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Do you know what's being injected in your face?

If you think that toxin and filler have one-size-fits-all formulas, you couldn't be further from the truth – we investigate exactly what's in your chosen injectable

Injectables are still amongst the most popular treatments being asked for at aesthetic clinics, with many of us asking for botulinum toxin (Botox) or dermal fillers to smooth, rejuvenate or reshape our faces. But do you really know what is being used, what those injections are designed to do and for how long?


You’re probably a lot more familiar with the word Botox than ‘anti-wrinkle toxin’ – Botox is the brand name of the first and most popular toxin that was approved for aesthetic purposes some 20-odd years ago.  However, there are other anti-wrinkle toxins on the market that your doctor may be using.

The choice of toxin is usually down to your doctor’s preference but unlike dermal filler, all facial toxins approved for aesthetic use perform in the same way. Once injected, they paralyse the muscle they are injected into so it doesn’t move, resulting in fewer and shallower wrinkles.

The brands Botox and Dysport both contain the bacteria Clostridium Botulinum. In large amounts this is the toxin that causes botulism, a type of serious food poisoning, but in tiny, diluted amounts it is an effective and safe anti-wrinkle toxin that will last for up to four months before it is dissipated by the body.

The new injectable on the block is Xeomin – the main difference is that this toxin contains a ‘naked’ form of botulinum toxin and no added proteins (which other brands add to make the product more user-friendly). This means it is less likely to cause an allergic reaction, as some people are allergic to these proteins.  Another advantage is that it doesn’t need to be refrigerated and is stable at room temperature, making it a popular choice with doctors.

Dermal fillers

Dermal fillers are gel-like substances that are injected into the face to replace lost volume, give structure or more definition depending on where they are injected. There are in fact many brands and viscosities on the market – from firm to thinner and more fluid – which enables them to be used in different places.

Hyaluronic acid fillers

The most used fillers in the UK are made of hyaluronic acid, which is found naturally in the skin. When injected, hyaluronic acid acts like a sponge to attract water to the skin. Made of different densities depending on what they are designed to do, the molecules of the hyaluronic acid are first stabilised and then ‘crosslinked’ into a kind of lattice to make them hang around for longer in the skin. The best-known brands used in the UK are Juvederm and Restylane.

  • Juvederm is a collection of fillers of different densities designed to be used in different areas of the face. Juvederm Voluma XC is a thicker gel used for giving structure to cheeks and chins, whereas Juvederm Vollure XC is favoured for lips and to smooth out lines.

  • Restylane is likewise a collection of fillers designed to treat various issues. The original Restylane was best for smoothing away wrinkles and folds and plumping lips, whereas Restylane Lyft is a thicker gel used to correct severe wrinkles and folds such as nose-to-mouth folds and to plump up deflated cheeks.

All these fillers will last between six to 18 months before they are broken down by the body, depending on the volume injected in the first place and your own metabolism.

Collagen stimulating fillers

These fillers also come in the form of injectable gels that plump out the area where they are placed, however they also contain a stimulating substance that helps the skin create its own supportive collagen which develops over the course of two years.

The most well-known brands are Sculptra, Ellanse and Radiesse, but unlike hyaluronic acid fillers they can’t be dissolved, so if you aren’t happy with the results all you can do is wait it out until all the filler is absorbed by the body. Also in this class of fillers is Lanluma, a collagen stimulant filler that has recently been licensed in the UK for reshaping and adding volume to buttocks.

  • Radiesse is best for severe-to-moderate facial creases such as nose-to-mouth folds, but can also be used to plump up deflated cheeks as well as contouring the face. It contains a type of mineral that has tiny calcium particles suspended in a thick gel-like solution which stimulate the production of collagen.  Over time the gel is absorbed and the body metabolises the calcium, leaving behind your own collagen. This means that fewer touch-ups may be needed to maintain results.

  • Sculptra contains an active ingredient called poly-L-lactic acid which is a synthetic substance that encourages the formation of new collagen. The poly-L-lactic acid takes around six months to be absorbed by the skin, by which time it has built new collagen that will last for six months, meaning that it may take more than one treatment – four to six weeks apart – for best results.

  • Ellanse contains minute round particles of polycaprolactone that are naturally absorbed by the body and stimulate collagen growth over time.  Lasting between 18 months and three years, this high viscosity filler also gives an immediate visible result and can also be used on the hands and decolletage.

Permanent fillers

These were the first types of filler on the market which contained substances such as silicon, which the body is unable to break down. Fortunately, nowadays most doctors would never agree to injecting anything permanent into your face, as time has shown they are not a good option.

Like anything that is injected into your face, your body may, at some point in the future, decide that it doesn’t like this foreign substance and ‘encapsulate’ it by growing collagen around it in a hard lump to shut if off from the rest of the body. Also, your face will change as it naturally ages and the filler may no longer be exactly where you want it, leaving you looking a bit odd.

The most important thing to remember is that injecting the face takes skill and a thorough medical understanding of the intricacies of the face with its network of veins, nerves and muscles. It’s vital to see a highly qualified doctor or nurse practitioner to make sure that you get the best result for your face (or body), and that it is injected in a safe and effective manner.


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