New Injectables - Worth It?

Of all the new injectables coming out (Evolence, Prevelle, Reloxin, etc.), which ones are working the best? Are they better than what is already out there (Botox, Juvederm, etc.)?

Doctor Answers 7

Botox, Juvederm, and Radiesse set the standard for injectables

Overall, when I see these new products coming out of Europe, I do not see any that are better than what is currently being used. The gold standard is still set by Botox, Juvéderm and Radiesse.

Evolence is based on porcine collagen, and I think it is a step backward. The industry is going away from using animal products. Why go backwards? Evolence lasts 6 or 7 months, but so does Juvéderm and Radiesse lasts 10 months to a year.

Reloxin produces results similar to Botox and is being used in Europe. There are claims that its effects last up to a month longer than Botox. It is very interesting to keep an eye on but also to wait to see if it meets our safety standards in the US.

Seattle Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

You can't go wrong with Juvederm

Juvederm, Restylane, and Prevelle Silk are all injectable wrinkle fillers made from hyaluronic acid. Evolence is a porcine(pork)collagen based filler. Many more wrinkle fillers are awaiting approval by the FDA so it will become increasing difficult to keep them all straight.

Fillers differ in formulation. Some are more plumping and some last longer than others. There is also a significant difference in cost. The key is to find the right office with a great injector who has access to the latest fillers and makes recommendations based on your goals and budget.

Evolence is being advertised widely here in Knoxville. We have decided not to carry it in our office at this time. The main benefit of collagen fillers versus hyaluronic acid fillers is that patients may experience less swelling initially after collagen. However, the makers of Evolence caution against using Evolence in the lips as studies have shown that it can form hard nodules. We find that if our patients are likely to swell, they swell in the lip area.

We have been using Juvederm with great success since it originally came on the market. This year, the FDA confirmed our experience with the lasts longer than other hyaluronic acid fillers. And in many cases, based on new clinical data, it is lasting up to a year with a single treatment. Even better, Juvederm, in conjunction with Botox®, makes both products last longer.

In terms of the difference between Juvederm and Restylane, the hyaluronic acid in Juvederm is manufactured in a smooth gel versus a gel particle suspension in Restylane. This different formulation is providing our patients with a smoother, longer lasting correction. We also find our patients bruise less with Juvederm.

Another filler that you asked about is Prevelle Silk. Prevelle Silk is a new hyaluronic acid filler from Mentor Corporation, the company we use for our breast implants. It is different from Juvederm and Restylane because it contains lidocaine. Some patients find that's all the pain blocking they need depending on the area they are having treated. It's formulation is perfect for treating really fine lines. We are having great results using Prevelle Silk under the eyes. Because of its thinner formulation, Prevelle does not last as long as Juvederm or Restylane. Still, if you are on a budget or considering fillers for the first time, Prevelle is an excellent choice.

David B. Reath, MD
Knoxville Plastic Surgeon
4.9 out of 5 stars 108 reviews

New products - beware of hype

I agree with the other doctors.
What we have now - Botox, Restylane, Perlane and Juvederm family products - are great injectables and have a proved safety and efficacy track record. We know how long they last, we know they are safe, and we know whast to do if anything ever goes wrong.
I am skeptical about the new products.
Evolence is made from pig skin, and I feel in this day and age we don't need to resort back to using animal derived products.
Prevelle we tried in the office on several patients, and it went away in two-three weeks.
Elevess we were planning on trying, but several syringes that we had were cloudy and particulate. Since the insert states that the product should be clear with no particles, the quality of the product concerned me enough about that I decided not to inject it.
New products may be much cheaper for doctors to buy. Some of them may pass the savings on to you in terms of reduced price per injection, and some of them may be tempted to just make more profit. In any case, be careful and do your research, as always.

Stella Desyatnikova, MD
Seattle Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Not every "me-too" product is as good as the original, but some are better

It seems that every pharmaceutical company wants to get into the cosmetic injectable business these days. More and more fillers, trying to grab some of the business that Juvederm, Restylane and Radiesse have the lion's share of, are coming out now or in the near future.

Many are not improvements of what we currently have, however, and some are clearly inferior. My favorite fillers are Juvederm Ultra, Juvederm Ultra Plus, Radiesse and Artefill. These four fillers fill (no pun intended) all the needs that I treat patients for.

I keep an open mind to new fillers, but so far, nothing that has come out in 2008 has been worth getting excited about.

Next year, Juvederm should be coming out with a version containing lidocaine for anesthesia, that will probably be worth incorporating into my filler portfolio.

Lorrie Klein, MD
Laguna Niguel Dermatologic Surgeon
4.9 out of 5 stars 216 reviews

Choose a knowledgable and ethical provider to help you separate reality from hype

Advancing technology is a way of life, even in cosmetic medicine. Having said that, it can be very difficult for the layperson (and even the professional!) to separate hype from reality.

In general, I would stick to treatments that have a proven record of safety and efficacy. Newer treatments may offer additional benefits compared to older treatments, but in some (but not all!) cases these benefits may be unproven or there may be other drawbacks.

An honest and knowledgeable provider should be able to help you separate the reality from the hype.

Larry Fan, MD
San Francisco Plastic Surgeon
4.3 out of 5 stars 14 reviews

Ignore the early marketing and stick with proven injectables

In cosmetic medicine and surgery, you will find 90 percent marketing and 10 percent science. And the marketing comes before the science. So we don't know about the new products.

Evolence may have real promise, but I would not use it now except in a research study. The fact is, we do have excellent products like Botox and Juvederm right now that have strong science behind them.

Don't be the first to try out something new. Many new products and procedures fall by the wayside with experience.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

New Injectables - Reloxin vs. Botox

Prevelle is a hyaluronic acid based filler. It requires no down time and is very well tolerated. It is inexpensive in comparison to Juvederm and Restylane but not as long lasting. Prevelle is absolutely not a replacement for Juvederm but a nice option for first time users or people on a budget.

Evolence is a porcine (pig) collagen. There have been reports of lumps and bumps in the lips with this product.

Reloxin, a product similar to Botox will soon be available once it receives clearance from the US FDA. I have no doubt that there will be many doctors who will jump on the Reloxin bandwagon immediately so they can promote being one of the first to use Reloxin. I will not be among the first to use Reloxin. Botox is tried and true. I have been using Botox with success for over 15 years. Reloxin may prove to be very effective. However, I need to see a lot of evidence of efficacy before I abandon the gold standard for something new in widespread use.

Keep in mind that new is not always better. Take the safe approach and find a physician you trust who has extensive experience with cosmetic injectables and get his or her opinion on new products. look at the history of Artefil (Artecoll) and Radiesse (Radiance).

These were popular products at one time, and very popular with the media. One company is now bankrupt and the other seems to have fallen out of favor with physicians and consumers.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 120 reviews

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