CosmoDerm™/CosmoPlast™

WRINKLES

NATURE OF THE PROCEDURE

Collagen is one of the proteins in your body that gives support to the skin. When collagen ages, whether naturally or accelerated by sun damage or smoking, it "collapses" and thus forms a wrinkle. This is nothing to do with dry skin. Dry skin does not cause wrinkles.

CosmoPlast/CosmoDerm is human bio-engineered collagen that is used for correction of scars and wrinkles. It gives support to the skin. It will replace your collagen that has been lost or that has collapsed, and the treatment itself may even stimulate more of your own collagen to grow around the injected product. CosmoDerm and CosmoPlast are not made from any human embryo or cadaver tissue. It is not made from cows or any other animal.

This product is FDA approved for the correction of wrinkles. It will slowly become absorbed and dissipate, and as it does so, the wrinkle or other tissue defect will slowly begin to reappear. At whatever point you wish, usually in 4-6 months, you may simply call to come back for another treatment session.

CosmoDerm is the "thinnest product" which is often used for wrinkles around the eyes, and CosmoPlast is cross linked and made to last longer, particularly for the areas around the mouth and the lips.

FEES

Test dose - none necessary.

1 cc of CosmoDerm or CosmoPlast - $390

All fees are subject to change. The fee is always what is current at the time of your actual treatment. Old fee schedules, handouts, or web site fees do not apply. Any quoted fees must be in writing and are only good for six months. No "verbal" quotes are accepted.

SCHEDULING

Dr. Coverman must see all new patients prior to the first treatment session. That this time he will discuss your overall cosmetic concerns and develop a skin treatment program just for you. In addition to other dermal filling materials such as Restylane or Artecoll (Artefill), he may offer alternatives including the use of topical products, Botox, ablative and non-ablative lasers, microdermabrasion, and other techniques that might be appropriate for your care. There is a fee for this visit.

Because there is a needlestick and the remote chance of bruising, do not schedule your CosmoPlast/CosmoDerm treatment immediately before any big social event. If you have a big party on the weekend, try to schedule your actual CosmoPlast/CosmoDerm treatment on a Monday or Tuesday. Otherwise, CosmoPlast/CosmoDerm injections may be performed at any time, and you may immediately return to all normal activities.

There is a $150 non-refundable fee for missed appointments without a 24 hour notice.

PRETREATMENT

If you have ever had herpes or think you may have (cold sores or fever blisters), inform Dr. Coverman or our staff prior to scheduling your appointment. We will give you a series of anti-herpes pills to take the day before the treatment, the day of, and the day after. This should help to suppress or prevent herpes from flaring, but there are no guarantees. A herpes flare could cause pain, pigment, infection, and scarring.

Dr. Coverman strongly recommends that a numbing cream be applied prior to the treatment. Although this won't block all discomfort, often it can improve this by at least 50%. You may purchase some of these over the counter (Ela-Max) but we recommend Betacaine LA. This is a patented product that is compounded by Medical Center Pharmacy in Tampa, Florida. We have tried almost all other similar products on the market, and this is by far the best. By law, this must be dispensed directly to the patient, and this will be shipped promptly directly to your home. For your convenience, we will fax the prescription for you. We will need your credit card information in order to do this but we immediately SHRED that information and do not save it anywhere.

Please apply this one hour prior to your intended procedure. It will work even better if you place saran wrap over the cream and then tape all of the edges airtight. Some patients don't want to come to the office with cream or plastic on their face, so if you bring the cream with you, we can apply it for you just prior to your treatment. Although it won't be on as long, a little bit is always better than nothing.

SAVE the numbing cream! It can be used again for this treatment, other treatments like it, or for waxing, hair removal, even insect stings and sunburns. You will always find a use for this cream. NEVER put it on a fresh burn, infected skin, inflamed skin, or an undiagnosed rash. For any questions, always ask Dr. Coverman.

TREATMENT DAY

CosmoPlast/CosmoDerm is injected personally by Dr. Coverman using a very narrow gauge skinny needle. He does not use nurses, assistants or PA's. He will ask you to point out the sites that you would like treated, and the procedure only takes minutes. Even with the numbing cream there will be a brief pinprick needlestick. The discomfort is generally over immediately upon completion of the procedure.

Women may apply make-up and go back to normal activities. There is a chance of pinpoint bruising, and there is the possibility of some minimal swelling as the material is injected. Since some of this is water for dilution, the "swelling" often goes down quickly. You may resume all normal activities.

POST TREATMENT

No special instructions. Do not sunburn for the next week. Do not exercise or drink alcohol on your treatment day.

COMPLICATIONS

There is of course a needlestick, and because of that there can be pinpoint bruising. Usually, if any, this clears within a few days and can be covered by make-up. There is some immediate overcorrection which may be visible to others, but as some of the water for dilution is absorbed, this goes down quickly. The correction with CosmoPlast/CosmoDerm is immediate and you may immediately resume all normal activities.

Dr. Coverman will discuss other potential complications with you at your office visit.

FOLLOW-UP

There is no special follow-up. You do not need to come back to be rechecked unless you perceive any complication. Please schedule your normal CosmoPlast/CosmoDerm visits well in advance so that you can get the appointment time that you wish.

OTHER FILLING SUBSTANCES

You will be hearing about other new filling substances in the print, TV or Internet media. BE VERY CAREFUL! Some of these products (such as Radiance (Bioform) or Silicone) are not yet FDA-approved for wrinkles. They may be FDA-approved for other uses, but be very careful when you read the "pitch" or other advertising by physicians using these products. If they are "FDA-approved" make sure they are FDA- approved for what your treatment is to be. Some of these may be used for urinary incontinence or filling tissue defects from AIDS, but that is not the same as treating wrinkles. Please remember, "the worst thing about Collagen is that it doesn't last forever; the best thing about Collagen is that it doesn't last forever." You really don't want something that "lasts forever" or is "permanent." What if the injection is asymmetric? What if we hit an inapparent subcutaneous "pocket" that left a visible lump?" What if there were "beading?" You are stuck with it. As you age, your skin will thin, and these "permanent" products may show.

Radiance (Bioform) is currently used for stress urinary incompetence. The product is calcium hydroxylapatite microspheres in a gel carrier. It basically creates bone. I am not sure putting bone in your lips or directly under your skin is a good idea. What happens when you get older and your skin naturally loses some subcutaneous fat and support? Will this material be visible or shift? What if you don't like where it was placed?

The same applies to liquid silicone and Artecoll. All of these procedures with small microspheres sound very appealing and "permanent." That is there appeal - and that is their downfall. When and if these products become FDA-approved FOR WRINKLES, then Dr. Coverman will be among the first to use them, and will use them as aggressively as he currently uses CosmoPlast/CosmoDerm, Zyderm Collagen, and soon to be released Restylane. Although some of these products don't require a test dose, although they may be widely promoted, although you may see glowing magazine reports about them, always ask the following questions:

1. Is the product FDA approved? 2. Is this product FDA approved for the purpose that I am using it for? 3. How long has it been out and what is its track record? 4. Is it too permanent? What if I don't like what I see? 5. What is the experience of the person injecting this material?

The use of many of these materials are highly "technique" dependent. Dr. Coverman is the leading user of filling substances in Austin. He has had more experience in using injectable filling substances than any one in Austin, beginning in 1981 with his first use of injectable Zyderm Collagen. You should always trust experience, technique, and history of knowing what is best and what might not be best despite media hype. When Dr. Coverman feels it is safe for you to use the products, he will offer them.

Top