Microincision
Face Lift
& Brow Lift
Collagen treatment results
Questions
& Answers
.....Before
.....,...... ..............................................................................After.............
Collagen treatment effectively removes most signs of aging and brings back the youthful face once again.
Collagen
implants and Collagen Replacement Therapy is a proven, non-surgical treatment
from which you can obtain immediate results. Collagen Replacement
therapy replenishes the skin's natural collagen. The natural appearance
of your skin may be enhanced as the contour of the support structure is
restored. By supplementing your skin's own collagen. Collagen
Replacement Therapy helps smooth facial lines. as well as most type of
scars. Depending on age, skin condition, and the amount of sun damage,
your treatment program swill be tailored to incorporate your individual
needs. Dr. Rapaport's expertise in this field is well known, and
you can expect excellent care.
MORE
ON COLLAGEN: QUESTIONS & ANSWERS
The way
your skin looks is directly related to the way your skin is supported.
Aging, disease, injury - these are some of the factors that can weaken
the collagen fibers that give your skin its underlying strength.
Until the 1970s, it wasn't possible for doctors to replace damaged collagen.
Now, both Zyderm Collagen and Zyplast Collagen Implants are available.
Made of highly purified bovine collagen, these materials can be injected
into your skin to supplement your body's own collagen and actually fill
certain lines and facial furrows.
This booklet will not take the place of a consultation with your doctor,
but it will answer some of the questions often asked about treatment with
injectable collagen. And it will help you and your doctor decide whether
Zydermor ZyplastCollagen treatments can help to smooth your skin.
What
is collagen?
How
was injectable collagen developed?
How
long has injectable collagen been used?
How do Zyderm Collagen and Zyplast
Collagen work?
How
does ZydermCollagenâ differ from Zyplast Collagen?
Which
skin depressions cannot be helped by either material?
Should
injectable collagen take the place of surgical procedures such as face-lifts
and dermabrasion?
How do collagen creams differ from injectable collagen?
Can anyone be treated with Zyderm Collagen or Zyplast Collagen
Implants?
What is involved in injectable collagen treatment?
How does the skin test work?
When does treatment start?
Do the injections hurt?
How will my skin look and feel immediately after treatment?
How common are treatment reactions?
Are there any other types of reactions I should be aware
of ?
Does the correction last forever?
How often will I need a "touch-up" injection?
Without touch-up injections, how will my skin look?
What
is collagen?
Collagen is a natural protein that provides structural support. It is
found throughout the body - in skin, muscle, tendon, and bone. Fibers
of collagen are woven together like threads in fabric to form a framework
into which new cells can grow. In the skin, collagen provides texture,
resiliency, and shape.
The collagen in human skin is very similar to the collagen found in certain
animals. As a result, animal collagen has had many medical applications;
for example, animal collagen has been used in sutures for over a century.
Heart valves used during surgery are also made of collagen. Injectable
Zydermand ZyplastCollagen Implants are made of collagen from cow skin
that has been highly purified. back
to top
How
was injectable collagen developed?
In the early 1970s, a group of biochemists and physicians at Stanford
University were researching alternatives to skin grafts. In the course
of this work they developed the concept of purifying animal collagen so
thoroughly that it could be used to replace lost skin tissue. Further
research by Collagen Corporation led to the development of Zydermand ZyplastCollagen
Implants. back to top
How long has injectable collagen been used?
Injectable collagen was first used to treat patients in 1976.
Since then, over 500,000 people have been treated with either Zydermor
ZyplastCollagen Implants. The procedure is administered routinely by over
3,500 physicians nationally, and in more than 20 other countries. back
to top
How
do Zyderm Collagen and Zyplast Collagen work?
Both Zydermand ZyplastCollagen Implants lend additional support to the
collagen network within the skin. When a physician injects small amounts
of either material directly into areas where the body's own collagen has
been weakened, depressions can be raised to the level of the surrounding
skin. Thus, lines and scars can be minimized, texture is improved, and
the skin has a softer and more even tone. back
to top
diagram
How does
Zyderm Collagen differ from Zyplast Collagen?
Zyderm Collagen was formulated especially for people with small or superficial
contour problems. It can be particularly effective in smoothing delicate
frown and smile lines, as well as the fine creases that develop at the
comers of the eyes and above and below the lips. It can also help correct
certain kinds of shallow scars.
Zyplast Collagen
was designed to treat depressions requiring a stronger material. It is
used for more pronounced contour problems (such as deeper scars, lines,
and furrows) and for areas upon which more force is being exerted (such
as the comers of the mouth).
Zyderm and Zyplast Collagen Implants may be used alone or in conjunction
with one another. Your physician will determine the potential benefits
of each and an appropriate course of treatment. back
to top
Which
skin depressions cannot be helped by either material?
Depressions with sharp edges and narrow "ice pick" acne scars
do not usually respond to these materials. back
to top
Should
injectable collagen take the place of surgical procedures such as face-lifts
and dermabrasion?
