Dan's Papers - October 30, 2009 - Raving Beauty

Remember collagen injections? Before using collagen as a filler for nasolabial folds (those two lines - or folds, depending on how deep yours are - that run from the sides of the nose to the top of the lips), first you had to be tested to see if you were allergic. Most collagen came from cows (thus the term "bovine collagen"), and some women who were allergic were able to use collagen from cadavers. Both options seem equally unappealing, particularly now that there are so many injectables with lovely-sounding names such as Radiesse®, Restylane® and Juvéderm™.

They all do the same thing and they don't require allergy testing. They act as fillers for fine lines, folds and wrinkles, not only in the nasolabial folds, but also for the vertical lines around the lips. They can also be used to plump the lips. While each of these fillers erases folds and lines, most differ in how long their results last.

There is another injectable that promises to actually rebuild collagen. The product is Sculptra™, a synthetic material not made from human or animal sources. The main ingredient is Poly-L-, a derivative of the alpha hydroxy family. Sculptra has been approved since 1994 for treatment of facial wasting in HIV patients, but this year it received approval for cosmetic use.

I spoke to Jeanine B. Downie, M.D., a board-certified dermatologist in both New York and New Jersey. Her private practice, Image Dermatology, is located in Montclair, New Jersey. Dr. Downie is frequently featured on the "Today" show, "Good Morning America," "The View" and many other national TV shows. She said, "I have been using Sculptra cosmetically since 2004." According to Dr. Downie, the product is gaining popularity. "It works best on sagging skin," she said. It is also used around the temples and where hallowing tends to show age. Most remarkably, Sculptra can be used in the hands, which seem to age faster than the rest of our bodies due to sun exposure and working conditions.

All doctors have different fees, but Dr. Downie charges $1,000 per vial. Typically a patient is injected once a month for three to six months. Results usually last two years.

Unlike Radiesse, Restylane and Juvéderm, which are generally used for fine lines and folds, Sculptra can be used for larger areas of the face. It can define cheekbones, build weak chins and fill in hallows underneath the eyes.

If there is a buzzword in beauty, it is volume. We want volume in our hair, our eyelashes, our breasts and even our butts. Full is glamorous, full is youthful. One of the causes of aging in women is the lower level of estrogen. Estrogen not only keeps us fertile, but also keeps us looking young. I remember my grandmother touting the benefits of hormone replacement therapy after menopause. Today, however, we know better, and most physicians agree the risks outweigh the benefits.

If you want to do more than fill a fold or freeze a brow with Botox, you might consider Sculptra. Like any injectable Dr. Downie told me there are some risks (like bruising at the injection site). But the procedure is safe when performed by a qualified, board-certified dermatologist.