American women say they have found the fountain of youth in a syringe, but there's a catch: It's illegal to use in the United States.
Hyaluronic acid, marketed under the names Restylane and Perlane, is tremendously popular in the 61 countries where it is legal to use as a wrinkle filler. It occurs naturally in the body as part of the medium where skin cells live.
And those who have received the treatment rave about their results.
"When I look at myself in the mirror and I don't see the deep grooves … I feel ecstatic and I feel happy," Bonnie Rose, 41, told ABCNEWS' Good Morning America.
ABCNEWS' Dr. Nancy Snyderman says Restylane can be more effective than collagen.
"We've all heard of collagen, an animal substance used to plump up and fill in lines and creases in the face that cannot be smoothed by Botox," says Snyderman. "But collagen comes from cows, and carries about a 3 percent risk of allergic reaction."
Perhaps a bigger downside is longevity. Collagen injections typically last about three months — meaning more visits and more money are required for maintenance.
"Collagen is very variable," says Wendy Lewis, a former longtime collagen user and independent cosmetic surgery consultant in New York City. "It's fine if you are in you're 20s and you just want your upper lip done, but once you get into your late 30s and the line is a little deeper — you find that you're living in your dermatologist's office."
Restylane is what has satisfied Lewis and thousands of others all over the world who wanted an alternative filler without collagen's pitfalls.
And the findings of a clinical trial comparing Restylane to collagen in 137 patients offer promising news that Q-Med, the Swedish-based manufacturers of Restylane, hopes will bring it one step closer to approval by the Food and Drug Administration for use in the United States.
The results, which will be presented today at the 29th annual meeting of the American Society for Dermatologic Surgery, found that hyaluronic acid worked better, lasted longer and required less product than collagen to fill facial lines.
Additionally, this preparation of hyaluronic acid was found to have no risk of allergic reactions. Earlier preparations derived from rooster combs have been associated with inflammatory reactions in the past.
"The products that were used in the '60s, '70s and '80s were very, very different, even though they're hyaluronic acid," says New York City plastic surgeon Dr. Paul Lorenc, who participated in the clinical trial for the FDA. "[Restylane] is a non-animal-derived product."
Crossing the Border
Many American women who want to reap Restylane's benefits, which can last as long as a year, are traveling to countries like Britain where it is legal to use.
Dr. Nick Lowe has been using this new class of injectable fillers for the past six years at his office in London's Cavendish Square.
"One of the puzzles is why we've got all of these fillers available in Europe and why we haven't in the United States," he says. "I think one of the benefits of the American system is the FDA regulations, and the FDA are very, very careful — as they should be — before these products are allowed on the market."