Collagen induction therapy vs dermal fillers | Singapore Guide 2024

What is collagen induction therapy? It consists of biostimulators capable of activating your fibroblasts to produce collagen. Dermal fillers are gel-like substances that are injected beneath the skin to restore lost volume, smooth lines and soften creases, or enhance facial contours.

What is sculptra. What is Ellanse? | 少女针.童颜针是什么?

These are forms of collagen induction therapy.

Sculptra is a unique PLLA based collagen boosting filler (poly-L-lactic acid = PLLA). (collagen induction therapy)

Sculptra works to restore your facial volume by activating fibroblasts in your skin to produce new collagen in a process known as neocollagenesis. Type 1 and Type 3 collagen are the key products.

Ellanse (collagen induction therapy) is a PCL based collagen stimulator, officially approved by MHRA in the UK and the FDA in the USA and for restoration and/or correction of the signs of facial fat loss (lipoatrophy) and is used for treating facial lines and wrinkles

What are patient reviews for sculptra filler? (collagen induction therapy)

On realself, a leading unbiased, objective patient review website based in the US, sculptra scores a whooping 82% from 1,041 reviews. Dont take my word for it. Read the 1041 reviews on their site. =) In my clinic experience, aesthetic treatments tend to yield subjective results. It is not often we get such high patient satisfaction rates. So for >1000 reviews and 82% ratings, its certainly SPEAKS volumes of the treatment.

Sculptra has been FDA approved for more than a decade, so it is backed by science and time tested evidence. The long term side effects have been well investigated.

What are patient reviews of facial fillers | dermal fillers in Singapore so far?

From realself, Dermal fillers have a >90% satisfaction rate for facial volume restoration and enhancement based on 3134 reviews. The reason being, Hyaluronic acid fillers have been FDA approved for use for more than a decade, so its safety and efficacy is without question.

What are patient reviews of Ellanse? | 为何要选择打少女针?

Because it’s a longer-lasting filler, you may have delayed side effects for as long as it stays in your body. It can’t be dissolved, if you don’t like the result or have a complication. RealSelf reviews who said it’s Not Worth It reported lumps and other visible side effects. Overall, a satisfaction rate of > 75% if used correctly in the right candidates.

However, do note that as of now… ELLANSE IS still NOT an FDA approved filler. The long term side effects have not been as extensively investigated as the fillers above, and persistent nodules and granulomas tend to occur in patient’s with altered immune reactions.

What is the cost of ellanse, vs sculptra vs facial fillers | dermal fillers in Singapore?

在新加坡打少女针价钱? 在新加坡打玻尿酸.乔雅登.绿珠兰.瑞蓝价钱?

This varies across the board. Cost depends on experience of injector. In experienced hands, prices of dermal fillers starts from $650…. Here is a breakdown.

Sculptra starts from $1500 per vial / session. Depending on your skin quality vial is 3-5 cc of product. (collagen induction therapy)

Ellanse starts from $1200 per syringe. Each syringe is 1cc of product. (collagen induction therapy)

Juvederm starts from $850 per syringe.

Teosyal starts from $650 per syringe.

Restylane starts fromm $700 per syringe.

There are basically 2 main types of dermal fillers.

Hyaluronic acid dermal fillers lnclude Restylane, Juvederm, Boletero, Teosyal range

Semi permanent, collagen boosting dermal fillers include Radiesse, Ellanse, Sculptra

What are the pros and cons of Sculptra vs Ellanse | 少女针.童颜针

Form of collagen induction therapy.

Pros of Sculptra:

1. Unlike hyaluronic acid fillers, that volumise sunken faces and fill wrinkles. Sculptra has the additional ability to promote collagen production over time.

2. With neocollagenesis, effects of sculptra last up to 36 months.

3. Collagenesis leads to skin tightening, whitening and brightening, a unique feature of sculptra.

Cons of sculptra:

1. Sculptra requires a minimum of 3 sessions unlike dermal fillers treatment which can be completed in 1 sitting. So more trips to your doctor is needed.

2. The results are not noticeble after a session. One would need at least 3 months for neocollagenesis to take place. So this takes time.

3. In some patients, who have reduced collagen producing properties, the effects of sculptra are reduced in terms of volume restored and duration or result.

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Sculptra vs Perlane | Restylane Lyft, which is better?

Price wise, Restylane Lyft starts from $799 in experienced hands.

Longevity is between 6 – 12 months.

