SKINCARE
Alpha hydroxy acids
Ampoules & serums
Anatomy of the skin
Botox
Chemical peels
Cleansing basics
Cosmetic Surgery
Masks
Moisturisers
Non-surgical facelift
Skin analysis
Skin disorders
Treatment creams
Wrinkle fillers

BODYCARE
Aromatherapy
Massage
Reflexology

OPTIMAL HEALTH
Amino acids
Anti-oxidants
Homeocysteine
High protein diets
Know your fats
Nutrition
Tissue salts
Vitamins & minerals
RDA vs ODI

GENERAL
About me
Articles of interest
Effects of the sun
Fact or fallacy
FAQ's
Newsletter
Products & Prices
To take or not to take
In my humble opinion

THE PERFECT WRINKLE FILLER - IS THERE ONE?

From implants and injections to lotions and potions. They all claim to fill those dreaded lines on our face but what's the difference and which one is right for you?

Ageing is a fact of life however, it is not age itself that bothers people, but rather the visible signs of ageing that can make us feel old. The health of our skin – whether on our face or on our body - plays a huge part in how old we feel and is seen as the most common indicator to others of our age. As the body’s largest organ, skin is hugely influenced by our body’s general well-being – if our body is not healthy, this is often reflected by our skin.

UNDERSTANDING THE SKIN
First we need to understand how wrinkles are formed before we try reduce them. [See also 'Anatomy of the Skin']

Skin is held tight and smooth by three main critical components: Collagen (dense fibres for strength), hyaluronic acid, and elastin (elastic fibres for suppleness). These chemicals combine to create a firm, spongy meshwork under the skin surface. This elastic structure keeps the skin surface smooth and firm.

As a person ages, the epidermal cells become thinner and less sticky as the rate of cell production slows. The thinner cells make the skin look noticeably thinner (older skin is often described as being more 'papery').
The decreased stickiness of the cells decreases the effectiveness of the barrier function allowing moisture to be released instead of being kept in the skin. This causes dryness and can make skin more prone to dehydration related conditions such as roughness and itching.

The effects of aging on the dermal layer are significant. Not only does the dermal layer thin, but also less collagen is produced, and the elastin fibers that provide elasticity wear out. With this lower level of elastin and collagen, skin ultimately yields to the forces of gravity, causing sagging and drooping.

Also, sebaceous glands get bigger but produce less sebum, and the number of sweat glands decreases. Both of these changes lead to skin dryness.

The fat cells in the subcutaneous layer give skin a plump appearance but, with age they begin to get smaller and disappear, the epidermis starts to sag, and wrinkles form.

Whilst these effects are likely to happen to all of us, the speed and extent to which skin ageing occurs is only partly influenced by genetic factors. Far more significant influences on ageing are lifestyle factors.
Skin enemy No.1: The sun. [See also 'Effects of the sun']

INJECTABLES AND IMPLANTS

We've been searching for the perfect wrinkle filler for ages. For over 30 years, injectable fillers and implants have been widely used to "replace" the collagen your skin loses over time. These injections and implants are placed just beneath your skin where your body accepts it as its own.
Remember there is always an exception to the rule and so some fillers can cause an allergic reaction.

Injectable fillers and soft implants are performed on an outpatient basis. Filler injections, sometimes referred to as a “lunchtime” procedure, usually take less than twenty minutes of your time. Filler injections are relatively painless and are performed with a local anesthetic. They are injected under your skin, beneath the wrinkle, through tiny needles. Several injections may be required, depending on the depth and length of the wrinkle.

Soft implantation procedures for lip augmentation or to fill nasal labial areas are done under a local anesthetic. A small incision is placed at either end of the treatment site. Then, the implant is inserted through the incision and gently positioned. The incisions are closed with a suture. The procedure takes about twenty to thirty minutes.

The current trend tends towards fillers produced from a crystal-clear gel form of hyaluronic acid, a sugar that occurs naturally in the body.

Collagen is the oldest and best-known cosmetic filler. Newer natural and synthetic products are available, each with its own advantages and disadvantages.

Bovine Collagen Fillers
Bovine collagen is processed from the skin of cows. Approved in the 1980s as a wrinkle treatment, bovine collagen is still in wide use as a cosmetic filler.
Bovine collagen is effective, and less expensive than other treatments. It can cause allergic reactions, so allergy skin testing is generally done before beginning the injections.
Collagen injections are usually broken down naturally by the body. Injections need to be repeated two to four times per year to maintain results.

