Collagen fillers were one of the first injectable fillers to be offered as an anti aging treatment.

As collagen is nature's skin support system injecting collagen into sagging skin seems like an obvious way to perform a non surgical facelift.

Recently though - natural collagen fillers are being replaced by other dermal fillers based on hyaluronic acid like Restylane.

Facial fillers are increasingly popular anti aging treatments  - so if you're considering a filler of any sort - here's some information to help you decide. 

Where does the collagen come from?

Your options are either bovine sourced or human sourced collagen.

Bovine collagen has been around the longest and is the least expensive option. Commonly used brand names are Zyderm and Zyplast.

Human collagen is sourced in a variety of ways - the most common being skin cells taken from human newborn foreskin after circumcision.

That may sound a bit gruesome - and to be fair it probably is.  What you need to worry about most though - is not where the tissue comes from but just how it is treated and tested after it's extracted.

All human tissue has to be tested for conditions such as HIV and hepatitis - and treated to remove all cells before being processed into an injectable form.

The most common brand names for human collagen injectables are Cosmoderm and Cosmoplast.

What's the procedure?

If your doctor is using bovine collagen you will be advised to have a skin test where a small amount of collagen is injected into your forearm to see if you have an allergic response.

The area injected will be checked after 2 - 3 days and again after 4 weeks to see if there is any swelling or tenderness. Around 3% of people will have a positive skin test preventing them from having treatment with bovine collagen.

Collagen fillers are injected through very fine needles inserted into the skin along the edge of the treatment area. Human collagen fillers in injectable form already contain an anesthetic so you shouldn't feel any discomfort.

Because part of the injection consists of salt water, the doctor will overfill the area. The salt water will then be absorbed into the tissue within two days leaving the area smooth and plump with a marked decrease in wrinkles and lines. You will get some redness and discomfort immediately following the treatment which should disappear within a couple of days.

No bandaging is needed and you'll be free to resume your normal daily activity almost immediately. That includes wearing make up and sunscreen.

What are the downsides?

One important drawback is that injected collagen is quite quickly degraded by the body's enzymes meaning you'll need more injections.

Bovine collagen tends to have a short life span of up to 3 months while the more expensive human collagen may last up to 6 months when injected.

The problem is the results for either type are totally unpredictable and some women have been know to reabsorb collagen filler in the lip area in under a month. acid - are taking over from collagen as the filler of choice for many surgeons as there is less risk of allergy and they are more long lasting.

What about the risks?

As long as the procedure is carried out by a qualified plastic surgeon, the risks associated with collagen fillers are few and any complications that may arise are rarely serious.

The greatest risk is that of allergy but providing the allergy test is clear this should not be a problem. Human collagen is less likely to lead to allergy than bovine collagen, which carries a 3-7% risk of this happening.

Other risks include infection, abscesses, open sores, skin peeling, scarring and lumpiness, although all of these are extremely rare and usually associated with poorly trained physicians. If you have a history of cold sores you may find that they break out if the collagen is injected close to your lips.

It is also worth bearing in mind that connective tissue disease could arise after bovine collagen injections although no definite link has been established.

Can anyone have a collagen filler?

No. There are certain people who should avoid collagen fillers. If you suffer from rheumatoid arthritis, scleroderma or dermatomyositis, collagen should be avoided. If you have acne you won't be able to have collagen fillers because of the increased risk of infection.

If you have any of these conditions, then you should think about an alternative dermal filler or a different anti aging treatment - perhaps a less invasive approach.

What will it cost me?

On the surface collagen fillers appear to be an inexpesive anti-aging option with each syringe costing between $300-$700.

However, you need to remember that this could be a lot more depending on the degree of sagging and wrinkling you want to correct. The number of syringes you need will depend on the size of the area and the severity of the wrinkles.

You also need to bear in mind that this is not a long term anti-aging solution. If you are being treated with bovine collagen, you need to commit to paying around $1500-2500 per year for all the anti-wrinkle treatments you would need. You are unlikely to want less than four in a year.

With human collagen, you will pay more per treatment but you will need less to maintain your new look as each treatment will last longer. You also need to consider the repetitive nature of the treatments and the discomfort involved.

What alternatives should I consider?

The main alternative is a dermal filler based on hyaluronic acid like Restylane. This type of filler lasts longer and recent research has shown the hyaluronic acid injections can stimulate the body's own supplies of collagen bringing long term anti aging benefits too.

There are also fat fillers - where fat is taken from elsewhere in your body and reinjected into your face. Using your own fat cells removes the need for testing as there won't be an adverse reaction.

Your doctor may also suggest chemical peels, laser resurfacing or microdermabrasion in addition to the collagen filler.

Of course if you really want to slow the aging clock - natural anti aging strategies such as proper skin care, sun protection and healthy lifestyle choices should be given priority.

Much can be done before radical treatment needs to be considered. If you're sure you want to go ahead - find a great plastic surgeon and discuss all the options before deciding that a collagen filler is right for you.

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