FACE lifts may be a thing of the past. Youth is just a painless shot away. Along with collagen and the recently US FDA-approved fillers including Hylaform and Restylane, a slew of new fillers - some which last years instead of months - are being investigated both here and abroad, says Dr Sandhya Shetty, dermatologist.

"Wrinkles result from the loss of three skin components: Collagen, hyaluronic acid, and elastin," Dr Jamuna Pai explains. "Today, we can replace two of these components (collagen and hyaluronic acid) that are lost as skin ages," she says. "While there are no elastin fillers, some products are being developed that may stimulate elastin," she adds.

Take A Lift

The latest derma product to hit Europe is called Juvederm, a new filler that doctors claim lasts longer than Restylane. Like Restylane and Hylaform, Juvederm is also made from hyaluronic acid and is injected with an ultrafine needle, but the product itself comes in the form of a gel. You not only get a plumping effect but also a lift! Although trials have begun, Juvederm still hasn't been approved in the US; but it's already popular in Europe.

Dermatologists in France claim this filler causes less tissue injury, less inflammation, and fewer damaging free radicals when compared with other fillers. Free radicals break down hyaluronic acid, so the results of Juvederm may last longer (up to 15 months).

Jump Start Your Skin

Another type of filler, called Sculptra, is known as a dermal stimulator because it stimulates the skin's dermis layer to make more collagen. An advisory panel to the US FDA has recommended approval of this product for use as an injectable filler to reconstruct HIV patients suffering from loss of facial fat that makes them appear ill. This is a common side effect of some medications used to treat HIV. Sculptra does not offer immediate gratification. "It provides a slow correction as it is injected and gets the skin's fibroblast cells to make more collagen," explains Dr Shetty.

"There is no immediate difference. You have to wait for the product to work, and it can take about a week," she says. Currently, people receive this treatment once a month for four months, and the results can last up to two years.

"If you use it in combination with hyaluronic acid and collagen fillers, it would solve the problem of no immediate gratification," she adds.

Another filler in the pipeline is Artecoll. Made from a mixture of small microspheres of a chemical called polymethymethacrylate, or PMMA, and collagen, it enhances the tissue under the upper layers of skin, ironing out wrinkles. "It's supposed to last three to four years and obviously is one of the more expensive treatments," says Dr Shetty. "And although it's been approved in Canada, doctors have noticed side effects," she adds. Some women who underwent the treatment developed long-lasting granulomas, a solid group of inflammatory cells that sometimes form a visible lump under the skin.

Radiesse is another long-lasting injectable filler. Made of tiny microspheres of calcium hydroxyappetite, the same mineral that makes up bones and teeth, it is said to have been initially developed to treat vocal chord paralysis. But soon, scientists found that it works well as a wrinkle filler. Manufacturers claim it can last anywhere from two to five years.

Looking to the future of wrinkle fillers, Dr Jamuna Pai says, "The best filler is one that is long lasting, but not permanent. You don't want one that lasts more than three to five years because as people age, your skin thins out and features change, and you might begin to see lumps and bumps and mounds of tissues."

"These fillers work great alone, but the trend seems to be to use them in combination," says Dr Shetty, predicting future tastes.