I was (and am still!) moved by videos of cruel animal slaughters for meat on social media, and besides caring for people who come knocking at ERUFU Care, I’d like to share my love with animals, too!
I have thought of trying out a vegan lifestyle, not just having a vegan diet (only taking food and drinks without any animal ingredients), but also removing any products (and by-products) containing animal ingredients. I haven’t been using my old leather purse since I’ve watched those videos!
Shalini and Lisa have always been interested in anti-aging therapies to sustain their youthful looks. I’ve heard of collagen fillers, and boy do they sound cool! But when I discussed about this with Romeo, he said that most collagen fillers in the market are made from cow origins.
If we’re interested in collagen fillers, we definitely need to understand better about what goes into our body! So I’ve interviewed Dr Jeswender from Dermlaze Clinic, and he gave very good insights on how to choose the right dermal filler.
Dr Jeswender Singh is a Medical Aesthetic Consultant, who has been practising aesthetics for 15 years. He has been for aesthetic training specifically for Asian skin type in China and South Korea, besides laser aesthetics training in America. He regularly gives laser training for skin and beauty.
He has been certified by many internationally recognized organizations throughout his career in pursuing aesthetic medicine, only to deliver the best of his abilities for his patients.
The subject of collagen fillers can be pretty complex, so I’ve divided these information into 3 sections: Should we use collagen fillers?, What are the other choices?, and How to identify if we’ve made the right choice.
Should we use collagen fillers?
1. What exactly is collagen?
Collagen, in human or animal, is the most abundant protein that makes up most parts of the living body. Collagen is a natural protein, that makes up 70%-80% of our skin dermal layer. Thus, replenishing collagen on our skin becomes essential in order to maintain a youthful look by delaying the signs of aging.
While we can’t demand our collagen production to run like when we’re younger, we may, however, induce some collagen to add on to what we have, or cause the body part to produce more collagen.
Collagen is widely used in the medical, cosmetic, and research fields, with most collagen obtained from animal tissues.
How can collagen from animal tissues match to our human body? This can be solved by using protease (an enzyme) to break down the intermolecular cross links that bind collagen molecules in a highly organised manner (which increases our tissue strength). The process of breaking down collagen produces atelocollagen, which is used for collagen dermal fillers.
2. Collagen for dermal fillers?
When we’re aging, our dermal collagen production reduces. New collagen splits up into excessive, fibrous collagen over time, and eventually dies off, resulting in wrinkles and folds on our skin!
Hence, collagen for dermal fillers may be a way to help you regain your youthful looks by “plumping up” your wrinkles and folds. Compared to modern Hyaluronic acid (HA) fillers, collagen fillers are thinner, so it is less likely to produce irregularities when injected very near to the facial skin surface. They are also useful in correcting fine lines and wrinkles.
So here’s the 2 main categories of collagen fillers:
- Collagen fillers of animal origin
- Collagen fillers of human origin
Let's see how they work!
3. Collagen fillers of animal origins
The first FDA-approved (Food & Drugs Administration, U.S.) injectable collagen filler derived its content from bovine dermal collagen (cow’s skin), and the latest naturally occurring collagen filler are derived from porcine tendon (pig’s tendon).
Bovine collagen fillers were developed with the aim of a less expensive source for dermal fillers. During the earlier days of developing collagen fillers, in 1958, the first collagen used was extracted from fresh calf skin. Today, one of the most recent bovine collagen fillers made in Japan derives its collagen content from Australian bred calves’ skin.
However, a skin allergy test before injecting bovine collagen fillers is required. Hence, porcine-derived collagen fillers were produced shortly after. Porcine collagens are more biologically compatible with humans, so no allergy tests are required, as all potentially antigenic compounds that might induce allergic reactions have been eliminated.
Benefits of Bovine collagen fillers:
- Contain lidocaine, a numbing agent that reduces the injection pain, and generally last for about 2-4 months after being injected.
- Easy to inject
- Widely known for the correction of the various wrinkles including the glabellar region, forehead line, and nasolabial fold.
Benefits of Porcine collagen fillers:
- May last for up to 12 months after injection.
- Good to treat facial wrinkles, nasolabial folds, and tear trough deformities.
4. Collagen fillers of human origins
Prior to the introduction of the Hyaluronic acid (HA) fillers, collagen fillers were widely used and were considered as the golden standard among other dermal fillers. Human collagen fillers were also developed alongside animal-derived collagen fillers to get rid of the hassle of skin allergy testing (particularly for bovine collagen fillers).
