April 6, 2009 — Doctor Simon Ourian, Medical Director of Epione Beverly Hills, located in the exclusive shopping, restaurant and hotel enclave in Los Angeles, California knows all about dermal fillers. Year after year he is one of the leading injectors of dermal fillers and Botox Cosmetic in the United States. He knows this because the manufacturers tell him so. More than ten years ago Doctor Ourian opened his practice in Beverly Hills devoted exclusively to injectables and other minimally invasive cosmetic treatments.
“There are two types of wrinkles, ” explains Doctor Ourian, “dynamic wrinkles and static wrinkles. Dynamic wrinkles happen when we use our facial muscles to frown or to smile. Crow’s feet are an excellent example of dynamic wrinkles. Botox is the treatment of choice for dynamic wrinkles. A static wrinkle can be seen when the face is at rest. These often occur in the nasolabial folds. The main purpose of dermal fillers is to correct static wrinkles though I find they are an excellent tool for treating acne scars.”
For most people, both men and women, aging is the cause of static wrinkles: as we age there is a natural loss of elastin, collagen and hyaluronic acid in the skin. These elements provide structure and volume for the skin. The most common dermal fillers are:
Collagen: Trade names include CosmoDerm, Cosmoplast (human collagen), Zyderm, and Zyplast (bovine collagen). Due to the risk of an allergic reaction, collagen products typically require a skin test prior to treatment. “Collagen was the first dermal filler I worked with”, says Dr. Ourian, “but I think the drawbacks outweigh the benefits.”
Restylane: Manufactured by Medicis Pharmaceutical Corporation, Restylane is made from hyaluronic acid, one of the structural components of skin noted above. It is considered a semi-permanent filler and will last six to twelve months. Medicis claims that Restylane is the best selling dermal filler in the world.
Juvéderm: Manufactured by Allergan, Inc. (the makers of Botox) Juvéderm is also a gel made from hyaluronic acid. According to Allergan’s website Juvéderm is the ONLY hyaluronic acid (HA) filler FDA approved to last up to 1 year and is the first hyaluronic acid dermal filler that the Food and Drug Administration (FDA) has approved as being safe and effective for persons of color.
Radiesse: Manufactured by Bioform Medical Inc. Radiesse, formerly known as Radiance, is composed of calcium based microspheres suspended in a water based gel. According to the manufacturer Radiesse stimulates the body to produce new collagen in a process called collagenesis. Bioform has clinical data to support their claim that Radiesse may last more than two years.
“What is the best dermal filler?” asks Dr. Ourian. “The one that, in my medical opinion, is most suitable to meeting my patient’s aesthetic goals. I don’t use a cookie cutter approach; I examine each patient, discuss their needs and goals and make a recommendation based on my ten plus years of experience, it’s a collaborative process.”