WASHINGTON(AP)
Hundreds of thousands of baby boomer women who think they've
found an antidote to aging in cosmetic facial fillers must be
better informed of possible risks, government health advisers said
Tuesday.
A panel of independent advisers urged the Food and Drug
Administration to revise the labeling to include the possibility of
long lasting reactions such as bumps under the skin, blotches and
scars.
"It is almost a no-brainer," said Dr. Michael Bigby, a
Harvard Medical School dermatologist. "The current label is
not adequate." The gel-like fillers, which have become hugely
popular in the last few years, are injected into the face to smooth
away wrinkles.
Manufacturers and plastic surgeons say fillers have an excellent
safety record. But Tuesday's FDA hearing raised questions about
unapproved uses, untrained technicians giving injections, and a
lack of long-term safety data. The hearing was a first step as the
FDA considers whether to regulate fillers more closely.
Plastic surgeons pledged to help the government track safety,
improve training and provide clearer information to consumers.
Women, and even some men, are drawn to skin fillers by the
promise of youthful good looks at far less cost and trouble than a
face lift. A touchup two or three times a year can boost deflated
middle-age egos. Unfortunately, for some patients, the result can
be blotchy skin, bumps on the face and worse.
Different from Botox, which is derived from a toxin that acts on
facial muscles, wrinkle fillers are like the biological equivalent
of a bit of spackle, except they're injected into the face.
They include such products as Juvederm, made by Allergan, Inc., and
Restylane, from Medicis Aesthetics Holdings.
FDA officials are concerned that fillers are being used for
purposes they were never tested and approved for, such as plumping
the lips, which are extremely sensitive.
There are also questions about a lack of clinical evidence on
how darker-skinned patients fare with the beauty treatments. More
black, Latino and Asian patients are trying plastic surgery, and
some information suggests they may be susceptible to unsightly
blotches and other complications from fillers.
"The trouble is that once this material is in the hands of
physicians, there's really not much control over how it's
used and where it's placed," said Dr. Scott Spear, a
Washington plastic surgeon. "That creates the potential for a
certain amount of mischief.
"But the good news is that, by and large, these are very
safe materials," Spear added. "They have a very healthy
risk profile."
FDA scientists will present the advisory panel with data on 823
patients who suffered serious reactions after treatment with
fillers between 2003 and this September. The overwhelming majority
were women, and the most common age group was 50- to 60-year-olds.
Plastic surgeons performed some 1.5 million cosmetic surgery
procedures with fillers last year alone.
Although no deaths were reported to the FDA, the complications
were troublesome enough that 638 of the patients required follow-up
medical treatment.
Most reactions involved minor swelling and redness,
complications that could be expected. But the FDA said it also
received reports of "serious and unexpected" problems,
including facial, lip and eye paralysis, disfigurement, vision
complications and some severe allergic reactions.
A small number of patients _ 19 _ went to the emergency room
with life-threatening allergic reactions, such as difficulty
breathing. Twelve developed infections that required
hospitalization.
"The FDA has been rushing these products to market as if
they were lifesaving medical products," said consumer activist
Diana Zuckerman, president of the National Research Center for
Women & Families. "They should be requiring better studies
since these products have only cosmetic benefits but potentially
lethal risks."
Some problems reported to the FDA may be due to unapproved or
"off-label" use of fillers. For example, the FDA does not
recommend them for plumping the lips, but some doctors see no
problem with that.
Another challenge is the sheer variety of fillers. Most are
eventually absorbed into the body, but one type contains tiny,
round, smooth plastic particles that the body does not absorb. Some
are made from natural substances and others are not. That means
they may react differently in the body.
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On the Net:
Food and Drug Administration:
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