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Facial Rejuvenation Rewind: the History of Injectables Recounted by Plastic Surgeon Dr. Henry Garazo

Injectable fillers, wrinkle relaxers continuing to change cosmetic surgery landscape

HAGERSTOWN, Md., Jan. 13, 2014 /PRNewswire/ — When the FDA approved the bovine collagen filler Zyderm® in 1981, a new era of cosmetic enhancement was born. For the first time, age-related changes could be treated without surgery, improving the appearance of wrinkles and restoring lost volume through a minimally invasive procedure.

Dermal (or wrinkle) fillers and wrinkle relaxers have revolutionized cosmetic medicine, says Dr. Henry Garazo, a leading Maryland plastic surgeon. Dr. Garazo has recently published an infographic on his website depicting the history of injectable products, including dermal fillers such as JUVEDERM® and Restylane® as well as wrinkle relaxers like BOTOX®.

"We're light years ahead of where we were with early collagen-based injectables from the 1980s," says Dr. Garazo. "For example, there are now several popular dermal fillers that not only plump the skin but also stimulate the body's production of new collagen, bolstering the skin's underlying structure. With the recent approval of a filler focusing on cheek augmentation—Juvederm Voluma™—the cosmetic improvements these products can provide continue to grow."

The use of injectables for facial rejuvenation has been an exciting development in the field of cosmetic surgery, allowing options for patients who had been unable to afford surgery or who were unable to commit to a surgical procedure. As shown in the infographic on Dr. Garazo's site, 21 different injectable products have been approved by the FDA, each with unique properties and benefits. Although the effects of all the products are temporary, the improvements from some can last as long as 5 years.

All Injectables Are Not Created Equal: Wrinkle Relaxers vs Wrinkle Fillers
Injectables fall into two distinct categories: wrinkle relaxers and wrinkle fillers. Dynamic facial wrinkles are formed through repeated muscle contractions, such as furrowing the brow or squinting. Wrinkle relaxers block the signals from the nerves to the muscles so they are temporarily unable to move, causing dynamic lines and wrinkles to then relax. BOTOX®, Dysport®, and Xeomin® are the three FDA-approved wrinkle relaxers, each containing botulinum toxin to block nerve impulses. BOTOX® received U.S. Food and Drug Administration (FDA) approval to treat frown lines in 2002 and has proved to be an extremely popular form of aesthetic treatment. BOTOX® injections were the number one non-surgical cosmetic treatment in the United States in 2012, according to the American Society of Plastic Surgeons (ASPS), up a staggering 680% since its introduction.

Like wrinkle relaxers, wrinkle fillers have dramatically expanded options for facial rejuvenation. With the FDA approval of the first hyaluronic acid (HA) dermal filler Restylane® in 2003, plastic surgeons have had an option for producing longer-lasting, more predictable results than earlier collagen-based products. The dermal fillers in use today are composed of a variety of different substances, including collagen, a protein found in the human body; hyaluronic acid, a sugar that occurs in the human body; calcium hydroxylapatite, a mineral found in human bones and teeth; poly-L-lactic acid, a synthetic polymer; and polymethylmethacrylate beads, a man-made polymer that does not degrade in the body.

Each year continues to bring new developments in the history of facial rejuvenation, says Dr. Garazo, offering expanded options for patients. He suggests consulting with a board certified plastic surgeon to determine which products might best fit an individual's needs, as well as to understand when a surgical solution might be more appropriate to meet a patient's aesthetic goals.

About Dr. Henry F. Garazo: Plastic surgeon Dr. Henry Garazo is board certified by the American Board of Plastic Surgery and has been selected as one of America's Top Plastic Surgeons by the Consumers' Research Council of America for five consecutive years. He practices in his hometown of Hagerstown, Maryland, at The Galleria, 1140 Conrad Court, Hagerstown, Md., 21740-5905. Reach him at (301) 791-1800 or www.plasticsurgeryservices.net.

Media Contact: Dr. Henry F. Garazo, (301) 791-1800 or www.plasticsurgeryservices.net