Spa Magazine

The latest wrinkle fighters and fillers provide a minimally invasive shot at younger-looking skin.

Dysport: Smooths Wrinkles

Botox has enjoyed a cushy monopoly in the marketplace for years, but now it has some competition-namely Dysport, which has been blasting wrinkles in Europe and Brazil for more than a decade. 

Botox and Dysport use different types of a protein complex derived from botulinum toxin A, but to similar effect: They block the release of the neurotransmitter acetylcholine to prevent the muscle contractions that cause wrinkles. Doctors who have tried this new injectable are happy with the outcome. "In the small number of patients I've treated, the results last longer with Dysport, and it's equally effective," says cosmetic dermatologist Ava Shamban, M.D., an assistant clinical professor of dermatology at UCLA and an investigator on the FDA clinical trials of Dysport. 

What's more, patient diaries report that Dysport smooths wrinkles faster-within 24 to 48 hours in some cases, versus four to six days with Botox, according to Shamban. Like Botox, Dysport is best for dynamic lines-wrinkles such as crow's-feet, frown lines, and forehead lines that show up when you make facial expressions-rather than wrinkles that are apparent even when your face is relaxed, such as laugh lines.

Risks As with other botulinum toxins, there's a chance of Dysport spreading past the injection site if the correct dosage isn't administered. However, some think this could be an advantage in larger areas like the forehead and underarms. (It can be used there to control sweating.) Other side effects include temporary, minimal bruising and swelling at the injection site.

Cost About $400 per treatment; results last approximately three months.

Juvéderm: Plumps Skin 

As we age, we lose collagen-a naturally occurring protein that gives skin its firmness. To help patients retain a youthful look, physicians can inject collagen to fill in lines and lips. The original fillers, made from bovine collagen, lasted up to a year but required skin testing because they can cause an allergic reaction in some people. Those fillers were followed by human collagen, which doesn't require testing but only lasts three months. (Evolence, a filler made of porcine collagen, was recently discontinued by the manufacturer for business reasons.) 

Hyaluronic acid-based Juvéderm avoids both collagen-related problems because it doesn't require testing (hyaluronic acid is a biocompatible, natural complex sugar) and it has staying power. "I like it for nasolabial lines and folds [laugh lines] and marionette lines [which run from the mouth down to the chin]," says Steven Pearlman, M.D., director of the Division of Facial Plastic Surgery at St. Luke's-Roosevelt Hospital in Manhattan. The filler also has a longer-lasting, thicker version-Juvéderm Ultra Plus-to help fill in deep-set wrinkles.

Risks Hyaluronic acid absorbs water from the body, which can cause swelling for the first 24 to 48 hours after injections, particularly around the eye area. If injected too superficially, such as in a very fine line, there's a chance that the filler will produce a bluish tint within the skin. Juvéderm Ultra Plus' thicker texture ups the risk of lumpiness. In most cases, both the bluish tint and lumpiness can be corrected by using hyaluronidase, an enzyme that dissolves hyaluronic acid.

Cost About $600 to $800 per treatment; results last six to nine months.

Sculptra: Boosts Collagen

Sculptra was initially developed to counteract facial wasting in HIV patients, and a modified version-Sculptra Aesthetic-has recently been approved by the FDA to treat age-related facial volume loss in healthy adults. The injectable-which is made of poly-L-lactic acid, a synthetic material that is compatible with the body-serves as a collagen stimulant, so it may take time and multiple treatments for results to become visible. 

"It's like sowing seeds in a field; you have to wait for it to grow," says Shamban. But the wait is worth it: Shamban notes that you can get very smooth and even results. "If you're looking to avoid plastic surgery, you can get a nice lift without that tight skeletal look," she says.

Risks There's a chance of temporary small bumps developing under the skin. Initial bruising and swelling at the injection site also may occur.

Image:  Oliver Eltinger/Age Fotostock