Brand name: Silikon
Major risks: Allergic reactions can occur. It can have a hard feel under skin, and may look lumpy or uneven under the skin.
Stability: Because migration and lumping can occur several years after having the injections, its stability is questionable.
Liquid injectable silicone is a permanent soft-tissue filler that is injected into wrinkles to produce fibrous tissue and a gradual increase in volume. Use of large quantities of impure silicone has led to a number of serious complications, including migration of the product, deep tissue infection, cellulitis, and even death. Use of small amounts of pure liquid silicone, via the microdroplet technique, is thought to have a low complication rate (less than 1%). However, lumps can occur weeks to years after treatment.
(Sources: Plastic and Reconstructive Surgery, December 2007, pages 2034-2040; and Journal of Plastic, Reconstructive, and Aesthetic Surgery, January 2007, pages 11-18.)
Sculptra/Newfill
Brand name: Sculptra (called Newfill in Europe)
Major risks: Similar to all dermal injections, but it is unlikely to cause an allergic reaction so no skin test is required prior to treatment.
Stability: Benefits can last between one to three years.
Sculptra is the trade name for the dermal filler poly-L-lactic acid. It differs from all other agents in several aspects. Poly-L-lactic acid is a synthetic but also is a biodegradable, biocompatible, immunologically inert peptide polymer that is believed to stimulate fibroblasts to produce more collagen, thus increasing facial volume. In the United States, poly-L-lactic acid is only FDA approved for the treatment of HIV-associated fat loss, which makes the face look gaunt and haggard. It is also routinely used off-label for the correction of skin folds such as the lines that run from the nose to the mouth. It is approved in Europe for filling wrinkles. Sculptra’s main limitation is that two to three treatments are needed to achieve results and they need to be done four to six weeks apart.
Use of Sculptra on the hands has increased; unfortunately, however, the incidence of nodules in this location may be as high as 10% and the nodules are often visible, unsightly, and difficult to treat.
(Sources: Journal of the American Academy of Dermatology, December 2008, pages 923-933; and Journal of Cosmetic and Laser Therapy, March 2008, pages 43-46.)