Human Collagen Fillers
Human collagen, mass-produced from cultures of human cells, became available in 2002. Human collagen causes dramatically fewer allergic reactions, so skin testing is usually not needed. It is more expensive than bovine collagen, and injections also need to be repeated every three to six months.

Hyaluronic Acid Fillers
Hyaluronic acid is a naturally occurring polysaccharide (chain of sugars). It's a normal part of the support structure under the skin. Age depletes hyaluronic acid in the skin, but injections can replace it.
Various natural and synthetic hyaluronic acid (HA) products are available. In the newest products, the HA molecule is modified to break down more slowly. Cosmetic results can last nine months or longer. Allergic reactions are very rare. In my opinion, if you're going for fillers, this is the one to go for. Most commonly used/recommended filler in this catagory is Restylane™ - see below.

Fat Transfer (Microlipoinjection)
Ever wish you could move that fat from your thighs to somewhere it might look a little better? Fat transfer, also called microlipoinjection, is one of the safest wrinkle treatment methods available because it uses the patients own fat. In the procedure, the doctor draws a small amount of fat from the thigh or buttocks with low-power liposuction. The doctor then injects the fat into the targeted facial areas. The procedure can provide very long-lasting results. While a large amount of the fat may be reabsorbed by the body within several months of the procedure, as much as a third of the total injected volume can remain in the body for years.

Poly-L lactic Acid (Sculptra) Fillers
When injected under the skin, poly-L lactic acid (PLLA) stimulates skin cells to make collagen. Poly-L lactic acid is nontoxic, and has been widely used as a component of suture material for years.

PLLA is FDA-approved for cosmetic treatment of certain skin conditions in HIV patients. It is often legally used "off-label" to treat wrinkles in otherwise healthy people. It's considered "semi-permanent," meaning results can last for months to years.

Calcium Hydroxyapatite (Radiesse) Fillers
In 2006, the FDA approved calcium hydroxyapatite for cosmetic injection. This cosmetic filler is made of the minerals that give bone its strength and texture. These minerals are ground into tiny particles and suspended in water solution, which is injected under the skin.
In the trial that led to its approval, calcium hydroxyapatite worked significantly better and lasted longer than collagen injections to reduce severe wrinkles.

Polymethyl methacrylate (PMMA) Fillers
Polymethyl methacrylate is a new, permanent cosmetic filler. PMMA has been used for decades as a cement for bone surgery and in the making of dentures, and was recently FDA-approved as an injectable cosmetic filler.
In cosmetic surgery, tiny PMMA microspheres suspended in some biological fluid or bovine collagen are injected under the skin to reduce wrinkles or scars permanently.
Artecoll® uses PMMA microsperes suspended in bovine collagen. It is necessary to establish allergic reactions to bovine collagen before undergoing this treatment.
Although PMMA is biologically compatible, MMA is considered to be an irritant and a possible carcinogen.
Personally I'll leave the cement for the bricks in my house.

No downtime
Injecting fillers into the grooves of wrinkles on the face at a superficial level can do much to decrease the signs of facial ageing. The procedure takes a few minutes and the patient can return to work – even though the injected site might be a little red and puffy for a few hours. The mild swelling is usually gone within a day or two.

Treatment, effects and side-effects
An HA filler is injected into the wrinkles and holds shape for 6 - 12 months. More viscous products, used for deeper wrinkles and folds, can last up to 18 months.
After the treatment, some common injection-related reactions may occur, such as swelling, redness, pain, itching and tenderness at the implant site. These typically resolve spontaneously a few days after the injection.

Other types of reactions are very rare, but about 1 in 10 000 treated patients experience localised inflammatory reactions of a hypersensitive nature.
These reactions either starts a few days after injection or after a delay of two to four weeks, and are generally described as mild to moderate and self-limiting, with an average duration of two weeks.

Choose the best surgeon
If you're thinking of undergoing a treatment, it’s a good idea to choose a reputable surgeon who will give you a clear idea of the treatment and how it works. Costs vary from doctor to doctor and remember, this is your face we're talking about, so don't count your pennies when looking for a good surgeon.