No. Injectable collagen treatments are not meant for people who have excess
facial skin or for those who want a major resurfacing of the skin. However,
doctors often use iyderm or ZyplastCollagen Implants in conjunction with
surgery to fill in depressions not amenable to surgery. By using injectable
collagen following a face-lift or dermabrasion, surgical results can be
enhanced. back to top
How
do collagen creams differ from injectable collagen?
Regardless of the ingredients, moisturizers work only on the skin's surface
as a temporary cap to help retain water. Zydermand ZyplastCollagen Implants,
however, are medical products that are injected below the skin's surface
where contour problems begin and where collagen replacement can help. back
to top
Can
anyone be treated with Zyderm Collagen or Zyplast Collagen Implants?
No. Your doctor will inquire about your medical history and administer
a skin test to determine if you are an appropriate candidate for treatment.
If you have a history of allergy to other bovine (cow) collagen products,
severe allergies (indicated by a history of anaphylaxis [shock], or a
history of presence of multiple severe allergies), if you are currently
on corticosteroid or immunosuppressive therapy, e.g., prednisone, or are
undergoing or planning to undergo desensitization injections to meat products,
you cannot receive injectable collagen. Also, people who are sensitive
to lidocaine cannot receive collagen implants, as a small amount of this
anesthetic is contained in Zydermand ZyplastCollagen Implants, and in
the Collagen Test Implant. Furthermore, people who have had a previous
allergic reaction to either Zydermor ZyplastCollagen may not be re-treated.
Neither Zydermnor ZyplastCollagen Implant should be used for breast augmentation,
and neither material should be injected into bone, tendon, ligament or
muscle.
If you have a personal history of autoimmune disease which includes (but
is not limited to) rheumatoid arthritis, psoriatic arthritis, scleroderma
(including CREST syndrome), systemic or discoid lupus erythematosus, or
polymyositis, a dietary allergy to beef, or if you have recently been
on corticosteroid or immunosuppressive therapy, your physician may want
to administer additional skin tests before deciding if you should be treated.
If you have any questions about these medical conditions, be sure to discuss
them with your doctor. You will also be skin tested prior to treatment.
Anyone who exhibits a sensitivity to the material, as demonstrated by
the skin test, cannot proceed with treatment. back
to top
What
is involved in injectable collagen treatment?
There are three steps: a skin test, the treatment series, and periodic
touch-ups. back to top
How does the skin test work?
To determine if you are eligible for treatment with either Zydermor ZyplastCollagen
Implant, your doctor will inject a small amount of collagen into your
forearm, just below the skin's surface. Both you and your doctor should
watch the test site closely for four weeks for any signs of sensitivity
to the material such as redness, swelling, or itching. Pay special attention
to your test site durin2 the first three days since the majority of test
reactions occur durin2 this period. At the first sign of any of these
problems, contact your doctor.
Only about three out of every 100 tested patients show a sensitivity to
the test and cannot be treated with injectable collagen; 97 percent of
all tested patients can be treated. back
to top
When
does treatment start?
Treatment can begin after the four-week test observation
period if you are not sensitive to the skin test. Treatment involves a
series of office visits - usually two weeks apart. Most patients see considerable
improvement in one to three treatment sessions depending on the size,
shape, and texture of the area undergoing treatment. back
to top
Do
the injections hurt?
You may find that the injections are somewhat uncomfortable particularly
around the nose or lips. However, both Zydermand ZyplastCollagen Implants
contain a small amount of lidocaine that helps numb the area temporarily,
and most people report that the injections are relatively painless. back
to top
How will my skin look and feel immediately after treatment?
Most patients feel comfortable in resuming their normal activities following
treatment. Temporary puffiness of the treated areas, however, should be
expected, especially with ZydermCollagen Implant.
With both Zydermand ZyplastCollagen Implants, you may also notice temporary
blushing, slight bruising, and tenderness around the treatment sites.
Like the puffiness, these are normal occurrences and all should subside
within a few days. Although the material is generally not visibly distinguishable
from the surrounding skin, some patients have reported that they were
initially able to feel the outline of the injected collagen.
However, as the new collagen is incorporated into your own skin, the treatment
site takes on the natural look and feel of healthy skin. Any redness and/or
visible swelling that persists for more than a few days may indicate a
reaction to the material.
Be sure to report this or any other questionable symptoms to your doctor.
back to top
How
common are treatment reactions?
With more than 500,000 people treated to date, only a small number of
patients (approximately 1-2 percent) have developed an allergic reaction
after one or more treatment injections. These reactions may consist of
prolonged redness, swelling, itching and/or firmness at some or all injection
sites. Most have lasted between three and four months, but in some cases
have exceeded one year.
In less than I% of treated patients, formation of a scab and sloughing
(shedding) of the tissue at the treatment site have been noted, which
can result in a shallow scar. On rare occasions, abscess formation has
occurred at implantation sites. These reactions develop weeks to months
following injections, and may result in induration and/or scar formation.
Also, in fewer
than 5 per 1000 treated patients, the following have been reported: systemic
complaints such as flu-like
symptoms (nausea, fever, dizziness, headache, malaise, joint aches), rash,
blurred vision, tingling, numbness or difficulty in breathing.