Only a single session is needed, but depending on volume required, several syringes may be used.

Sculptra vs Juvederm Voluma, which is better?

Price wise, Juvederm voluma starts from $899 in experienced hands.

Longevity for midcheeks is touted to last up to 24 months.

Only a single session is needed, but depending on volume required, several syringes may be used.

Sculptra vs Ellanse, which is better? (collagen induction therapy)

This would be dependent on the clinician. In my clinical experience, I have had very nice results with sculptra. Several of my patients have fedback preferring the long term results of sculptra for skin volumizing, brightening and tightening.

What are the risks and side-effects of Sculptra?

In experienced hands, sculptra is safe and effective, as evidenced by realself.com.

Common risks of Sculptra include transient tenderness, swelling and bruising at the injection sites. 

There is a risk of lumpiness under your skin so be sure to massage firmly and attentively the first 5 days to optimise collagen growth.

Are there any post-treatment instructions after Sculptra?

After Sculptra injections, you are advised not to have any alcohol or exercise for the first 3 days to reduce the chances of bruising and swelling. 

I encourage my patients to follow the magic rule of 5s for facial massaging. 5x a day, 5 min each day for 5 days.

Is sculptra suitable for everyone?

I would avoid sculptra in patients with thin skin.

And in patients with poor neocollagenesis properties.

Pregnancy and breastfeeding are also contraindications.

How about Ellanse, Asthefill, PCL based fillers? (collagen induction therapy)

These are forms of collagen induction therapy.

Background: Aging signs can be corrected through volume restoration in multiple soft tissue layers and in the supraperiosteal plane using hyaluronic acid (HA) or non hyaluronic acid (non-HA) fillers. The non-HA bioresorbable polycaprolactone (PCL)- based filler with collagen-stimulating properties has a proven safety profile, but rare potential complications such as nodules and granuloma can occur. Furthermore, PCL based fillers cannot be immediately removed by injection of an enzyme.

What is Ellanse used for? What is Ellanse?

It is a unique filler which has collagenesis properties and is a form of collagen induction therapy.

Is Ellanse a permanent filler?

Ellanse is a unique dermal filler that works by correcting the wrinkles and folds in the skin, but also by stimulating the body’s own natural collagen to have a long lasting, natural result. It is a semi-permanent filler.

What studies support the safety and efficacy of Ellanse?

Polycaprolactone-based dermal filler complications:
A retrospective study of 1111 treatments

(collagen induction therapy)
Shang-Li Lin MD

There were no cases of intravascular injection, nodules/granulomas, or infection.
Conclusion: The complication rate of the PCL-based filler was found to be low, and there were no cases of intravascular injection, nodules, and/or granulomas during the 3-year observation. Longer-lasting edema was associated with a higher injection volume and malar edema was related to lymphatic compression.

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1. Are dermal facial fillers safe and effective?

Dermal fillers have been FDA approved for the FACIAL Volume restoration for more than 20 years. Numerous level 1 evidence papers can be found, demonstrating its efficacy in the face. Worldwide, there have been more than 50 million dermal filler treatments performed. Hence it’s efficacy is without doubt. Regarding safety, it is safe in experienced hands. Do scroll down to the end of this page to learn about the risks.

2. Will I look worse than before once I stop facial fillers |botox | threadlift treatments? Will my face age faster, sag faster etc?

This is a myth. Your face will return to its original state. Fillers and botox will not accelerate ageing. Ageing is a dynamic process that remains unchanged.

3. Why are there so many different dermal fillers in the market? 

Sculpting your face with dermal fillers is a work of art. Just as Picasso uses different colour paint to work his magic, I use different types of fillers to bring out your features in different parts of your face.

Ultra light dermal fillers are excellent for hydration and achieving a dewy skin appearance – Examples include restylane vital light, redensity 1

Soft dermal fillers are excellent for undereye and lips. Examples include Restylane Kiss, Juvederm Volift.

Firm dermal fillers work best for chin and nose. Example would be Perlane, Ultradeep.

A mid density dermal filler would be perfect for the cheeks. – Example would be voluma, RD4.

4. Will I look better the more dermal fillers I put into my face?

Does more sleep more you more refreshed? Or optimum amount of sleep? So its the same with fillers, you want the right doctor to inject in the right area, with the right amount of filler. Not too much, not too little.

So remember, it is important to know when to stop. Aesthetic treatments can be rather addictive.

