Ideal Dermal Filler Characteristics

Administration

• Basic administration
• Painless
• Outpatient (minimal recuperation)
• User-friendly
• Large amount available
• Easy storage

Material

• Non-allergenic (decreased risk of hypersensitivity)
• FDA approved
• Non-carcinogenic/non-teratogenic
• No migration
• Minimal inflammation
• No overt cutaneous change (undetectable)
• Reproducible
• Durable
• Minimal adverse sequelae
• Stable (inert)
• Affordable

Filler Material

There is an ever-expanding menu of materials and devices for soft tissue augmentation and they can be classified, based on either derivation or site of cutaneous placement. Autologous materials (adipose, collagen) are harvested from the same patient and hence have no risk of immunologic reaction. However they require an initial harvesting procedure and are limited by a potentially limited donor reservoir. Xenografts are semi-synthetic formulations harvested from a different species (bovine and porcine collagen, avain hyaluronic acid derivatives). These are readily available and carry a low risk of infection and rejection. Allograft materials are harvested from human cadaveric tissue, have a minimal risk of hypersensitivity reaction but pose a theoretical risk of infection from the donor tissue. While synthetic substances (expanded polytetrafluoroethylene) may provide longer lasting results and have an unlimited supply, they frequently require surgical insertion, as opposed to injection, and they may cause site-specific mechanical difficulties. The injectable collagen products meet many of the criteria of the ideal product for soft tissue augmentation as they are ambulatory, reproducible, predictable in their effect and FDA-approved, and they have an extensive safety profile.