Collagen, Dermalogen, Fat Injections and Botox in Cosmetic Surgery

In recent years, cosmetic injectables such as collagen, Dermalogen, a patient’s own body fat and Botox, have become the first, and most subtle, line of defense against the signs of aging and skin damage. Dr. Loving’s extensive experience as a plastic and cosmetic surgeon gives him a comprehensive understanding of muscle and tissue structures and the effects of aging and gravity on the layers beneath the skin’s surface. In addition, his years of training and practice in the more dramatic rejuvenating procedures such as face lifts, liposuction and breast surgery, have made him an expert in proportion, balance and the discreet aesthetics of cosmetic rejuvenation. These talents, applied to cosmetic injectables, allow Dr. Loving to significantly-but without surgery or scars–diminish the wrinkles and deflations that appear in aged or damaged skin.

Uses of Injectable Fillers

Injectable fillers are a temporary, but effective and easily-maintainable way to treat frown lines, acne scars, cheek depressions, vertical lip lines, marionette lines (the lines between the corners of the mouth and the chin), worry lines in the forehead, minor and deep smile lines and facial scars.

Types of Injectable Fillers

Collagen Replacement Therapy is perhaps the best-known of injectable fillers. Facial lines and depressions are caused by the thinning of the body’s natural collagen due to sun exposure, smoking and aging. Collagen is the main component of the dermis, which lies below the uppermost layer of the skin. The dermis is the supporting structure for the skin above it. When the collagen in the dermis degrades, the overlying skin shows these changes by developing wrinkles, lines, furrows and depressions. Collagen Replacement Therapy addresses the age- and stress-related wear on the skin’s natural collagen by supplementing it, thereby compensating for the structural losses and erasing the undesirable effects they have on the skin’s surface. Collagen is injected in the doctor’s office, takes about a half hour, is minimally painful and leaves no scars. The only sign of this treatment is minor redness which fades in a few hours.

While collagen is made from purified bovine (cow) sources, Dermalogen is made from purified human tissue. Dermalogen can usually be tolerated by those patients who are allergic to collagen. Some patients have also found that the plumping and recontouring effects of Dermalogen lasts longer than do those of collagen. Like collagen, Dermalogen is injected in the doctor’s office in a procedure that takes about a half hour. It leaves no scars, only some very temporary redness.

A patient’s own fat may also be used as an injectable filler. Under local anesthesia, fat is removed from a pre-determined area of the patient’s body via a tiny tube which is inserted under the skin. This procedure does not
require any stitches and leaves only a small surface mark which usually does not scar and fades over time. The fat that is removed is then spun into an injectable that has little to no possibility of causing rejection or allergic reaction in the patient since it is entirely composed of the patient’s own tissue. Using a patient’s own fat as an injectable is a more involved process than is using collagen or Dermalogen, but it has the considerable advantages of being nonallergenic and longer-lasting. After being injected into the determined sites, the fat is partially absorbed and partially vascularized. That is, some of the fat is adopted by the surrounding blood vessels and tissue, making it a permanent addition and correction to the area.

Maintenance of Injectable Fillers

When a patient’s own fat is used as an injectable, it may be desirable to repeat the procedure after a year or two. Collagen and Dermalogen maintenance is usually done about every three to six months. The lips tend to absorb injectables more rapidly than do smile lines, frown lines, cheek areas and scars. Depending on the look desired, patients may want to maintain lip injectables every two to three months. Most patients find that the maintenance
involved in using injectables is usually less time-consuming, more rewarding and often less expensive than that required by their regular hair appointments.


Over the past few years, Botox has become the most effective and popular non-surgical way to erase some of the most resistant wrinkles and lines in the face and neck. Botox is injected in very minute amounts into the muscles under and around wrinkled areas. These are usually areas that are susceptible to expression lines, such as the space between the eyes, where many people create wrinkles by repeated frowning. Botox is a purified and highly refined neurotoxin complex which works by inducing an atrophic lengthening of the injected muscle and a corresponding shortening of the muscle’s antagonist. Following an injection, muscles in the wrinkled area are unable to assume the position that caused the skin to fold and wrinkle. In effect, Botox does chemically what many patients do when they look in the mirror and momentarily smooth their lines and wrinkles with their fingers. Even deep furrows between the brows can be smoothed, as the muscles that allow the skin to settle into grooves are rendered inactive by Botox.

Patients considering Botox should understand that the complex’s effect is motor, not sensory. A patient who has Botox, therefore, will not be able to furrow his or her brow, but feeling and skin sensitivity in that area between the eyes will not be at all diminished. Botox is most commonly used to diminish lines in the forehead, around the yes and on the neck.

Maintenance of Botox

The effects of Botox usually last from six weeks to several months. Most patients have injections every two to four months. While the muscular effects are completely reversible over time, the wrinkle-soothing effects are cumulative and usually dramatic in their improvement of the treated area. To request more information or to schedule a consultation with Dr. Loving, please call 212-472-0900.