Evolution is a mixture of microscopic, uniformly sized soft spheres of polyvinyl embedded in a so-called viscoelastic gel of poly(acrylamide-co-DADMA).

Evolution - nitty but not gritty ... Viscoelastic gels tend to flow freely as a uniform gel; very important when used as a filler in the skin. Poly(acrylamide-co-DADMA) gel is very stable in the skin and takes about 2-3 years to degrade of its own accord once in the tissues. The spheres within are absolutely soft and round, about 40 microns in diameter (too small to clog small vessels and too big to be eaten up by the body’s white cells). They provide the volume. Furthermore the spheres are porous so that the invading tissue molecules are able to anchor them and stabilise them readily at the site of injection – an important factor that combats any tendency for the spheres to migrate. The spheres provide attachments for the network of molecules – rather like bricks in a wall.

Evolution under the microscope ... Suspension of porous microspheres (polyvinyl gel) in a non-absorbable hydrogel (poly<acrylamide-co-DADMA>)

Evolution - the "attractive" filler ... The whole implant, gel and spheres, has one more ingenious feature – the presence of a gentle positive electrical charge. Once injected, the gentle positive charge attracts negatively-charged molecules towards it; the most important ones being hyaluronic acid (the major hydrating agent in the skin) and other glucosaminoglycans, the all-important collagen and elastin precursors. Over a period of about two months after injection, hyaluronic acid and other glucosaminoglycans begin to migrate towards the Evolution implant attracted by the gentle positive charge. These are drawn right into the interior of the Evolution, forming a soft, spongy mass that, because of the presence of hyaluronic acid, improves the quality of the overlying skin and gives the implant a completely natural feel. Gradually the gel portion becomes incorporated into the tissues as it stimulates the skin to replace the gel with its own collagen, already on site due to the action of the positive charge.

1 At time of injection 2 Immediately after Body's own molecules (negatively charged) are attracted towards the centre of the Evolution by the gentle positive charge. 3 After two months Body's own molecules become incorporated into the Evolution mass. Note how the molecules penetrate the pores in the spheres to stabilise the mass completely.

How does Evolution differ from other fillers? The innovative safety factor of Evolution lies in the fact that there is no reaction by the cells of the body, unlike other permanent fillers to date.  Existing permanent fillers work by accretion – a foreign-body reaction stimulated by the injected particles themselves. The final result, the increased volume is brought about by an increase in tissue cells. The problem is that there is no way of predicting exactly when a cellular reaction will begin, and when it will end. Such fillers do not work very well in the older person (just when you need the product!) and may work too well in others.  Evolution, however, works by a molecular influx. Molecules of hyaluronic acid and other glycosaminoglycans are attracted towards the implant by the gentle positive charge. Once the positive charge has become neutralised (positive and negative = neutral) then the attraction stops. It is a self-limiting process.  Evolution works therefore by augmenting and replacing the fluid within the tissues – the so-called extra-cellular matrix. The volume gained is due to an increase in tissue fluid not cells. The process is self-limiting and therefore predictable.

Indications ... Evolution can be used to fill relatively deep lines and folds; nose-to-mouth lines, deep forehead lines and chin lines. It can also be used to replace lost tissue – cheeks and depressed scars. Evolution can be layered within the tissues to give the desired result – filling at all skin levels for a uniform, natural look. Note no inflammatory reaction. Evolution at different layers in the skin

After the injection ... Once injected, Evolution may cause slight swelling, like all fillers, but this rapidly subsides and will retain about 65% of the original injected volume. The Evolution will after about two months become stable and essentially part of your own tissues. Residual concentrations of filling products – according to time

Particular care ... Most doctors prefer to prescribe oral anti-viral medication for anybody who suffers from recurrent cold sores (herpes simplex) prior to treatment of the mouth area. Evolution is considered an implant and so should not be injected when there is concurrent infection (eg acne, sinusitis, dental abcess). Until the implant has stabilised (2 months) it is advisable to cover any intense dental treatment with a single dose of antibiotics. Seek guidance from both your dentist and your cosmetic practitioner. As for all other filling injections, it is wise to avoid exposure to the sun for about 24 hours following injection, and not to take any unnecessary medication, recreational drugs or alcohol.

Contraindications ... Unlike some permanent fillers, Evolution can be used in people who have a tendency to develop cheloids (scar overgrowth). It is preferable to avoid using any unnecessary medication, including Evolution and Outline during pregnancy. Again as for other fillers, people who suffer autoimmune disorders are recommended to seek the advice of their responsible physician prior to receiving treatment.

Need for allergy test ... No part of the product has been derived from animals and therefore allergy testing is not required. Treatment can be started at the first visit.

Combining Evolution and Outline ... Deep, ingrained lines can be filled with Evolution (for the volume effect) and then the remaining top layers and skin crease can be specifically treated with Outline at the same session. Outline can also be injected over Evolution at a separate treatment session.

Top-ups ... Because Evolution is a permanent product the line should not be over-filled, rather allow the passage of time to reveal the full benefits. If a top-up is required then it is recommended after about two months. Outline can be topped up after a similar time.