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	<title>Observer &#187; Trayf Chic! Pig-Derived ‘Evolence’ Freshens City Faces</title>
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		<title>Observer &#187; Trayf Chic! Pig-Derived ‘Evolence’ Freshens City Faces</title>
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		<title>Trayf Chic! Pig-Derived ‘Evolence’ Freshens City Faces</title>

		<comments>http://observer.com/2009/03/itrayfi-chic-pigderived-evolence-freshens-city-faces/#comments</comments>
		<pubDate>Tue, 10 Mar 2009 23:00:00 -0400</pubDate>
					<link>http://observer.com/2009/03/itrayfi-chic-pigderived-evolence-freshens-city-faces/</link>
			<dc:creator>Meredith Bryan</dc:creator>
				
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		<description><![CDATA[<p><img class="alignleft" src="http://nyoobserver.files.wordpress.com/2011/06/l_bryandarrick-e-antell_0.jpg?w=255&h=300" />Over the past few years, age-conscious Manhattanites have filled their faces with all kinds of crazy stuff, from Botox to hyaluronic acids to fat from their own saddlebags. But recently, Jennifer, a slender 50-year-old who works on Wall Street, decided to plump up her cheeks with a new collagen called Evolence, made from pig tendons, that she had seen advertised on television. &ldquo;They mentioned that Demi Moore supposedly used it for laugh lines,&rdquo; she said. &ldquo;They <em>intimated</em>. And that kind of did it for me.&rdquo;</p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">Jennifer was untroubled by the barnyard origins of Evolence, which arrived on the market in September 2008 but has yet to become a buzzword on the society circuit. &ldquo;I heard in the media that it was derived from the pig and it sounded rather gross to me, but then they elaborated that we have similar tissue,&rdquo; she said breezily. </span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">And so on Monday, March 2, Jennifer arrived at the Park  Avenue office of Darrick Antell, a plastic surgeon. Dr. Antell&rsquo;s nurse wiped the makeup from the patient&rsquo;s cheeks and applied a topical anesthetic; the doctor himself then injected a single syringe of whitish substance into her cheeks via a tiny 30-gauge needle. The entire procedure took 15 minutes and cost $700. Jennifer rode the subway immediately back to work afterward.</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">&ldquo;I <em>love</em> it!&rdquo; she enthused, calling from her office several days later. &ldquo;I&rsquo;m getting looks. &lsquo;Oh, your skin looks great.&rsquo; I think it&rsquo;s because the cheekbones are a little more defined. It&rsquo;s kind of subtle.&rdquo; There has been no bruising and no swelling&mdash;common, if typically short-lived, side effects of hyaluronic acid injections&mdash;just a minor, lingering pain to the touch. She even went back for another syringe the next day. &ldquo;I just thought it looked so pretty,&rdquo; she said.</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">&nbsp;</span></p>
<p class="MsoNormal"><strong>&lsquo;A HUGE BREAKTHROUGH&rsquo;</strong></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">In the 1980s, we got ourselves shot full of bovine collagen (which required an allergy test several weeks beforehand, never desirable when one is seeking an instant pick-me-up). In the &rsquo;90s, we began freezing our faces with a derivative of the botulism toxin. In 2003 came Restylane, a breakthrough hyaluronic acid (or H.A., as it&rsquo;s known in the trade) derived from bacteria. Nowadays many New York doctors also offer Radiesse, a filler made of synthetic liquid bone, and Sculptra, which was invented to treat the hollow cheeks of H.I.V. patients.<span>&nbsp; </span></span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">But &hellip; pig fat? <em>Oy vay</em>! </span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">&ldquo;It&rsquo;s a huge breakthrough,&rdquo; argued Dr. David Goldberg, a dermatology professor at Mt. Sinai School of Medicine, who will soon publish a study on the use of Evolence in the eyelids; he estimates he&rsquo;s used it on 200 or so patients already. &ldquo;There&rsquo;s nothing wrong with the H.A.&rsquo;s, but the negatives of H.A.&rsquo;s historically have been that there can be a fair amount of swelling, which you don&rsquo;t get from any collagen, including Evolence.&rdquo; </span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">&ldquo;It&rsquo;s easier in some cases to hide from the husband,&rdquo; allowed Dr. Howard Sobel, a Park Avenue cosmetic dermatologist, in an email. </span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">Carol R., 52, an Upper East Sider who has previously been injected with Restylane, Radiesse, Juvederm and longer-lasting silicon, tried Evolence from Dr. Sobel&rsquo;s needle for the first time two months ago. &ldquo;I usually bruise down on my chin no matter <em>what</em> they inject,&rdquo; she said. &ldquo;It gets blue, and then it gets purple. It&rsquo;s not very attractive. You look like either you got punched in the face or you did something. Every <em>woman</em> knows you did something.&rdquo;</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">But with Evolence, Carol exulted, &ldquo;I didn&rsquo;t swell at all!