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Are natural fillers like Restylane safer?

Posted:9:43 a.m. Friday, Aug. 8, 2014

By Anita Mandal, M.D.

Question: I’ve been getting Restylane™ and Juvederm™ in my hollow cheeks. I’ve read that Bellafill® lasts much longer. However, I prefer natural hyaluronic acid fillers like Juvederm. Isn’t it safer to inject a natural filler into my face?

Answer: There are many misconceptions about “natural” fillers. Some patients believe that hyaluronic acid or HA fillers like Juvederm, Perlane™ and Restylane are more “natural” because the HAs in these fillers are the same as the HAs produced by our own bodies. It’s important to realize that the HAs in these commercial fillers are not extracted from our bodies but are synthesized in factories.
A similar concept applies to the filler Radiesse™, which consists of calcium hydroxyapatite, a substance also found in our bodies. However, the calcium hydroxyapatite in Radiesse is not produced by our bodies. Unlike HA fillers and Radiesse, Sculptra™, which lasts longer, contains synthetic crystals which stimulate your bodies own natural collagen production. Bellafill®, which lasts even longer than Sculptra, contains synthetic PMMA crystals which also stimulates one’s own collagen production.
To summarize, the filling one gets from Sculptra and Bellafill® is primarily from our own body’s collagen. In contrast, the filling from Radiesse and HA fillers is from a synthetic substance that is not naturally produced by our bodies. Even the collagen injections of the past two decades typically came from bovine or cow collagen, not human collagen.
As we age, our bodies gradually lose the ability to produce as much collagen and elastin as we did in our 20s. To replace lost volume, either a filler that stimulates our own collagen above what our bodies can do on their own at a given age or a filler that contains substances that won’t immediately break down or react in our tissues is needed.
Careful consultation with a Facial Plastic Surgeon who has a thorough knowledge of surgical anatomy and is a skilled injector is the first step in determining the most suitable filler option for you.

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