No Substitute for Cosmetic Injections
Popularity of anti-aging injections continue, as do false claims and risk
April 7, 2009 - There is no debating that despite the economy, women and men are still investing in themselves, particularly in appearance enhancing treatments that restore youth and erase wrinkles. While reports indicate retail buying and consumer spending has declined in recent months as much as 35%, statistics show that the demand for anti-aging injections like RestylaneÂ®, RadiesseÂ® or newly introduced EvolenceÂ® remain popular with nearly 4 million cosmetic injections procedures performed in 20081 by qualified specialists including plastic surgeons, facial plastic surgeons, oculoplastic surgeons and dermatologists. What is unknown is how many injections are performed by unqualified physicians or non-physicians, or how many injections are performed using imported, counterfeit or otherwise illegal injectable substances.
Author of The Botox Book2, plastic surgeon Michael Kane, MD of New York isn't surprised by the popularity of injectable anti-aging solutions. "People don't always have the time to take away from daily life to recover from surgery. They don't want a sudden change in appearance, but they do want to look younger and prevent aging," offers Kane. Sorting through the hyped and the proven non-surgical solutions to aging isn't however, easy. Experts in the field offer these 3 proven solutions:
Solution #1, Consult an expert: Injections can offer dramatic improvement and natural-looking results to make you look younger, but the visible outcome you achieve is highly variable based on your existing appearance and the skill of the physician who treats you. "For more advanced aging conditions injections may provide a limited outcome; options such as surgery may be more appropriate," says Dr. Kane. "A doctor who understands and regularly treats patients with both injections and with surgery can evaluate your conditions and make a recommendation personalized, and most effective for you. Injectors without expertise in facial anatomy, injectors who don't have a scope of training, understanding or expertise in all the options to treat aging conditions have a limited perspective. All too often, the result will be a very limited benefit to your appearance."
Solution #2, Don't accept substitutes: Brand names and FDA approval are two things every consumer should ask about before accepting an injection, says Dallas plastic surgeon Jeffrey Kenkel, MD. "There are a number of approved dermal fillers, injections that plump the skin or smooth creases, and several more brands in the pipeline," says Dr. Kenkel. To avoid confusion, ask your doctor, and do your own research. The current status of cosmetic injections in the U.S. is readily available at injectablesafety.org. In addition, Dr. Kenkel advises consumers carefully re-consider the investment in collagen-boosting and line-filling creams that offer very limited results lasting a few hours at best. "There are several FDA approved dermal filler brands including RestylaneÂ®, PrevelleÂ®, and RadiesseÂ® that plump from the inside out with proven results that last for many months. No cream can boast such consistent long-lasting benefit." Restylane, for example, is FDA to approved to last up to 18 months.3
Neuromodulators are drugs that moderate or temporarily interfere with nerve function. For those who want to look younger, this means that an injection can diminish the muscle actions that create lines on the forehead, around the eyes, and around the mouth according to Dr. Kane. "Injections can slow down aging in the people who aggressively squint and who dramatically lower and raise their eyebrows. By simply slowing these movements you both preserve natural animation and can prevent lines or delay sagging eyelids," says Dr. Kane. ReloxinÂ® is currently pending FDA review as the first neuromodulator designed specifically for cosmetic purposes, and although years down the road, there may be a true non-injection alternative. "I have been working with the RevanceÂ® corporation for several years to develop a topical means to deliver a neuromodulator painlessly and prevent wrinkles," notes Dr. Kane. Purely investigational to date, Revance topical toxinÂ® is currently in phase 2B of FDA clinical trials to assess its potential applications in cosmetic medicine. There is no other topical alternative to prevent expression lines from forming.
Solution #3,Take injections seriously: Injections may be categorized by many as beauty treatments, but first and foremost cosmetic injections are medical procedures. "Any medical procedure carries the potential for side-effects. You may not like the result, you may experience some bruising or swelling, but fortunately these potential events are lower than nearly any other medical procedure, when prescribed and administered by a qualified physician," says Dr. Kenkel. "Take treatment seriously, it's not something to do at a party, on vacation or at any other whim. Know the doctor who is treating you, establish a relationship that you trust so you know where to turn after treatment whether you have questions, concerns or to repeat the outcomes when it is time to refresh treatment." A recent study by the U.S. FDA demonstrates that the percentage of complications from cosmetic injections is .01%, or 1 in 10,000 procedures.
1 American Society for Aesthetic Plastic Surgery, Cosmetic Surgery National Data Bank, 2008.
2 Kane, Michael. The Botox Book, St. Marten Press, 2002.
3 Persistence and Improvement of Nasolabial Fold Correction with Nonanimal-Stabilized Hyaluronic Acid 100,000 Gel Particles/mL Filler on Two Retreatment Schedules: Results up to 18 months on Two Retreatment Schedules. Narins et. al. Dermatologic Surgery 2008;34:S2-S8. 4U.S. FDA Executive Summary, Dermal Filler Devices, November 18, 2008 (http://www.fda.gov/ohrms/dockets/ac/08/briefing/2008-4391b1-01%20-%20FDA%20Executive%20Summary%20Dermal%20Fillers.pdf)
The Physicians Coalition for Injectable Safety is an alliance of specialty physician organizations including the American Society for Aesthetic Plastic Surgery, American Academy of Facial Plastic and Reconstructive Surgery, the American Society of Ophthalmic Plastic and Reconstructive Surgery, the International Society for Aesthetic Plastic Surgery and the Canadian Society for Aesthetic Plastic Surgery. The mission of the Coalition is to provide the public with unbiased and necessary information on injectable cosmetic treatments, appropriate injectors and where to safely access cosmetic medical procedures. Our goal is to promote treatment supervised by properly qualified and trained, board-certified doctors and to promote only the use of U.S. FDA-approved, appropriately administered product. More information can be found at http://www.injectablesafety.org.