Evolence is a relatively new injectable filler from Ortho-Neutrogenia, which is a Johnson and Johnson company. Johnson and Johnson is reintroducing collagen to the filler market. The main advantage of collagen is its consistency. Collagen also is associated with less bruising and swelling after injection than the hyaluronic acid fillers, like Restylane and Juvederm. Dr. Goldman prefers to use Evolence for more superficial wrinkles and creases. He feels the hyaluronic acid fillers work better in deeper folds. Mainy patiens benefit from layering of two different filler: Evolence in superficial creases and Radiesse or one of the hyaluronic acid fillers, like Restylane, in the deeper folds.

Earlier collagen products had two problems: (1) they only lasted a short time, 3 months or so and (2) a small percentage of patients had sensitivity to the human or bovine (cow) collagen used. Skin testing was therefore required, and there was a theoretical risk of infection also. Evolence has solved the first problem by purifying or stipping the collagen of associated proteins, which reduces allergy potential and eliminates the need for skin testing. Evolence comes from a porcine (pig) source. After purification, the collagen is then cross-linked. This cross-linking allows Evolence to last longer than prior collagen products. In clinical testing and use, Evolence lasts 6 months or more, equivalent to Restylane and Juvederm.

Dr. Goldman has one of the largest injectable filler practices in Northern Ohio. As a result, he was recently named an Evolence Star Trainer by Ortho-Neutrogenia/Johnson and Johnson, to train other physicians in injection techniques. He uses the injectable fillers as part of a full spectrum of option for facial rejuvenation. He believes in a graduated approach to facial rejuvenation, starting with non-surgical techniques, including Botox, injectable fillers, and medical-grade skin care as first-line treatment. The second treatment tier involves more aggressive non-surgical techniques like CO2 laser resurfacing with the Fraxel Re:pair laser and more involved injection techniques like fat injection (using the patient’s own fat) or layering of multiple different fillers concurrently.

Surgical options are graduated as well. The facelift remains the gold standard for facial rejuvenation, but other procedures including the endoscopic brow lift, eyelid lifts (blepharoplasty), and neck lifts can be used in conjunction with, or instead of the facelift, in appropriate patients.

Dr. Goldman’s extensive experience with facial surgery gives him a thorough understanding of facial anatomy, allowing him to use more advanced techniques than other physician less experienced in surgery and injection techniques.

Feel free to email or call with any questions about Evolence, Botox, or facial surgery.