Welcome Back Collagen?
April 28th, 2009
Allure magazine has just reported the availability of a new injection material, Evolence. Manufactured by Ortho-McNeil-Janssen Pharmaceuticals, Inc., it received FDA approved almost a year ag0. Now available in the US, it gives another choice to patients requesting injectable wrinkle treatments. Other injection materials include hyaluronic acid (Restylane ®, Juvéderm ®), hydroxyapitite (Radiesse ®), autologous fat (fat from your own body), and other collagen products (Zyderm ®, Zyplast ®, Hylaform ®, Cosmoplast ®).
The Evolence collagen is sourced from porcine (pig) tendons. It is crosslinked using a patented technology using D-Ribose a natural sugar. Due to the genetic similarity between pig and human collagen and the crosslinking process, dermal allergy pre-testing is not necessary.
The search for the ideal injection material to improve facial wrinkles, augment facial bones, and enlarge lips has endured over a century long pursuit for plastic surgeons. The first material tried in the 19th century was paraffin or wax. The chemical induced inflammation and ruled out this material out of the question very early on. Interestingly, I recently saw a patient from Asia who had received such an injection in the 1990’s!
Women searching for larger breasts in the 1940’s and 1950’s received silicone injections. The reactions were so serious, it was banned in the US. Unfortunately, silicone breast injections continued elsewhere in the world for some time. In 1994, the FDA approved injectable silicone for detached retina treatment. The off-label (not approved) injection into the face has continued since that time. Sadly this practice has migrated outside the standards and medical protocol of physician’s offices. It can be found in home parties and offered at hotels where it is being injected by individuals without medical training. Poor results are common.
Collagen injections were first approved by the FDA in 1981. Since that time there has been a string of new collagen products, each trying to improve on the last. Problems including allergic reactions, visible material under the skin, and skin loss (necrosis) have plagued these products. Only widespread clinical use of Evolence will be able to confirm the reported risks and benefits for this product.
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