Evolence Discontinued

The economic downturn continues to particularly hurt "cosmoceutical" companies.  Evolence is the latest victim.  Ortho Dermatologics (a division of Ortho-McNeil-Janssen Pharmaceuticals, which is itself a division of Johnson & Johnson) has discontinued Evolence.

What is (was) Evolence?

• A soft-tissue filler based upon porcine collagen (from a pig)
• Excellent safety record:  Unlike bovine collagen (from a cow) which caused multiple allergies, Evolence was never associated with a single allergy.
• FDA approved on June 30, 2008:  The federal government was satisfied with its safety and efficacy.
• It has been used similarly to Juvederm and Restylane, especially at the nasolabial folds (connecting the nostrils to the corners of the mouth).
• Less swelling and bruising than Juvederm and Restylane
• Similar longevity as Juvederm and Restylane

If Evolence was similar to Juvederm and Restylane (and with less bruising), why wasn't it more popular?

Lumpiness.  A number of my patients noted that Evolence was not as soft or smooth at its competitors.  While the lumps were never visible, they were palpable (and apparently annoying).

My mother loved Evolence.  Women in their 60s and 70s have thinner skin, which tends to bruise significantly (with all of the injectable products).  When my mother had requested Juvederm, Restylane, Elevess/Hydrelle, or Radiesse, the subsequent bruising had persisted as long as two weeks.  However, with Evolence, the black-and-blue marks were smaller and resolved within a few days.

Evolence has filled a niche in my practice:  It is useful in patients who would like to minimize bruising...

• because they have a big event tonight!
• because they are older.
• because they naturally have thin blood.
• because they are on blood thinners (like Coumadin, Plavix, or aspirin).

What will be the new anti-bruising injectable filler?  In this economy, I don't know.  I certainly hope that Evolence is soon replaced.