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Where Have the Collagen Facial Fillers Gone?
by: Dr Barry Eppley

The use of collagen seems to be so natural and logical for the concept of soft tissue fillers that one may wonder why the use of these type of products does not dominate the injectable filler market. For over two decades collagen, in act, did but is now largely almost of historic interest. The reason that collagen is nearly gone from the market is because it goes away too quickly compared to other more contemporary filling materials.

The use of collagen derived from cows (otherwise known as bovine) was used for over twenty years as the only injectable filler product. Because of its animal origin, one had to be skin tested to be certain one wasn't allergic (as some patients are). As this was an animal material, the body recognized it as foreign and started to break it down immediately. Most bovine collagen injection results only last about 6 weeks. Their plumping effects start to go down almost immediately. When the collagen concept was tried using human-derived material, which did not require a skin test, its lasting effects have not proven to be much longer. It sounds more appealing but the results have not proven to be better.

Furthermore, one would think that injecting collagen into and under the skin would help promote new collagen production even if the original injection material does go away. But, in fact, it has proven to have no collagen promotion effects either. As natural as collagen injections sound, they have turned out to be quick-dissolving space fillers only.

Collagen has nearly completely and quite quickly been replaced by hyaluronic acid-based (HA) filler materials since their commercial introduction in 2003. HA materials are no better at promoting collagen development and don't necessarily resist breakdown better than collagen. But they have one outstanding property which makes it the preferred injectable filler is very hydrophilic which is a fancy term for acting like a sponge. It absorbs water and holds onto it, allowing a longer-lasting plumping effect due to the accumulation of water into the HA material. Eventually when there is more water than HA, the plumping effect is gone. But its persistence is usually at least twice as long as collagen.

Collagen is sort of being 'reinvented' today in different formulations where it is mixed with other injectable agents such as non-dissolving beads and the popular hyaluron-based fillers. But as a stand-alone product, it does not hold up over time.

Dr Barry Eppley is a board-certified plastic surgeon in private practice in Indianapolis, Indiana at Clarian Health Systems. ( He writes a daily blog on plastic surgery, spa therapies, and medical skin care at

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