New cosmetic surgery techniques will continue to expand as demand grows. Procedures such as facelifts, which were traditionally performed with scalpels, may in the future be done with lasers, as there are lasers that can now yield facelift-like results. Recovery times will be quicker and scarring will be less.

In decades to come, the possibilities in plastic and cosmetic surgery will become close to endless. Tissue engineering is no longer something out of a science fiction novel. The creation of living tissues in a laboratory setting for use as a replacement for damaged or diseased body parts is on the horizon. Think about it – the growing and reproduction of skin grafts, breast tissue, muscles, cells from vital organs and even nerves – lie just ahead in the medical future. And though the science is still in its infancy, there is no doubt that the future of cosmetic and reconstructive surgery will likely have tissue engineering at its core.

Artecoll® (available as ArteFill® in the United States)
Used in Europe since 1989, Artecoll may be the first permanent injection to treat wrinkles. The science behind it involves the injection microscopic plastic beads suspended in bovine collagen into the area needing treatment. Once the body absorbs the injected collagen, the tiny beads trigger the body to produce its own collagen, thus keeping cycle of collagen production permanent. Every time the collagen depletes, the beads tell the body to produce more.

Botulinum toxins
For some people Botox® is not strong enough, does not last long enough, or may simply not be an option due to their body’s natural resistance to the botulinum toxin. For these people the future may hold Myobloc® or Dysport®. Myobloc is botulinum toxin type B (Botox is type A) and therefore may benefit people who are resistant to Botox. Its dosage is larger than Botox (dosages are different- not necessarily larger as units are not the same between the two), but its effects are more immediate. Like Botox, Dysport is also a botulinum toxin type A. It, too, is a larger dose than Botox (again, units are different, not directly comparative). Patients treated with Dysport may require fewer treatments per year than those treated with Botox). Since 2009, the FDA has approved Dysport to treat forehead wrinkles and frown lines. Both products carry the same risk of allergic reaction as does Botox.

CosmoDerm® and Cosmoplast®
This technology uses the collagen-producing cells (fibroblasts) found in the discarded foreskins of infant boys after circumcision. Scientists have been able to isolate and then replicate these cells to produce the collagen needed for injection. Like the bovine collagen which had been commonly used to treat wrinkles, these products eventually are reabsorbed by the body and require another treatment 3-6 months later. However, unlike bovine collagen, with Cosmoderm and Cosmoplast – used to treat fine lines and deep wrinkles respectively – the patient does not need to be tested for allergies to the collagen. CosmoDerm and Cosmoplast were both approved by the FDA for use on March 12, 2003.

Hyaluronic acid
This is a natural component of skin tissue. Its function is to provide cushioning and lubrication to the skin. Earlier, two brands of hyaluronic acid – Restylane® and Hylaform® – were approved for use in mild wrinkle and scar treatment in Europe, Canada, and South America. With newer treatments available, Hylaform is not often used. In the US, the FDA has approved Restylane, Perlane® and Juvederm® (also hyaluronic acid fillers) for treatment of facial wrinkles and folds and lip rejuvenation. Restylane, which is a synthetic form of hyaluronic acid, has been shown to last up to an entire year, while Hylaform, derived from the hyaluronic acid of rooster combs, lasts anywhere from 3-6 months.

Derived from calcium hydroxylapatite, a substance found in human bones and teeth, Radiesse is an injectable paste used to enlarge the lips and fill folds and lines. The effects are reported to last for 2-5 years. Because Radiesse is derived from human tissue, there is little chance of allergic reaction. As of 12/06, the FDA has approved Radiesse for the long-lasting correction of moderate to severe facial wrinkles and folds such as nasolabial folds. Radiesse also received a second FDA approval for the long-lasting correction of facial fat loss (lipoatrophy) in people with human immunodeficiency virus (HIV).


© Copyright 1995-2016 The Cleveland Clinic Foundation. All rights reserved.

This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 9/18/2012...#11007