Collagen & Fat Fillers
Collagen and fat fillers, also called soft tissue augmentation,
is a procedure that correct wrinkles, depressions in
the skin, and/or scarring. Fillers can also create fullness
to the lips and cheeks. The effects of gravity, sun
exposure and years of facial muscle movement may be
maintained using injectable fillers. The procedure involves
injecting a substance (collagen and/or fat) into the
skin area being treated creating a fuller, more attractive
appearance to the face. The most important fact to remember
about injectable fillers is that the results are not
permanent. The desired results may last anywhere from
a few weeks to indefinitely. Injectables are usually
not sufficient for severe surface wrinkles on the face,
such as multiple vertical "lipstick lines"
that sometimes form around the mouth. This procedure
may be performed alone or in conjunction with a resurfacing
procedure, such as a facial laser skin resurfacing,
or a recontouring procedure, such as a facelift.
Collagen s a naturally occurring protein that provides
support to various parts of the human body: the skin,
the joints, the bones and the ligaments. Injectable
collagen, patented by the Collagen Corporation under
the trade names Zyderm and Zyplast, is derived from
purified bovine collagen. The purification process creates
a product similar to human collagen. Injectable collagen
received approval from the Food and Drug Administration
in1981. It is produced in various viscosities to meet
individual patient needs.
Collagen is used primarily to fill wrinkles, lines
and scars on the face and sometimes the neck, back and
chest. Injected collagen and fat are primarily used
to improve the appearance of the skin's texture. They
can help fill out deep facial wrinkles, creases and
furrows, "sunken" cheeks, skin depressions
and some types of scars. They can also be used to add
a fuller, more sensuous look to the lips.
In the medical world, the fat-injection procedure is
known as autologous fat transplantation or microlipoinjection.
It involves extracting fat cells from the patient's
abdomen, thighs, buttocks or elsewhere and reinjecting
them beneath the facial skin. Fat is most often used
to fill in "sunken" cheeks or laugh lines
between the nose and mouth, to correct skin depressions
or indentations, to minimize forehead wrinkles and to
enhance the lips.
How is a collagen or
fat injection procedure performed?
Treatment with collagen can begin after a skin test
determines that you're not allergic to the substance.
The collagen is injected using a fine needle inserted
at several points along the edge of the treatment site.
If a local anesthesia has not been used, you may feel
some minor stinging or burning as the injections are
administered. Since part of the substance is salt water
that will be absorbed by the body within a few days,
your doctor will slightly overfill the area. You may
be asked to hold a hand mirror during the procedure
to help your doctor decide when you've had enough.The
FDA approved collagen injections in 1981. They have
proven to be a very popular nonsurgical cosmetic procedure;
see current American Society for Aesthetic Plastic Surgery
(ASAPS) statistics. Injectable Zyderm and Zyplast collagen,
natural substances derived from purified bovine (cow)
collagen, essentially replace the natural collagen that
the skin loses over time. Collagen injections are most
useful in the treatment of frown lines, "crow's
feet," and nasolabial folds (smile lines). To improve
deeper creases or enhance lip fullness, there also are
filler materials, such as soft ePTFE (expanded polytetrafluoro-ethylene)
that can be surgically implanted.
Technique: Collagen, which contains local anesthesia,
is injected with a tiny needle into the skin depressions
being treated. Several injections may be needed, depending
on the length and depth of the wrinkle. The procedure
for both injections and implants takes less than an
hour. Implantation procedures for the lips and nasolabial
areas are done with a local anesthetic. A tiny incision
is placed at either end of the site. Then the implant
is inserted and positioned. Incisions are closed with
After both the donor and recipient sites are cleansed
and treated with a local anesthesia, the fat is withdrawn
using a syringe with a large-bore needle or a cannula
(the same instrument used in liposuction) attached to
a suction device. The fat is then prepared and injected
into the recipient site with a needle. Sometimes an
adhesive bandage is applied over the injection site.As
with collagen, "overfilling" is necessary
to allow for fat absorption in the weeks following treatment.
When fat is used to fill sunken cheeks or to correct
areas on the face other than lines, this over correction
of newly injected fat may temporarily make the face
appear abnormally puffed out or swollen.Body fat makes
excellent soft tissue filler material. Fat injection
(also called autologous fat transplantation) transfers
fat from one part of the body to another to recontour
the face; diminish frown lines, crow's feet and nasolabial
folds (smile lines); and provide definition to areas
like the cheeks and chin. It can also be used to fill
out depressed scarred areas on any part of the body.
Fat injection is not permanent, and may require an effective
Technique: The donor site (for example, abdomen, buttocks
or thighs) and the treatment site are injected with
local anesthetic. Intravenous (IV) fluids also are injected
into the donor site to facilitate fat collection. Fat
cells are extracted through a small needle attached
to a syringe. The fat is then processed to remove excess
fluids and reinjected with another needle in multiple
thin strands in the desired area. "Overfilling"
is a necessary corrective due to fat absorption in the
weeks after treatment. Fat also can be harvested during
a lipoplasty (liposuction) procedure in one area of
the body, and then reinjected in another. For longest-lasting
effect, patients generally receive 3 to 4 treatments
over a six-month period.
How long does a collagen
or fat injection procedure take?
15 minutes to one hour per session.
What type of anesthesia
Because the anesthetic agent lidocaine is mixed in
with collagen, additional anesthetic is usually not
used. However, if you are especially sensitive to pain,
your doctor may use a topical cream anesthetic or a
Freon spray to numb the injected area. Or, you may elect
to have an injected local anesthetic or sedative drugs.
