Early Attempts at Facial Augmentation
The practice of facial augmentation dates back to the late 1800s, when physicians experimented with paraffin wax and vaseline injections to alter facial contours. Unfortunately, these materials were associated with significant complications such as infection, granuloma formation, and migration, leading to their disuse.
The Silicone Era
The next significant milestone came in the 1940s when silicone was introduced as a filler substance. Initially, silicone injections were popular because of their permanency. However, over time, the use of liquid silicone fell out of favor due to significant complications like lumps, granulomas, and systemic reactions.
Collagen: The First FDA-Approved Filler
The modern era of dermal fillers began in the late 1970s when bovine collagen, marketed as Zyderm, was introduced. In 1981, it became the first soft tissue filler to gain approval from the United States Food and Drug Administration (FDA) for the correction of facial wrinkles. Despite its popularity, it had a few downsides, such as the requirement of skin testing before treatment and a relatively short duration of action.
Hyaluronic Acid Fillers Take the Stage
The advent of hyaluronic acid (HA) fillers marked a significant advance in aesthetic medicine. Hyaluronic acid is a naturally occurring substance in the body, making it a safe and effective filler. Restylane, a non-animal stabilized hyaluronic acid, became the first HA filler to receive FDA approval in 2003. HA fillers quickly gained popularity due to their superior safety profile, longer-lasting results, and reversibility with hyaluronidase if needed.
Today's Fillers
In the last two decades, a wide range of dermal fillers have been developed, providing more options for both patients and practitioners. These include other HA fillers like Juvederm and Teosyal, as well as synthetic fillers like Radiesse (Calcium Hydroxylapatite) and Sculptra (Poly-L-lactic acid). Each of these fillers has unique properties, allowing for a more tailored approach to meet individual patient needs.
