Long Lasting Injectables: Biostimulators vs. Fat injections

Injectable materials have been around for years, but recently hyaluronic acid gels like Restylane® and Juvederm® and more recently Voluma® have taken the place of collagen and silicone injections.

  • Fat injections also have been around for years, but in the advent of the discovery of stem cells contained in fat, the technology in fat harvest and injection has advanced making them fat easier to harvest and more viable.
  • Biostimulators help encourage your own bodies collagen production in the areas of injection. These can produce a natural volume enhancement in larger areas of the face, as well can have positive effects on the skin.

The downsides to synthetic volume fillers like Juvederm® and Restylane® are that they are not permanent and expensive, though they are very reliable, safe and reversible. With most volumetric fillers there is no donor site as the syringes are pre-filled and contain lidocaine for comfortable injections.

Fat injections can be permanent but involve a donor site from which the fat is harvested and the fat take can be unreliable. Fat has been the topic of interest because of its high concentration of stem cells which have been controversial though beneficial in multiple areas of medicine. Stem cells are primitive cells that can differentiate into any type of tissue, though the problem lies in directing them to correctly differentiate. The fat cells can be injected into areas and act as a permanent, soft tissue filler. They have been applied in the face and lips with catchy terms as the “vampire facelift”, though more recently applied to the breast (natural breast augmentation) and buttock (brazilian butt lift). In all areas, the fat is somewhat unpredictable with a 50 to 70 percent take of the fat injections. In larger areas like the buttocks it is not noticeable though in smaller areas like the lips, it can cause noticeable asymmetries if not injected carefully.

What is a Vampire Facelift?

  • The term Vampire Facelift is related to the use of the bodies own growth factors found in blood. This has been in existence for centuries when ancient people found a benefit of applying animal blood to the skin. These growth factors are extracted from a your own blood by separating the blood cells from the serum which is often called “platelet rich plasma” or PRP. The PRP is injected into the subcutaneous tissue or applied after micro-needling with the thought of stimulating collagen through a concentrated growth factor solution.

Sculptra® or poly-L-lactic acid is a synthetic injectable which stimulates collagen growth under the skin which results in a gradual and natural volume increase in the areas of injection. It can be injected in the face for deep lines and wrinkles as well to improve the shape of the face.

  • Primary areas of injection are: the cheeks, the temples, and the jawline.
  • Other areas of injection can be in the backs of the hands to improve the volume in this area.

The component of Sculptra® is the poly-L-lactic acid which is biocompatible and biodegradable material which acts as a scaffold for which collagen is built up on. The injection technique is different from other volume fillers as Sculptra® is diluted in about 9 cc of sterile water/Lidocaine and is distributed in a more liquid phase than gel fillers. The advantage of it is it can cover a large area, as well gel fillers can be layered on top of the areas of injection for complete correction of fine lines. Sculptra® usually requires up to 3 sessions of injections spaced 6 to 12 weeks apart, however once complete the result is lasting and even overlying skin quality improves.

Sculptra® does not take the place of a facial rejuvenation surgery and should not be injected in the lips, though it can improve the appearance of a patient not ready for surgery or in areas where surgery does not correct the volume loss associated with aging, such as around the eyes and mouth.

Biostimulators and fat injections should be considered in any plastic surgery facial consultation with Dr. Trussler in Austin Texas. Sculptra® can be discussed as a valid option for facial rejuvenation.

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