1. Traditionally, botox lasts 3 months.
2. Fillers last 6- 12 months depending on the brand and model.
3. Over the years, I have had patients telling me they only need to do botox every 6 months, and fillers every 18 months, all because they have been maintaining their treatments regularly.
4. Of course for those who did sculptra, I see them nearly once in 3 years lol.

FILLERS Q + A

How long do dermal fillers last?

The short answer is, typically 6 months and above, depending on your skin type, lifestyle and choice of filler.

One of the great advantages of dermal fillers is that the effects are fairly lasting but not permanent. The length of the treatment depends on a number of factors including

1. The area you have had treated
2. Quantity of dermal filler injected
3. Quality of skin
4. Age+ Lifestyle + Health
5. However, the range of dermal fillers in the market, are proven to last up to one year in (laugh lines) nasolabial lines and six months in the lips.

Is dermal filler good for your skin?

Yes, it replaces your lost Hyaluronic acid, which is a natural sugar molecule in your skin.

Are dermal fillers Better than Botox?

They work differently and serve different functions in your skin. In essence, they work best in combination. Botox soften dynamic wrinkle lines. Dermal fillers are for restoring volume loss and enhancing facial structure and shape.

Do dermal fillers actually work?

Yes, this is a medically proven treatment, HSA approved with more than 100 million dermal fillers done worldwide at last count. The results are instant and can last 6 months or more.

Who can have Dermal Filler Injections?

Any adult who is clinically indicated and deemed fit to make an informed decision about the treatment and its associated risks.

Who can’t have Dermal Filler Injections?

Anyone with the following

1. Previous allergic reaction to a Dermal Filler or someone with a allergy to Lidocaine
2. Pregnant or breast feeding mothers
3. Post plastic surgery patients, and those who havepermanent implants or fillers are also contraindicated for filler treatment.

What are the side effects of dermal fillers?

1. Short term side effects can include redness, swelling, pain, itching, bruising or tenderness at the injection site,
2. These can be relieved with a cold compress, paracetamol and arnica if you have no allergies.
3. There is no evidence to date of any long-term safety concerns associated with hyaluronic acid filler treatment, as the body naturally metabolises the product over time.

Are Dermal Fillers Safe?

1. There are many Dermal Fillers in the market.
2. It is vital to use trusted and reputable Hyaluronic acid Dermal Fillers.
3. These are the most scientifically documented HA based dermal fillers in the world with comprehensive studies that support their safety and efficacy.

What is the evidence for fillers?

Fillers have level 1 evidence for safety and efficacy from randomised studies conducted since more than a decade ago. This is especially so for hyaluronic acid filers.

Of course fat grafting can also be done, but thats a surgical option.

Can I improve facial balance and symmetry with Fillers ( Restylane, Juvederm, Teosyal)?

Yes facial balance and symmetry can be improved with fillers. The key is finding an injector with a good eye for beauty in order to achieve a natural look, to bring out your best features. I recommend having a consultation with an expert injector.

I am Asian and have thin skin. Will I get lumpiness with fillers?

Asians have a unique facial anatomy, so filler treatment is more focused on the central T zone.

Lumpiness occurs when the area of injected lacks soft tissue volume. A combination of good placement technique in the right injection plane, appropriate filler type and amount would help you achieve good results.

Undereye is a delicate area, so a small volume of extra soft filler would help. Good choices include restylane vital light and redensity 2.

Marionette lines and nasolabial folds require more dynamic fillers. Good choices include Juvederm voluma and Perlane.

I must stress, it is not so much the brand of fillers, but more the injector’s technique, and amount injected, that would help PREVENT lumpiness.

What are the benefits of dermal fillers?

1. A treatment with dermal fillers provides an easy way to enhance your looks.
2. The result of a single treatment can be seen instantly and lasts around one year for facial treatments and around six months for the lips.
3. With dermal fillers you will achieve a natural looking result that does not affect facial expression. Remember, your face changes over time, and treatments with dermal fillers allow you to control you looks naturally as you age.

What are dermal fillers?

1. Dermal fillers are an injectable substance made from natural and synthetic material and have been developed for injection into the skin to restore its youthful appearance.
2. Over 30 million people across the world have been successfully treated. The main type of dermal fillers in the market, are a soft gel consisting of stabilized, non-animal hyaluronic acid.
3. The gel is tissue-friendly and closely resembles the hyaluronic acid that exists naturally in the body. It is long-lasting but not permanent.

