Collagen injection

Definition

Collagen injections are a most frequently cosmetic procedure in which bovine or human collagen is injected into the face to temporarily reduce wrinkles , create fuller lips, or improve scar tissue.

A woman is having a collagen injection in her face to remove wrinkles and improve her skin tone. (Laurent / Photo Researchers, Inc. Reproduced by permission.)

Purpose

Most collagen injections are performed for cosmetic reasons, and do not serve a medical function. However, many individuals choose to have them performed to improve appearance, which can improve self-esteem and improve quality of life for some people.

Collagen injections are commonly used to decrease the appearance of fine lines and wrinkles of the face, such as laugh lines and crow's feet. They can also occasionally be used to improve the appearance of wrinkles in the neck. Collagen can also be injected into the lips to give the lips a plumper, fuller appearance. Acne and scarring of the face can also be treated using collagen injections. Cheeks that have a hollow or gaunt appearance can be made to fuller and more healthy using collagen injection.

Precautions

Although significant side effects rarely occur due to collagen injection, taking certain precautions can help to avoid serious complications. Some people are allergic to the bovine (cattle) collagen that is used most frequently for the procedure. The doctor should perform a test on the patient to ensure that bovine collagen can be safely used before the procedure. It is estimated that as many as 7% of people may be allergic to bovine collagen. Individuals who are taking certain medications or supplements may be required to stop taking the medications for a certain amount to time before the procedure to help reduce the risk of bleeding and to minimize swelling. Individuals with rheumatoid arthritis or other connective tissue problems should not have bovine collagen injections. Women who are pregnant or breastfeeding should not have collagen injections.

Description

As an individual ages, many of the substances in the face such as collagen and fat break down and are not replaced. The elasticity of the skin also decreases over time. This leads to a loss of material under the skin of the face. As this material decreases folds, lines, and wrinkles are created. Collagen can be injected directly into these areas to provide plumpness under the skin, raising deep lines and reducing wrinkles. In the same way collagen can be injected into the lips, increasing the material in the lips and gibing them a fuller, smoother appearance.

Collagen injections are generally performed on individuals between the ages of 35 and 60. Unfortunately, as aging continues the skin becomes less elastic. This means that in individuals of increased age collagen injections may be less effective at producing a youthful, full appearance, and reducing lines and wrinkles.

QUESTIONS TO ASK YOUR DOCTOR

• What type of collagen is going to be used?
• What results can be realistically expected?
• How long are the results expected to last?
• How frequently does the doctor perform collagen injections?

Two types of collagen are available for collagen injections. Bovine collage is derived from cattle, often from the bones, tendons, or hides. First approved for use by the United States Food and Drug Administration in 1982 it remains the most commonly used collagen for collagen injections. Human collagen is also available for use, and can be either derived from the individual's own tissues (autologous collagen) or manufactured from other human sources (allogeneic collagen).

The doctor injects the collagen into the area where improvement is desired. The collagen fills the area under the skin, raising the skin and filling in lines and wrinkles. The amount of collagen injected will depend on the depth and quantity of the lines or wrinkles being treated and the overall desired effect.

The collagen injection procedure generally only takes between 20 and 60 minutes, and is performed using only local or topical anesthesia. The patient may experience a slight stinging, pricking, or burning sensation when the injection occurs. Collagen injections are often considered a good option to other cosmetic procedures because they are relatively inexpensive. Collagen injections often costs only a few hundred dollars compared to the many thousands often required for a surgical cosmetic procedure.

Preparation

If bovine collagen is going to be used a test must be performed before the procedure to ensure that it is safe for use in that patient. The doctor will usually inject a very small amount of the bovine collagen into a non-exposed area of skin. The area is then monitored for four weeks to ensure there is no allergic reaction. If there is not, bovine collagen is considered safe for use in that person.

Before the procedure the individual should tell his or her doctor about all medications, vitamins , and supplements, including herbs, that he or she is taking. Many of these, such as aspirin and St. John's wort can increase the risk of bleeding or bruising . The patient will generally be asked to remove all make-up before the procedure. Then the area into which the collagen is going to be injected is cleaned and an anapestic is applied.

Aftercare

Aftercare for collagen injections is generally minimal. The patient can return to normal activities immediately. There may be tenderness, swelling, or bruising at the injection sites for a few hours or days after the procedure. Most patients, however, do not require pain medications as any discomfort is usually minor. In some cases further injections are shortly after the original procedure if the results are not completely satisfactory. In most cases the procedure needs to be repeated every three to six months because the collagen.

Complications

Although rare, there are a variety of potentially serious complications that can occur from collagen injections. An allergic reaction to bovine collagen can occur. The allergic reaction usually occurs in the form of itchy, red bumps on the skin In the area in which the collagen was injected. Although over many months these bumps often disappear, they may cause permanent scarring.

Other serious complications can occur after collagen injection. There is some risk for bruising, swelling, and tenderness at the site of injection, although this usually fades shortly after the procedure. In some cases bleeding may occur. Infections and scarring have been reported. There is some concern that contaminated bovine collagen could lead to serious disease such as Creutzfeldt-Jakob Disease, the human variation of the disease known as mad-cow disease.

Results

Most people experience good results with collagen injections. Results of the procedure will vary depending on the goal of the procedure and the area on which it was performed. After collagen injections fine lines and wrinkles are generally reduced, the appearance of deep wrinkles or lines can be reduced, lips are fuller, the appearance of acne is reduced, and may be less visible depending on the purpose of the procedure. Some people may not experience results as dramatic as had been hoped for and additional touch up procedures may be necessary.

KEY TERMS

Bovine collagen —Collagen derived from cattle, often made from bone, tendon, or hide.

Human collagen —Collagen derived from human sources, an alternative to bovine collagen.

Because collagen breaks down in the body over time, the results of collagen injections are not permanent. In most cases the procedure must be repeated every three to six months. When an individual is considering collagen injections this is an important consideration. Although collagen injections are relatively inexpensive, especially compared to other cosmetic procedures available, repeating the procedure two or more times a year for many years can be very costly.

Caregiver concerns

Collagen injections are usually performed by a certified dermatologist or cosmetic surgeon. He or she may be assisted by nurses or other health care professionals.

Resources

BOOKS

Arroyave, Efrain. Understanding Cosmetic Procedures: Surgical and Nonsurgical. Clifton Park, NY: Thomson Delmar Learning, 2006.

Dayan, Steven. Instant Beauty: The Complete Consumer's Guide to the Best Nonsurgical Cosmetic Procedures. New York: Haltherleigh Press, 2007.

Lipham, William J. Cosmetic and Clinical Applications of Botox and Dermal Fillers, 2nd ed. Thorofare, NJ: Slack, 2008.

PERIODICALS Baumann, Leslie, Joely Kaufman, and Sogol Saghari.

“Collagen Fillers.” Dermatologic Therapy 19, no. 3 (May 2006): 134-141.

“FDA Approves Dermal Filler for Facial Wrinkle Correction.” Dermatology Nursing 18, no. 1 (February 2006): 83.

Fernandez, Emmy M., and Christine L. Mackley. “Soft Tissue Augmentation: A Review.” Journal of Drugs in Dermatology 5, no. 7 (July-August 2006): 630–642.

ORGANIZATIONS

American Society for Aesthetic Plastic Surgery, 11081 Winner Circle, Los Alamitos, CA, 90720-2813, (888) ASAPS-11, www.surgery.org.

Helen Davidson