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    What's New With Dermal Fillers

    In the beauty section of the Los Angeles Times,a recent article discussed how lines develop from not only sun exposure and aging but from animation. It talked about the treatments to deal with these lines. Botox and Dysport paralyze certain facial muscles and prevent the contraction that causes creases. We have a variety of fillers to plump the hollowness and grooves.

    There have been some recent additions, including Juvederm XC and Hydrelle, which contain local anesthetic to help reduce the pain during injection. However, I will tell you that it takes a bit long for the painkiller to take effect and by that time, the piercing of the skin is done.

    Recently, there has been some interest in stem cells that would augment fat transfer into the face.

    The article mentioned that “fatty tissue has the highest percentage of adult stem cells of any tissue in the body,” and that, “adipose (fat) stem cells have the capacity of cell memory, especially in the use of re-volumizing the face.”

    My impression is that fat transfer is still not the preferred method because of the inconsistent results. Sometimes the fat can shrink. Sometimes it can get lumpy and that’s not what patients want. I prefer the man-made injectables because they have a very low incidence of lumps, bumps and reaction. If they were  to cause any trouble, the filler will dissolve and disappear within several months.

    One of the doctors quoted in the article said, “The difference between looking naturally beautiful and looking like a chipmunk is all in the technique.” I wholeheartedly agree. The art form is as important as the product. Technology alone is not enough to overcome lack of talent and judgment.

    - Robert Kotler, MD, FACS

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