There are generally 3 types of human collagen fillers:
(a) Bioengineered human collagen fillers,
These have their collagen content derived from cultured human skin fibroblast cells* in the laboratory.
*Human skin fibroblast cells are cells responsible for the making of collagen.
(b) Allogeneic human collagen fillers from human cadaver tissue (human corpse), and
These contain real human origins derived from the tissues of human cadavers (corpse), but don’t worry! The human cadaverous tissues used are taken from accredited tissue banks, which are highly purified, natural human collagen grown under controlled laboratory conditions. As they are sterile, there in no need for skin allergy testing, like the bioengineered human collagen fillers.
(c) Autologous human collagen from your own skin.
These are derived from your own skin. Collagen content extracted from your body would be processed in the laboratory for about 3-4 weeks. Your physician would then get it back in syringes to be ready for your dermal filler injection. However, usually only a limited amount of collagen tissue may be obtained with each injection. Thus, several treatments may be required to give you your optimum look. Although this might be very attractive to patients who are undergoing skin excision (surgery to cut off skin) procedures in plastic surgery, for those who are not, you might need to go through the skin harvesting (or skin grafting) procedures. Ouch!
While allogeneic human collagen fillers are said to be suitable to inject into our mid dermis, autologous human collagen fillers are suitable to be injected into or under your skin, as well as in the subcutaneous tissue.
Benefits of human collagen fillers:
- Most compatible content to humans
- Have the least recovery time required after treatment
- Usually last for about 3-7 months.
- Good for lighter wrinkles or fine lines, and are usually injected near your facial skin surface.
- Some are used for deeper injections to treat deeper wrinkles or any other defects.
5. Some drawbacks of collagen fillers
So would you trade in what you strongly believe in and your support for animal rights, in turn for your own beauty?
Collagen fillers are in fact, no longer produced or used in Europe or USA since 2010, but are still available in other parts of the world.
There are 4 main reasons why they have been discontinued:
In general, collagen fillers are older types of fillers, and they could cause many side effects;
Animal-derived collagen fillers (especially bovine collagen fillers) may cause hypersensitivity and immunogenicity among patients; thus
They require skin allergy testing as animal collagen protein may be different from human collagen, which is a time-consuming and inconvenient process; and
Collagen fillers are older fillers; they don’t last as long as newer, non-animal origins derived Hyaluronic acid (HA) fillers.
The older dermal fillers, like the bovine derived ones, come with many side effects and it’s now almost completely not in use anymore.
What are the other choices?
Vegans (a mini vegan like me as well!) or vegetarians might not like the idea of getting animal products, what more getting an animal-derived filler to be injected into his/her body! So what are the other dermal filler options for us?
1. Hyaluronic acid (HA) fillers (Temporary filler)
Well, if collagen fillers are not appealing to you, you may consider going for the newer, more current and widely used dermal filler - Hyaluronic acid (HA) fillers.
Unlike collagen fillers that generally contain cheaper collagen sources (mostly animal-derived content), hyaluronic acid is abundantly found in everybody’s joint, eyes, and skin. It’s a natural component that matches our body. Thus, HA filler injections can be reversible. Besides being a temporary filler (last for not more than 12 months), if you don’t like the results of having HA fillers injected under your skin, once the filler is absorbed into your body (don’t worry, it’s totally fine), you may get another filler of another brand or provided by other doctor(s).
By the way, when we want to volumise (replace the volume of our skin), it would be better for us to use HA and not collagen.
2. Hydrophilic gels of polyalkylamide (Semi-permanent filler)
Semi-permanent fillers like hydrophilic gels of polyalkylamide is not a chemical substance, but a water (solute)-based dermal filler that is capable of absorbing 99% of water. By the way, it is not animal-based; it’s biocompatible, and has very little reaction with human tissue, so you don’t have to worry about it.
It is composed of 96% water and 4% polyalkylamide, and is generally used for the treatment of deep defects. Once this semi-permanent dermal filler is injected, it forms a capsule to lock down the water, in order to maintain the volume of the treated area. It will remain at the treated body area for about 2-5 years, which then lose its ability to hold (lock down) the water, and thus exiting our body.
