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As of June 30 2008, a new soft tissue filler has been approved by the FDA for cosmetic facial application. With the name, EVOLENCE, it is an advanced collagen-based dermal filler that provides long-lasting treatment of moderate to deep facial wrinkles and folds, such as nasolabial folds. The results of treatment with EVOLENCE are immediate and its duration of action (persistence) is proven to last through six months. One year persistence data is still being gathered from the clinical trials so a longer than 6 month duration can not be confirmed at this time.

Unlike other dermal fillers that use hyaluronic acid (HA), which absorb water to create their effect, EVOLENCE is a true rebuilding agent due to its three-dimensional collagen structure. This collagen structure benefits patients as it is directly linked to the minimal bruising and swelling that might result. EVOLENCE does not use chemicals for cross-linking like many other products do, but instead uses natural sugar to improve durability. EVOLENCE® collagen is cross-linked through its patented GLYMATRIX™ Technology using the natural sugar, D-Ribose. The GLYMATRIX™ process is designed to mimic naturally occurring collagen in the skin by creating a true structural framework with natural, durable cross-links to ensure filler longevity, provide consistent and predictable results, and use natural ingredients for natural-looking results.The naturally sourced porcine collagen used in EVOLENCE is the most genetically similar to human collagen and has been used safely and effectively for decades in various medical applications, including heart valve replacement.

This new generation collagen filler is intended for injection into the mid-to-deep dermis for the correction of moderate to deep facial wrinkles and folds, such as nasolabial folds. The most common side effects of EVOLENCE injections are usually injection-site related and include mild swelling, redness, and pain. Other rare side effects include the development of small areas of firmness under the skin at the treated sites that may be noticed when the areas are pressed upon. When these do occur, they eventually resolve by resorbing away on their own.
With eight injectable filler products now available, the question becomes where does EVOLENCE fit? For those patients and physicians who would prefer a collagen-based filler, EVOLENCE lasts longer than those that have been historically on the market including Zyderm, Zyplast, Cosmoderm, and Cosmoplast.

Dr. Barry Eppley

Indianapolis, Indiana

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