Are longer lasting fillers any good?

Many people comment that hyaluronic acid fillers dont last, and they seek a more permanent soluntion. It is common to notice volumisation reduces as swelling subsides a few days after filler injection.

Historically, permament fillers have had a string of complications, from infection to nodules, granulomas etc

There is no antidote for these except surgical excision, leaving behind a permament scar.

It is best to stick to hyaluronic acid fillers as these can be reversed if needed.

What causes static fine lines, and  how can we treat static fine lines?

Static fine lines occur from collagen breakdown due to repeated muscle movement. They often exist around the mouth This is akin to bending a credit card, causing a crease to form from repeated movement.

Your options include filler injection and laser resurfacing.

Soft fillers will help to hydrate and plump up the lines and are your best choice. You can expect up to 75% correction.

What are granulomas and can they occur post fillers?

Granuloma is a delayed foreign body inflammatory condition, suggesting that your body had an adverse reaction to your fillers. It cannot be dissolved. It is not in your best interest to have further filler injections.

If you wish to remove the granulomas, surgical excision is an option, but that in itself is not without risks. Hence it may be better to just monitor it if it doesnt cause you any problems.

Concerned about filler result 3 days post treatment?

3 days is still too early to tell what your final result will be like. Tissue swelling is still present and can persist, depending on the volume and choice of filler. It is best to wait 14 days before doing anything to address your concern.

How to treat superior sulcus hollowing?

Superior sulcus hollowing occurs due to volume loss.

You are right to suggest that your options include filler and fat grafting.

Filler is a non surgical option and is effective with results lasting up to a year. There is a risk of blindness, so it is best to find an expert filler injector who is well versed with the microcannula technique to reduce your risk.

Fat grafting is operator dependent and carries other risks. Results will be more lasting.

Is there a filler that can fill my cheeks, lips and nasolabial fold together?

Fillers vary in density and propensity to attract water. Hence, there is no one size fits all filler that can be used throughout the face.

Cheeks and nasolabial folds respond well to denser fillers.

Lips are a delicate area, so a softer more dynamic filler is advisable to avoid an overdone look.

IMHO, I would suggest going slow and focusing on your top area of concern first to give yourself the best result there, rather than using one type of filler in 3 areas.

Bumps > 3 weeks after filler injection?

Based on the time course, this is not common. Your filler must have been placed superficially.  It is best to seek a formal review with your injector. A small measured amount of carefully placed hyluronidase can clear the bumps quickly.

How to achieve a heart shaped face?

A heart shaped face is a common request here in Asia.

The key is having a beautiful chin, slim jawline and apple cheeks.

How to correct indentation from hyaluronidase?

It is best to wait 2 weeks to see your final result. Then, you may opt for fillers to fill up your indentation, which is essentially an area of volume loss.

I am stressed. How can I correct my facial asymmetry?

Most of us have a certain degree of facial asymmetry, and that is what makes us unique.

Your options include seeing a craniofacial surgeon vs an Aesthetic Physician. In addition, it is good to focus on ways to handle stress and build on your positivity.

After mastering the above, you can then consider simple measures, for example lip fillers to lift your left mouth corner and botox to your left masseter to improve the fullness over your left jaw.

Why is chin filler some common in Asians?

​​In Asia, chin fillers is a commonly performed treatment as Asians tend to have a small chin.

Commonly, our chin is small and would benefit from enhancement to increase both the vertical and anterior projection to give us a more defined, 3D look.

Options include a chin implant and chin fillers.

I would start with fillers, then if you like the result, you can move on to a more permanent solution ( implant).

Chin fillers and botox for v shaping?

​In Asia, chin fillers is a commonly performed treatment for V face shaping.

I often combine it with botox to the mentalis to relax the muscle for 3 main reasons.

1. To smoothen the chin

2. To reduce appearance of the mental crease

3. To increase longevity and shape of the chin filler by reducing uneven muscle pull.

Can I go under the sun after filler injection?

Generally excess sun will not have a major effect on your fillers. However, for good wound healing and recovery, it is best to wait until your swelling subsides, which can range from 48 to 72 hours depending on the amount and choice of filler.

What is hyaluronic acid?

