Some Theory: At the most superficial level in the skin is the most shallow wrinkle or line its depth of involvement is into the superficial dermis and will do well with a filler designed to be placed in the superficial tissues. The next level involves a mid-depth wrinkle going into the middle third of the dermis and will also do well with filler designed for placement at the superficial level of the dermis. After this we have the deep wrinkle and/or skin fold. This structure involves the deepest level of the dermis and will need a bulking agent placed into the deep dermis or into the subcutaneous tissues to affect change from a distance.
See an example of how lines form: (from www.restylaneusa.com )
See an example of how fillers work: (from www.restylaneusa.com )
Superficial agents are the group of fillers that are placed into the deep dermis and mid to superficial dermis. They are designed to affect change where placed. They are best used for mid-depth to fine wrinkles, the border of the lip, acne scar depressions, tear trough and crows feet.
Included in this group:
Restylane
Hylaform
Collagen
NOTE: SILICONE SHOULD NEVER BE USED
Bulking agents are the group of fillers that are placed to into the deep dermis and into the subcutaneous plane. They are designed to affect change at the surface from afar. They are best used for deep folds (Nasolabial and Marionette), hollowing, and atrophy.
They include all of the fillers in the Superficial group (but not vice versa) as well as:
Radiance
Fat
Alloderm
NOTE: SILICONE SHOULD NEVER BE USED
Dr. Andrew Klapper. Copyright 2007. All Rights Reserved.
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