Evolence: The New Filler in Town

Evolence was approved by the Food & Drug administration in late June 2008, and is now being rolled out across the nation. It is a porcine (pig) collagen based product which has been available in Canada and Europe for about 2 years. It is much longer lasting than the original bovine (cow) collagen or the human based collagen that is now available as well. It has a number of advantages and at least one significant disadvantage.

The original collagen product, Zyderm, was the first commercially successful filler. Zyderm was a very good filler in that it flowed very smoothly and could be used to sharply fill very narrow spaces, especially the space joining the pink part of the upper lip with the skin. Two disadvantages of Zyderm were potential allergic reactions, requiring skin testing prior to use, and its lack of durability. It tended to disappear in about 3 months. The problem of allergic reations disappeared with the introduction of human based collagen, but the short lifespan remained, and some felt that the human collagen did not perform as well as the bovine collagen.

Evolence has been approved for filling lasting 6 months, but it is seeking approval for a one year duration, and that appears to be accurate. The original version of Evolence was reported to have a somewhat lumpy flow pattern, but that appears to have been corrected. It is not allergenic, so no skin test is required. How well this fills, compared to the original collagen product, remains to be determined. One fact is clear. Evolence "sets up" quickly. If there is a lump, it must be massaged out within seconds, or it is there as long as the filler lasts. There is no way, other than excision, to reverse it. None of the other fillers have this characteristic, which makes this filler quite unforgiving.
Evolence does not attract water, as do the hyaluronic fillers, so there is less swelling associated with its injection. It also may be associated with less bruising than the hyaluronic acid fillers.
Evolence is clearly not a filler for beginning or unskilled injectors. Its place in the filler spectrum remains to be determined.

Gerald N. Bock MD
California Skin & Laser Center
Stockton & Lodi, CA

Comments

[Sasha]

I'm really eager to have it :)