This type of semi-permanent filler could restore the natural moisture of our skin, giving them the necessary strength and flexibility, due to the stimulation cell - fibroblasts that synthesize collagen and elastin for our skin firming. By injecting into the deeper layers of our skin, hydrophilic gels of polyalkylamide could be used to correct our facial volume, shaping facial contours and body parts - they smooth out the sharp facial features, correct shapes of the nose and chin, breast or buttocks, as well as remove any soft tissue defects.
However, for me, this option may not be as safe as temporary, HA fillers.
3. Poly-L-Lactic Acid
How about an alternative that stimulates our own collagen? These types of dermal fillers last longer, too! You may perhaps consider these few other types of fillers.
Collagen fillers induce collagen into our skin, while Poly-L-Lactic Acid helps in stimulating our own collagen.
Poly-L-lactic Acid contains content that were made from surgical threads widely used for suture by doctors in the body during operation. It’s not animal based, either. Poly-L-lactic acid is a temporary dermal filler composed of a biocompatible and biodegradable synthetic polymer. No pretreatment skin test is required.
Poly-L-lactic acid could stimulate our own collagen through fibroblast activation. As a result, the volume increases in the treated facial area over time. The amount of collagen present at the treated area has been found to gradually increase at 3-6 months after the dermal filler injection. Poly-L-lactic acid can be degraded by our metabolism and break down into water and carbon dioxide.
How to identify if we've made the right choice?
Dr Jeswender is very friendly and he’d shared with me so much about what dermal fillers options are available, that are non-animal derived, that suits vegetarians, or vegans’ preferences. Besides, he also gave me some advice on making the right choice!
There are so many different brands of dermal fillers from various countries. Each brand has its own quality, reliability, price, as well as grades (Grade A, B, etc.). It is important to identify which brand is suitable for us, instead of following the trend, or getting any cheaper options.
It’s good to have a budget but it would be better to avoid getting dermal fillers from unknown brands and sources - these products are most likely unauthorised, provided to you by unregistered doctors, or unauthorised persons from beauty centres. Sometimes, you may come across beauty centres that claim to have doctors in their hotel rooms or apartments for your treatments. It is no longer practised in Singapore, but Malaysians are still unaware about what they’re paying for in beauty treatments. Sometimes, you might also end up paying more than you should for a proper dermal filler injection.
Dermal fillers must be clinically done for you as they involve injections, something that goes into your body. Therefore, it’s highly advisable for you to go to a proper medical aesthetics clinic that clearly states the word “Clinic / Klinik” on their sign boards.
Did you know that silicone is banned as dermal fillers? According to the U.S. Food and Drugs Administration (FDA), liquid silicone or silicone gel is NOT approved for injection to fill wrinkles or augment tissues anywhere in the body.” If you use it in your body, it feels very hard like a rock under your skin, and it’s hard to be removed (only can be removed via surgery that involves cutting off your skin). However, it’s still currently available in beauty centres in Malaysia.
In Thailand, certain dermal fillers can be purchased over the counter (in shops) and can be self-injected. These dermal fillers are most likely not medically approved, and they might not come in pure form - there might be other chemical formations in the ingredients, or impurities such as unwanted toxics. Hence, it’s best to get dermal fillers done by a licensed doctor under our Malaysian Medical Council (MMC).
Besides getting a proper treatment from a licensed doctor, a doctor’s techniques and expertise counts, too. Different doctors have different injecting techniques and use different filler products. In any case, do discuss with your aesthetic physicians on the products used whenever you decide to enhance your aesthetic features!
Just as what Dr Jeswender advised, you should know more about dermal fillers by arranging a consultation with doctors. So before you’ve come to a conclusion, do let yourself be open to more options available around you!
Dermlaze Skin Clinic is a one-stop centre for all your medical aesthetic needs. Our medical team has over 30 years of experience in medical practice and will be more than willing to advise you on the available options for treatment. At Dermlaze Skin Clinic, we believe in providing good advice to our patients using one of the latest methodologies as well as one of the most up to date equipment in the field.
The centre prides itself with providing high quality medical laser and aesthetic treatments which show significant and consistent results. The centre is fully equipped with modern and sophisticated laser technology aiming to enhance your looks. In addition to aesthetic medicine, the clinic also has vast experience in providing treatment for anti-aging.
Juliet’s Reminder: Besides having this article written for vegans or strict vegetarians, I would also like to take this opportunity to create awareness among all of you that, whatever you’ve decided for injectable or skincare products, do keep track with their contents, too! If you’re not sure about them, you should always ask your physician before the treatment starts!