Both the donor and recipient sites are numbed with
local anesthesia. Sedation can be used as well. If you
elect to use sedation, be sure to arrange for a ride
home after your treatment.
Where is the procedure
Injectables are usually administered in a surgeon's
office-based facility. If, however, you are being hospitalized
for a facelift, necklift, browlift, or any other procedure,
your injections may be administered in the hospital
When can I return home
and resume normal activities?
You should avoid exercise or other strenuous activities
for 24 hours after your treatment. However, after that
time you should be able to resume your normal activities.
Speak with your physician about what he or she specifically
recommends for you.
How do I prepare for
a collagen or fat injection procedure?
During your initial consultation, your surgeon will
discuss the changes that you would like to make to your
appearance. Since the appearance of your face is a matter
of personal perception and preference, you will need
to discuss your concerns in detail so your surgeon can
determine the appropriate alternatives.
Prior to your procedure, the surgeon will perform a
complete health history and evaluate your face including
the skin, muscles and underlying bone. Knowledge of
your allergies, medications and previous surgeries should
be brought to your surgeon's attention at this time.
Collagen injections are generally off limits for pregnant
women, individuals who are allergic to beef or bovine
products, patients who suffer from autoimmune diseases,
and those who are allergic to lidocaine (the anesthetic
agent contained in the syringe with the collagen material).
Specific instructions to assist you in preparing for
this procedure will be given to you after the health
history and face evaluation is complete. Your experience
will be much smoother if you remain compliant with your
What precautions are
necessary during recovery?
Immediately following treatment, you may notice some
minor discomfort, stinging or throbbing in the injected
area. Occasionally some bruising or swelling will occur,
but it is usually minor. Any redness that appears in
the injected site usually disappears within 24 hours.
However, in some individuals, particularly fair-skinned
patients, this redness may persist for a week or more.
Tiny scabs may also form over the needle-stick areas;
these generally heal quickly. No bandaging is needed
and you are free to eat, drink, and wear makeup with
sun block protection shortly thereafter. There may be
some temporary swelling and redness in the treated area,
which should dissipate within a few days. If these symptoms
persist, contact your surgeon.
If a larger area was treated, you may be advised to
curtail your activity for a brief time. However, many
patients are able to resume normal activity immediately.
You can expect some swelling, bruising or redness in
both the donor and recipient sites. The severity of
these symptoms depends upon the size and location of
the treated area. You should stay out of the sun until
the redness and bruising subsides - usually about 48
hours. In the meantime, you may use makeup with sun
block protection to help conceal your condition. The
swelling and puffiness in the recipient site may last
several weeks, especially if a large area was filled.
What are the possible
complications after a collagen or fat injection procedure?
Allergic reaction is the primary risk of collagen.
To help determine if you are allergic to the substance,
your surgeon will perform an allergy skin test about
a month before the procedure. After the test is performed,
the test site should be watched carefully for three
or four weeks, or as long as your surgeon advises. Any
sign of redness, itching, swelling or other occurrences
at the test site should be reported to your surgeon.
Risks not necessarily related to allergies include infection,
abscesses, open sores, skin peeling, scarring and lumpiness,
which may persist over the treated area. Reports of
these problems are very rare. It is always important
to be informed about the possible complications before
any procedure. Be sure to discuss any concerns you may
have with your surgeon.
Allergic reaction is not a factor for fat because it's
harvested from a patient's own body. However, there
is still a small risk of infection and other infrequent
complications. Facial rejuvenation is very individualized.
It is always important to be informed about the possible
complications before any procedure. Be sure to discuss
any concerns you may have with your surgeon.
What results can I expect
after a collagen or fat injection procedure?
The most important fact to remember about injectable
fillers is that the results are not permanent. The body
eventually metabolizes the injected material. You should
not expect the same long-lasting results that may be
gained from cosmetic surgery.
In some individuals, the results may last only a few
weeks; in others, the results may be maintained indefinitely.
Researchers believe that age, genetic background, skin
quality and lifestyle as well as the injected body site
may all play a role in the injected material's "staying
power." However, the precise reason for the variation
of results among patients has yet to be identified.
If you've had short-lived results from fat injections,
you shouldn't necessarily assume that collagen injections
would work better for you. And, conversely, if you've
had disappointing results from collagen, don't assume
that injected fat is the answer. Although it's true
that some individuals' bodies are more receptive to
one substance than the other, others may find that neither
substance produces long-lasting results. Sometimes one
substance may work better than the other for a specific
problem. When injectables are administered by a qualified
plastic surgeon, complications are infrequent and usually
minor in nature. Still, individuals vary greatly in
their anatomy, their physical reactions and their healing
abilities. The outcome of treatment with injectables
is never completely predictable.
As stated earlier, the duration of results from collagen
injections is variable. Collagen's longevity depends
on the patient's lifestyle and physical characteristics
as well as the part of the body treated. In general,
the injected material is likely to disappear faster
in areas that are more affected by muscle movement.
Your doctor can help you determine how long you can
go between treatments to best maintain your results.
The duration of the fat injections varies significantly
from patient to patient. Though some patients have reported
results lasting a year or more, the majority of patients
find that at least half of the injected fullness disappears
within 3-6 months. Therefore, repeated injections may
be necessary. Your doctor will advise you on how to
maintain your results with repeat treatments.
Choosing the right surgeon
To obtain further information regarding Breast Asymmetry,
we advise you to consult with a qualified and experienced
board-certified plastic surgeon. Regardless of the type
of procedure you are considering, it is crucial to choose
the right surgeon for your individual goals. To receive
a complimentary consultation with a specialist in your
area, simply fill out our Online Referral
Form or call Toll Free 800.449.1884.