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.

One Filler Down

We are used to hearing announcements for new fillers, but we now have an announcement of the disappearance of an FDA approved filler. Artes Medical, the company that makes Artefill, announced its intention to file for bankruptcy. Artefill was the first "permanent" filler approved in the US, although silicone, now available in a medical grade, has been used off-label for this purpose.

The Lure of the New

New fillers are in various stages of development. Each new filler has to establish a niche for itself, to be able to differentiate itself from the already well established fillers. Evolence, which has recently been approved in the US, is the newest of the collagen fillers.

The Secrets of Natural Looking Filler

As the use of fillers becomes more prevalent and the uses of fillers more widespread, the goal of creating a natural look with fillers has become increasingly attainable. We now know that the best use of fillers is the replacement or creation of volume, rather than the simple filling of lines and grooves. Most people want to look better and younger, rather than look like someone else. Therefore, it is a good idea to have an idea of what is the goal that you're aiming for.

Six-inch Heels

As you may have read, the hottest fashion item this Fall is six-inch or higher heels. They have thick soles as well and make the wearer look more like a superhero than a dainty woman. At the Prada 2009 fashion show in Milan in September, two models tripped and others staggered. Reportedly models were crying in fear, backstage.

The Filler as Time Bomb II

Below is an email received today relating a patient's experience with Sculptra. Next is a follow-up email.

Dear Dr. Bock,

Is there any procedure that you may be aware of to remove these horrible "foreign body objects" per the dermo who saw me after the plastic surgeon got done with me.

They appeared five months after my first Sculptra treatment.  They are underneath both eyes.  Seems they were caused by my "normal healthy" reaction to having three Sculptra injections (Sculpta sounds so much nicer than Polylactic Acid, a better ring).

I'm not an HIV male, just an under-informed and angry (just what I don't want to be) in shock female who remembered when doctors seemed to help not harm.

ps:  The Plastic Surgeon did however manage to easily remove $5000 from my wallet but can't do a thing about removing these scars.  Sorry about my tone.  Truly any safe corrections you may know?  Of course, I also had zero results of any increased volume.  Guess I have "faulty collagen" too boot!  Who knew...

Thanks much for coming out against this product that should should never have been allowed on the market in the first place.

There should be more docs like you who just say no to this scam.

The King of Fillers?

In the June 2008 issue of Dermatologic Surgery there was a review published of the results of the use of Radiesse in 1000 patients, over a 52 month period. The results were remarkable because of the durability of the effect, and the relative lack of problems.

Fillers: How Long Do They Last

When patients come to the office for filler injection, they frequently ask how long the correction can be expected to last. This is a reasonable question and should be able to be answered in a straight forward manner. However, the answer is more complicated than it seems, and new information is further clouding the picture.

What's New in Fillers

There are a great number of fillers available, many of which are not currently approved in the US. The next major new filler scheduled to be approved is Evolence, a porcine derived collagen which was developed in Israel. The advantage of the original bovine collagen filler was its very smooth flow. Disadvantages were its short duration of effect and the need for a skin test. Evolence is said to persist  for a year but, unfortunately it appears to lack the smooth flow of the  earlier collagens. It does not require a skin test.  The company has  introduced a second generation product, Evolence Breeze, which may overcome some of the shortcomings of the original product. Until it is released, it remains an unknown.      

Cosmetic Fillers: How long do they last?

Collagen was the first of the fillers approved for human use. It had many desirable  characteristics and was especially valued for its smooth even flow. Because it was derived from cow hides and could occasionally produce allergic reactions, a skin test was required. However, the major shortcoming, the one that lead to the search for other filer materials, was its short lifespan.