1. Hyaluronic acid is a naturally occurring substance found in the body that helps to hydrate and add volume to our skin.
2. Natural hyaluronic acid is broken down by the body in one or two days so is constantly replaced.
3. As we age this replacement mechanism diminishes so the moisturising and plumping effects of hyaluronic acid decrease. Hyaluronic acid is used for aesthetic treatments, and has also been used for injection into arthritic joints to aid movement as well as eye surgery.

How long is the treatment?

1. The injection process takes 15-30 minutes.

What areas can be treated with dermal fillers?

Dermal fillers can be used to smooth away facial lines and wrinkles, create fuller lips, shape facial contours and revitalise the skin. The most common areas treated are:

1. The nose to mouth lines (Nasolabial fold).
2. Lines around the mouth (Perioral lines and mouth corners).
3. Natural lip enhancement and definition of the border.
4. Natural cheek augmentation.
5. Nose and chin enhancement.
6. Also can be used for replacing soft tissue volume loss and scar corrections.

Will dermal fillers treatment need pain relief? Will the procedure hurt?

1. Generally, pain relief is not necessary when injecting into the skin to correct lines and wrinkles. Some people may experience the treatment as a mild discomfort.
2. A local anaesthetic spray can be applied to the area for a more comfortable treatment experience.
3. Dermal fillers are also available with the local anaesthetic 0.3% lidocaine included for a more comfortable experience.
4. Our practitioner will be able to advise you on suitable anaesthesia for your treatment.

Will I notice the difference right away?

Yes, the aesthetic results are immediate. You’ll see the results as soon as your appointment is over—and no one else needs to know!

Will I need to take time off work?

Nope! You can have an appointment in your lunch hour then get right back to your normal routine.

Are there any risks or side effects with dermal filler treatments?

1. Millions of treatments have been performed with dermal fillers in the past.
2. Product related reactions are rare.
3. These reactions include redness, swelling, pain, itching, bruising or tenderness at the injection site. All skin injection procedures carry a small risk of infection.

How long will the effects of dermal fillers treatment last?

One of the great advantages of dermal fillers is that the effects are long lasting but not permanent. The length of the treatment depends on a number of factors including

1. The area you have had treated
2. Quantity of dermal filler injected
3. Quality of skin
4. Age+ Lifestyle + Health
5. However, the range of dermal fillers in the market, are proven to last up to one year in (laugh lines) nasolabial lines and six months in the lips.
6. After the initial treatment, follow-up sessions are normally recommended around every six to twelve months depending on the individual and the treatment.

Is there anything I need to know before I have the treatment?

1. We advise you to avoid using aspirin or other non-steroidal anti-inflammatory drugs, omega fish oil a couple of days before your treatment (unless they are taken for chronic medical conditions).
2. Avoiding these medications will reduce the risk of bruising and bleeding at the point of injection.
3. Ask our practitioner if you have any concerns.

Can everyone undergo dermal fillers?

1. DO: Most people can benefit from dermal fillers treatment. If you wish to reduce lines and wrinkles, create more defined or fuller lips, define the contours of your face, or boost your skin’s vitality, for a healthier more hydrated skin tone.
2. AVOID: Dermal fillers have not been tested in pregnant or breast-feeding women, Individuals with medical conditions that lower the body’s immune response or individuals undergoing therapy that is immunosuppressive may be more prone to infection by a skin injection procedure.
3. During your consultation, our practitioner will carry out a full medical assessment and discuss your needs for treatment.

Are there different dermal fillers products?

1. There is a range of different dermal fillers designed to be used at different levels in the skin to meet your treatment needs and maximise your treatment results.
2. Discuss with our practitioner during your consultation what type of products suits your needs best.

Do I need to take a skin test?

1. No skin test is required as hyaluronic acid dermal fillers do not contain any animal-derived ingredients.

Can dermal fillers be used if I have had laser treatment or a chemical peel?

If you have recently had a light laser or chemical peel treatment, so long as there is no skin wound, you are good to go.

When will I need another injection?

Many patients like to book touch-up injections as well as repeat injections to maintain the effects of treatment.

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References: 

1. COX SE, ADIGUN CG. Complications of injectable fillers and neurotoxins. Dermatologic Therapy. 2011;24:524-536.
2. Vartanian AJ, Dayan SH. Complications of botulinum toxin A use in facial rejuvenation. Facial plastic surgery clinics of North America. 2005;13:1.
3. Almeida et al. –Diffusion characteristics of botulinum toxin products and their clinical significance in cosmetic applications Journal of Cosmetic and Laser Therapy 2007 , 9 (supp1) 17-22