“In some parts of the world, cheaper—and obviously substandard—versions of the same neurotoxin have found its way into doctors’ supply networks.”
Thanks to their minimally invasive nature, relative affordability and convenience, injectable treatments have become the most popular cosmetic treatments worldwide. They are also valued for their versatility, which allows layering or combining different types of injectables, as well as their ability to complement results of surgical and other cosmetic treatments.
Posted: 18 June 13
By Louisa McKay
Injectables first gained a foothold in 1981 when treatments based on bovine collagen received approval from the US Food and Drug Administration. The next wave of injectables was made with human collagen. Over time, especially in the early 2000s, more and more types of injectables entered the market. Some contained neurotoxins previously used for medical purposes. Others used naturally existing substances that improved the appearance of the skin in one-way or another. As injectables became more popular, and both doctors and marketers learned from their mistakes, more and better injectables—some based on synthetic substances—entered the market.
What are the main types of injectables?
According to the US based Physician’s Coalition for Injectable Safety, injectables can be divided into four key groups:
- Wrinkle fillers
- Wrinkle reducers
- Fat injections
- Other injectables
Wrinkle fillers, or dermal fillers, contain substances that can restore a more youthful appearance to the ageing face. They can be used to fill in lines and wrinkles around the nose and mouth, enhance the shape and definition in the lips, chin and jawline and add volume or fullness to the cheeks, temples and under the eyes.
You will find a variety of wrinkle fillers in the market. They can be classified according to the substances they contain or by how long their results last. There are dermal fillers that produce temporary results, longer lasting results or permanent solutions. The duration of their effect varies depending on multiple factors, including the injection location, injection technique and the degree of correction that is achieved. Their effectiveness also depends on each individual’s body metabolism and how the body reacts to the injectable.
Temporary fillers typically contain naturally occurring substances found in connective tissue. Depending on the specific substances, the results from temporary filler injections can last from two to nine months.
Permanent and semi-permanent fillers are comprised of micro spheres suspended in a liquid or gel base and are usually used to correct deeper lines and creases. They can also restore lost volume in the face and hands. You can expect semi-permanent dermal fillers to produce results that last between 12 and 18 months. Permanent dermal fillers produce results that can last five years or even longer. Their ability to produce these results comes from the way the filler substance creates lasting or ongoing changes in the injected tissue.
Wrinkle reducing injectables, also referred to as anti-ageing injections or anti-wrinkle injections, are the reigning queens of the injectables arena. They contain a neurotoxin that blocks the nerve impulses that cause muscle contractions. In other words, they cause the muscles to relax. When the neurotoxin is injected into an area of the face, it effectively paralyses the muscles in that area that creates expression lines. In some cases, wrinkle reducers can also smooth out existing facial lines.
Effects from the neurotoxin only last a few months. Repeat injections are needed for continued results. Treatment over time can make the lines disappear completely, as unused muscles eventually lose their capacity to contract.
While anti-ageing injections have received approval from the US FDA and Australian TGA for injection between the eyebrows to remove glabella lines, they are commonly used off-label in other parts of the face and body. Off-label uses include injections for removing lines in the forehead, crow’s feet at the outer corners of the eyes and in the mid-chin area to remove a down turned mouth.
After choosing a qualified injector, make sure you know the brand of the injectable (there are only two brands currently on the market) and whether it has been approved by the TGA specifically for cosmetic purposes. You can always ask to see the packaging to verify the brand name and other details. In some parts of the world, cheaper—and obviously substandard—versions of the same neurotoxin have found its way into doctors’ supply networks.
Fat injections, also called fat grafting, use body fat extracted from one area of the body to create volume in another area. Sometimes fat grafting is used to enhance the lips, cheeks or breasts. Especially in older people, fat injections are used to replace the loss of fat volume that is part of the natural ageing process.
Fat injections are a natural and near permanent way of augmenting or enhancing soft tissue. The biggest challenge in fat injections is preventing the grafted fat from being absorbed instead of staying and growing where it is injected. Various techniques have been developed to minimise this reabsorption and improve the chance of permanent enhancement.
Usually the fat is extracted from the tummy, thighs, hips, buttocks or other fat-rich areas using liposuction. The removed fat is minimally processed to remove excess fluids and separate viable fat cells before it is reinjected in the area that requires enhancement. Fat from a liposuction procedure can be frozen and used it in later fat injections.
Fat injections can improve the appearance of limited areas such as the lips, or in much larger areas like the hands, cheeks, chin, buttocks or breasts. They can be performed on their own or combined with cosmetic surgery. Sometimes fat injections are used to improve or fine-tune the results of a previous procedure, like breast reconstruction, breast augmentation or rhinoplasty.
Make sure that your surgeon is an accredited professional with experience in fat grafting. It’s also important to ask how often the procedure is performed at the chosen facility, and what specific technology is to be used for liposuction and for processing the fat to be reinjected. You may also want to inquire whether any excess fat can be frozen for future fat injections.
Other injectable treatments include sclerotherapy, mesotherapy, fat-dissolving injections, cellulite injections and injection of the human growth hormone.
Sclerotherapy is used to treat visible veins and blood vessels. In many cases it is considered the standard method of treatment for spider veins.
Before considering other types of injectables you may want to know what the Physicians Coalition of Injectable Safety (PCIS) says about them.
According to the PCIS, neurotoxins, dermal fillers, fat injections and sclerotherapy are widely accepted as “cosmetic injectable treatments to enhance your appearance and improve the signs of aging. Other injectable treatments being offered to consumers today are not widely accepted and may not be TGA approved for injectable or for cosmetic purposes.”
Which injectables are right for you?
Which injectables are best suited for you depends on your cosmetic needs. Before agreeing to any procedure, discuss the available treatments with a qualified doctor, cosmetic doctor or dermatologist.
Is there a catch?
You bet. The results you get from any injectable treatment are directly related to the skill of the injector. So before you sign on the dotted line, make sure that the person on the other side of the syringe has the training and experience to do the job.
Once you have verified the credentials of your injector, you may want to find out more about the specific type of injectables he or she has recommended for you. Some questions you need to address: What is the brand? Has it been approved by the Therapeutic Goods Administration (TGA) for cosmetic purposes? Did the product come straight from the manufacturer or was it obtained elsewhere? It is also considered a fair and safety-conscious request to ask to see the packaging to verify the brand name and other details.
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