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©2013 UpToDate ® Print Email Examples of biodegradable filling agents* Filler type Name Properties Uses Duration • Hyaluronic acid (HA) Restylane ® Restylane-L ® Perlane ® Perlane-L ® Non-animal HA; cross-linked with BDDE Correction of moderate to severe wrinkles and folds (eg, nasolabial folds); lip enhancement 6 months Juvéderm ® Ultra Juvéderm ® Ultra XC Juvéderm ® Ultra Plus Juvéderm ® Ultra Plus XC Juvéderm ® Voluma Δ Non-animal, cross-linked HA; XC formulations contain lidocaine Correction of moderate to severe wrinkles and folds (eg, nasolabial folds) 6 to 12 months Elevess™ Non-animal HA + lidocaine; cross-linked with BCDI, sodium metabisulfite preservative Correction of moderate to severe wrinkles and folds (eg, nasolabial folds) 12 months Prevelle ® Silk Non-animal HA + lidocaine Correction of moderate to severe wrinkles and folds (eg, nasolabial folds) 6 months Teosyal ® Non-animal HA, cross-linked with BDDE; reduced protein and bacterial endotoxin level, no lidocaine Correction of fine lines to deeper rhytides and facial sculpting 6 to 12 months Revanesse ® Ultra Non-animal HA, cross-linked with BDDE Correction of moderate to deep rhytides, as well as lipoatrophy and facial wasting 6 to 12 months Calcium hydroxylapatite microspheres (CaHA) Radiesse ® Synthetic CaHA microspheres (25-45 µm) suspended in an aqueous carboxymethylcellulose gel carrier For correction of moderate-to-severe facial wrinkles and folds (eg, nasolabial folds); for the correction of facial lipoatrophy 12 months Poly-L-lactic acid (PLLA) Sculptra ® Microparticles of PLLA induce fibroblastic activity; PLLA particles are eventually metabolized For restoration and/or correction of facial lipoatrophy 12 to 24 months Sculptra ® Aesthetic For correction of shallow to deep nasolabial fold contour deficiencies and other facial wrinkles Autologous fat n/a Harvesting and reinjection of fat Dermal/lip augmentation Months to years Platelet-rich fibrin matrices (PRFM) SELPHYL ® System PRFM generated through collection and centrifugation of blood; stimulates cell proliferation and skin rejuvenation over time Glabellar lines, nasolabial folds, acne or post-operative scars, full-face contouring, and other dermal defects 3 months to years

Dermal/lip augmentation Months to years Platelet-rich fibrin matrices (PRFM) SELPHYL ® System PRFM generated through collection and centrifugation of blood; stimulates cell proliferation and skin rejuvenation over time Glabellar lines, nasolabial folds, acne or post-operative scars, full-face contouring, and other dermal defects 3 months to years BDDE: butanediol diglycidyl ether; BCDI: biscarbodiimide. * Collagen-based filling agents are additional biodegradeable fillers. • The duration of filler effect tends to be longer in the upper face and mid face than in the perioral region. Δ Pending FDA approval as XC formulation.