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The first injectable filler available in the United States was Zyderm I. It was approved by the FDA in 1981 for injection into skin folds and wrinkles related to the aging process or depressed skin scars. Zyderm II followed in 1983 and Zyplast in 1985. They were all basically collagen derived from cow hide. Each form was designed for injection at a different depth within the skin. The chemical composition of each differed slightly so they lasted for a variable number of months, usually 2 to 3 months. Aside from their temporary effect the other major drawback to their use was the need for skin testing. A small amount was injected under the skin and if the patient did not react to the material they could go ahead with a full treatment some weeks after the skin test. If the full treatment was given to someone who was sensitive/allergic severe allergic reactions could result including the loss of the skin over the injection site.