Contact a reputable surgeon or doctor in your area. For more information, visit the Association of Plastic and Reconstructive Surgeons of South Africa’s website.

MY FILLER OF CHOICE
Hyaluronic Acid (HA)
A substance found in the connective tissue of the body that cushions and lubricates. Hyaluronic acid also provides volume and fullness to the skin. Hyaluronic acid exists naturally in all living organisms and is a universal component of the spaces between the cells of body tissues (extracellular space). It is a polysaccharide that has an identical chemical structure whether it is found in simple bacteria or in human beings. HA can be found in many places in the human body, including:

1. The skin, where it creates volume (without HA, the skin would appear dry, withered and wrinkled)
2. The vitreous body, where it gives volume and shape to the eyes
3. The cartilage, bone and synovial fluid, where it acts as a lubricant, shock absorber and filter, amongst other things
4. Blood vessels
5. The umbilical cord, for lubrication and strength.

Function in the skin.
Hyaluronic acid plays a vital role in connective tissues such as the skin. The dermis of the skin comprises a network of collagen fibres within an interstitial substance composed largely of hyaluronic acid. The elastic properties of hyaluronic acid offer resistance to compression, so that the skin protects underlying structures against damage. At the same time, the non-Newtonian properties of hyaluronic acid allow the collagen fibres to move easily through the interstitial substance. This lubrication by hyaluronic acid allows the skin to accommodate the changes in shape and volume that occur when the underlying bones and joints move.

The hyaluronic acid gel in the skin also inhibits movement of foreign particles, such as bacteria. This makes an important contribution to the skin’s defensive function as a barrier to infection. The barrier also affects the free passage of other exogenous material, such as some drugs. This is the reason why some subcutaneous injections and drugs in creams or ointments include a small amount of the enzyme hyaluronidase. The enzyme degrades the hyaluronic acid gel around it, so that the drug is able to pass more freely through the tissues of the skin.

When we get older, the amount of HA in the skin diminishes as the skin cells lose their ability to produce hyaluronic acid. In addition, the molecular weight of the HA is decreased with age, so that it does not hold water as well as before. This can be demonstrated by squeezing the skin between the fingers. In young people, the skin rapidly restores itself to its original volume. However, as we get older, the skin’s ability to restore itself is reduced.

Restylane is a brand name of a synthetic form of Hyaluronic acid. This substance is identical in all species and tissue types, unlike collagen which differs between man and animals. Hyaluronic acid is present in all living organisms. It is a simple organic chemical that forms up into long threads. These tangle together and act like a sponge. It is the main ingredient in mucus after water. In the skin it creates volume, and is used to fill out folds and wrinkles. Restylane is a stable, bio-degradable, non-animal hyaluronic acid. It is produced under carefully controlled conditions in Sweden. It is a clear viscous gel. Local tolerance to the gel is excellent, with the material becoming absorbed into local tissues. The material is slowly metabolised and excreted by the same pathways as natural hyaluronic acid.

SANS SOUCIS
RenovAgeStop SH 1/10 contains Super Hyaluronic Acid, pearl extract and the new ingredient Renovage. Sans Soucis is the first house in the world to use this sensational new anti-ageing ingredient, and the first in Europe to use Super Hyaluronic Acid. Think of tomorrow‘s skin today – with RenovAgeStop SH 1/10, you can make sure your skin stays beautiful today and in the future!

* RENOVAGE helps prolong the life of skin cells
* Enhances skin cell function & stimulates skin metabolism
* Improves elasticity and firms tissue
* Extensively counteracts signs of skin fatigue
* Stabilizes the skin lipid and moisture content
* Softens and helps prevent lines and wrinkles
* With SPF 10

RenovAgeStop SH 1/10 24-hour Hydro Serum for all skin types - The refreshing hydro-gel reduces lines and effectively counteracts wrinkles caused by dry skin. With strengthening DermaxylTM, firming wheat protein and RENOVAGE in twice the concentration of the 24h care product. The new RenovageStop Serum is a must if you're 'dried out' after winter. Take 5 years off your face by getting rid of those fine dehydration lines.

RELATED ARTICLES:
Injectables and skin fillers - From A - Z
Anatomy of the skin
Alpha & Beta hydroxy acids
Botox
The Peel Appeal - all about chemical peels
Cosmetic Surgery - Is it for you?

Back to top