Of the patients who have developed an allergic reaction after treatment,
one-half had an unreported or unrecognized response to the skin test.
With proper monitoring of the skin test, many of these reactions could
have been prevented. The remaining one- half of this group developed allergic
reactions despite a response- free skin test.
An additional one percent of individuals experience symptoms similar to
those of an allergic reaction that may, however, occur periodically. Recent
research has shown that some of these patients are allergic to bovine
collagen.
If you observe any symptoms such as redness and/or swelling, please inform
your physician. He or she will deten-nine if you should discontinue treatment;
no further injectable collagen can be administered to anyone who has experienced
an allergic reaction to the material. back
to top
Are
there any other types of reactions I should be aware of ?
Yes. There is a possibility that you could experience a reaction related
to the injection process itself. However, this does not mean it is necessary
to discontinue treatment. For instance, mild bruising or a slight blush
could occur at the injection site. If you have previously had facial herpes
simplex at the site of injection, there is a chance that the injection
process itself could provoke another herpes simplex eruption. If you are
using aspirin or non-steroidal anti-inflammatory drugs that reduce coagulation,
you may experience increased bruising or bleeding at injection sites.
In addition, any injection carries a small risk of infection.
Some physicians have reported the occurrence of connective tissue diseases
such as rheumatoid arthritis, systemic lupus erythematosus, dermatomyositis
(DM), and polymyositis (PM) subsequent to collagen injections, in patients
with no previous history of these disorders. Statistical analysis comparing
the
number of collagen treated patients who were diagnosed with two rare connective
tissue diseases (PM)/(DM) with the expected number of these diseases,
suggests that the rate of occurrence of these two rare diseases appears
to be higher than expected in the collagen treated population. However,
a causal (cause and effect) relationship between collagen injection and
the onset of autoimmune disease or systemic connective tissue disease
has not been established.
Also, an increased
incidence of cell-mediated and humoral immunity to various collagens have
been found in systemic connective tissue diseases such as rheumatoid arthritis,
juvenile rheumatoid arthritis, and progressive systemic sclerosis (scleroderma).
Patients with these diseases may thus have an increased susceptibility
to an allergic response and/or accelerated clearance of their implants
when injected with bovine dermal coliagen preparations. If you have any
of these diseases, you should discuss this specifically with your doctor.
It is possible that, during the process of administering injectable collagen,
the needle could be accidentally placed into or through a blood vessel.
This has been reported to have occurred in less than I% of patients treated.
However, if it should happen, it could result in temporary discoloration
of the treated area and/or formation of a scab, and sloughing (shedding)
of this tissue at the treatment site can result in a shallow scar. Also,
as with other substances that are injected (particularly local anesthetics
and steroids injected into the head and neck area or the extremities),
there is a remote possibility of accidental injection of the material
into a blood vessel. This could result in blockage of the blood flow and
loss of circulation to nearby sites, which in one case resulted in permanent
loss of vision in one eye.
There have been infrequent reports of the injected collagen being visible
in the skin, in the form of a small raised or white area at the treatment
site, which may persist from a few weeks to several months. Also, some
areas (such as compressed scars) resist precise placement of the material,
resulting in a slight elevation beside the defect.
An understanding of the safety of injectable collagen is based on clinical
data from 1978 to the present. Ongoing research will continue to provide
more information. back to
top
Does the correction last forever?
No. Touch-up injections are usually needed to maintain maximum correction.
Because both Zydermand ZyplastCollagen Implants are similar to your own
skin, they will be altered by the same ongoing mechanical forces such
as smiling or other muscle activity and biochemical processes - such as
aging and active acne - that caused the original skin depressions. It
has been reported that the body may deposit its own collagen at the site
of collagen implantation. You should therefore be aware that part or all
of the correction may last for 2 years or longer. back
to top
How
often will I need a "touch-up" injection?
Most patients who choose to receive touch-ups for lines or furrows do
so within 3 to 12 months of the original treatment series. For scars,
and perhaps those depressions treated with ZyplastCollagen, the time between
touch-ups may be longer. But keep in mind that the amount of coliagen
used to restore full correction will be considerably less than that used
in the initial treatment series.
Use of Zydenn I Collagen Implant in an individual patient should be limited
to 30 cc over a one-year period. Use of Zyderm11 Collagen Implant in an
individual patient should be limited to 15 cc over a one-year period.
The combination of these products or of Zyderin in conjunction with Zyplastin
an individual patient should be limited to 30 cc over a one-year period.
The safety of injecting greater amounts on an annual basis has not been
established. back to top
Without
touch-up injections, how will my skin look?
Correction may subside gradually until your skin looks like it did before
treatment.
Touch-up injections will help you maintain your correction and can provide
a long-ten-n solution to skin contour problems. back
to top
For further
information write or call:
COLLAGEN CENTER
810 Abbott Blvd
Fort Lee, NJ 07024
c/o
Jeffrey A. Rapaport, M.D. , P.A.
http://www.jrapaport.com
(201) 224-6655.