispas?
The aesthetics industry is clearly a very big business with billions of dollars at play. ArteFILL is hardly a blessing to the distributors in this industry (doctors, spas, etc) who thrive on patient flow. Widespread use of ArteFILL could cause a massive slow-down in patient return rates; theoretically an ArteFILL customer would require seeing their doctor only twice per decade. Whereas in contrast there is Botox, a dream product for medical practices because patients interested in wrinkle relaxing must repeat visit at least 15 times in a 10 year period.
It's quite apparent that the profitability of Botox patients is not in the procedure, per se, but the customer life-time opportunity it provides the dermatologist or plastic surgeon who can sell the patient on products that have higher margins such as Thermage (which RealSelf readers report spending an average of $2600 per Thermage treatment).
Update Sept 2007: The Wall Street Journal reports the efforts of Dr. Arnold Klein to compel the FDA to revisit the safety of Artefill. "Dr. Klein says the longer duration of the new products comes with the risk of unsightly lumps that could require surgical removal and leave ugly scars"