Whoever said it pays to be beautiful neglected to mention how much it costs. But price has not been a factor for about 250,000 men and women who have added collagen injections to their beauty budgets in the last five years.
Often for a four-digit price tag, these skin-plumping-treatments-in-a-syringe can reduce wrinkles and fill in scars. The cost, and the fact that doctors alone can administer collagen, make it the sort of youth extender that used to be exclusive to the very rich.
But not anymore. To show how the mighty have fallen, neither celebrities nor socialites nor captains of industry hold sway. Of the thousands who have tried the treatment since it was approved by the Food and Drug Administration in 1981, a hefty portion are baby boomers working hard for the money, says Maureen Brunner of the Collagen Corp. in Palo Alto, Calif., the exclusive supplier of the product.
"When I started giving collagen injections five years ago, most of my patients were actors, actresses and models," recalls Dr. Edward Tobinick, a Beverly Hills dermatologist who was among the first to offer the treatments. "Now it's become a household item. A beauty aid for housewives."
Although it's possible to get a single injection for about $200, Brunner estimates that the price of the initial investment generally ranges from $500 to $1,000, depending on the depth and breadth of the wrinkles.
The effect is not permanent, however, because the bovine-based material is natural and subject to decomposition. To remain wrinkle free requires regular booster injections that add about another $250 to $500 to a user's annual bill.
Collagen: The word comes from the Greek for "glue" and defines a natural substance found in the dermis of mammals.
Plastic surgeons and dermatologists first used it to plump up depressions made by surgical scars and acne pits. But Brunner says her company's statistics show that 80% of current users have no other motive than to round out their wrinkles.
The success rate of the shots doesn't enhance the reputation of the collagen-containing moisture creams that many leading cosmetic companies offer.
"Medical science tells us, anything put on the surface of the skin is not taken into the skin," Dr. Frank M. Kamer, a Beverly Hills plastic surgeon and early tester of collagen injections, reminds patients.
As for face lifts--more traditional tools in the war on facial flaws--they seem to be in no danger of sagging sales despite the growing popularity of collagen-injection treatments.
"Collagen isn't a replacement for a lift," says Dr. Richard Strick, associate professor of medicine and co-director of Dermatological Surgery Training at UCLA.
Often, he points out, the two treatments are used together. A lift, which has never claimed to erase facial lines but will reduce sagging, is followed by collagen injections that will soften those lines cosmetic surgery can not remove.
Interestingly, the more popular collagen treatments become, the less inclined plastic surgeons are to administer them. Many now refer patients to dermatologists.
"I don't have time to give injections," Kamer says.
Strick explains that many plastic surgeons do as Kamer does, for financial reasons.
"They perform other techniques that are very lucrative," he says. "It's not cost effective for them to take time giving collagen treatments."
Brunner at the Collagen Corp. says a doctor's accumulated experience with the material is not an important requisite for a successfully administered collagen injections. But dermatologists absolutely disagree.
"The art of injecting collagen is completely technique dependent," Tobinick says. "Knowing where to inject it, how to feather the edges and blend it, knowing at what rate to inject and how to mold the material under the skin within 60 seconds of an injection are very significant things."
Even in experienced hands, there are risks to be considered. Of these, the worst is the danger of an allergic reaction--often in the form of a bumpy, red rash--that takes up to a year to clear.
UCLA's Strick points out: To reduce that possibility, doctors require at least one, sometimes two, skin tests before giving a full treatment. Statistics show that only about 3% of potential users prove to be allergic, he explains. But, he adds, in a small percentage of cases, reactions are delayed.
If collagen is injected into very thin skin, the material can form beads or bumps that can remain visible for several months, Strick says. And to make a temporary treatment even more transient, if it is injected too deeply into the skin, collagen is absorbed immediately and has no visible effect, Strick says.
Not a Panacea