&rdquo; She went out to dinner with two other couples the night of her injection. And it didn&rsquo;t trouble her in the slightest that what was in her face might also have been offered on the menu. &ldquo;I had [bovine] collagen for years,&rdquo; she said. &ldquo;I guess if you could eat bacon, you can put it in your face! And I <em>like</em> bacon!&rdquo;</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">Doctors similarly scoff at the notion that New York women might be wary of using pig fat to achieve a baby face. &ldquo;Oh, come on, when it comes to beauty?&rdquo; said Dr. Francesca Fusco, a much-loved dermatologist who shares offices with Dr. Patricia Wexler. &ldquo;In all the years I&rsquo;ve practiced, nobody&rsquo;s <em>ever</em> said, &lsquo;I&rsquo;m a vegetarian, so I don&rsquo;t want the bovine-based collagen.&rsquo;&rdquo; Indeed, perhaps our fetishization of the greenmarket has made us more inclined to pork up, facially speaking. &ldquo;It&rsquo;s like we have <em>farm-fresh</em> faces!&rdquo; Dr. Fusco giggled.</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">&ldquo;A lot of people would rather have a natural substance derived from a pig than a substance made in some <em>laboratory</em>,&rdquo; Dr. Goldberg said (H.A.s are cross-linked by chemicals; the creation of Evolence entails a patented technology involving sugar, sort of like a closely guarded barbecue-rub recipe).</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">Perhaps Evolence&rsquo;s most surprising characteristic, however, is that it is made in &hellip; Israel, by a company called ColBar Life Sciences, which was purchased by Johnson &amp; Johnson, the squeaky-clean American company widely associated with plump baby faces, in 2006. </span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">&ldquo;We think we have a game-changer on our hands,&rdquo; declared Monica Neufang, a Johnson &amp; Johnson spokeswoman for<span>&nbsp; </span>Evolence, just after returning from the annual meeting of the American Academy of Dermatology in San Francisco, which she called the new brand&rsquo;s &ldquo;coming out.&rdquo; (They had wooed dermatologists with live demonstrations and dinners).</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">Ms. Neufang said that the product had been approved by at least one rabbinical council but that religious patients should consult their rabbis for guidance &ldquo;We do not have rabbis on staff,&rdquo; she said. But: &ldquo;By the time you purify the product, the collagen that results is virtually identical to human collagen.&rdquo; </span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">She admitted that her company has thus far been rolling out its find rather stealthily. &ldquo;Our product injects very differently than H.A.&rsquo;s, and since that is the lion&rsquo;s share of the market, we wanted to make sure we have a robust training program in place for physicians, so we&rsquo;ve really been focusing on that for the first six months,&rdquo; she said. But in the next month or so, get ready to see Evolence <em>everywhere</em>, as the brand targets consumers more directly.</span></p>
<p><!--nextpage-->
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">&nbsp;</span></p>
<p class="MsoNormal"><strong>&lsquo;RED AND BUMPY&rsquo;</strong></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">But even in an era when dissecting the work done on celebrity faces is all but public sport, and everyone from George Clooney to Debbie Harry admits cosmetic &ldquo;enhancement&rdquo;&mdash;brawny tennis player Lindsay Davenport is even the spokesperson for Juvederm!&mdash;might Evolence&rsquo;s feed-lot beginnings invite increased scrutiny of our beauty addiction?</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">Julie, a 36-year-old doctor (though not a dermatologist) in Manhattan who had a Restalyne injection several years earlier, tried Evolence three months ago. &ldquo;It still looks good!&rdquo; she said the other day, calling from her office. &ldquo;I didn&rsquo;t have really bad lines to begin with, but it smoothed them out, gave it more of a fresh look.&rdquo; She equated it to &ldquo;a polish, like the top coat on your nail polish.&rdquo;</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">A reporter wondered what she thought of the product&rsquo;s porcine origins.</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">&ldquo;I didn&rsquo;t know that,&rdquo; Julie said. &ldquo;But thanks a <em>lot!</em>&rdquo;</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">She is Jewish, she added, albeit nonreligious. &ldquo;I don&rsquo;t really eat pig, so the fact that it&rsquo;s in my face isn&rsquo;t <em>thrilling</em>,&rdquo; she said. &ldquo;But I guess if you&rsquo;re doing something like this, you&rsquo;re probably not too concerned about those kinds of things anyway.&rdquo;</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">Karen, 58, of the Upper East Side, was more concerned about the adverse reaction she experienced after her first Evolence injection last month, which kept her close to home for about a week. &ldquo;I&rsquo;ve had a lot of fillers,&rdquo; she said. &ldquo;If you get a bruise, that&rsquo;s one thing, but I was very red and bumpy.&rdquo;</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">Her concerns were echoed by several New York doctors who are not yet sold on the swinish collagen du jour. &ldquo;There have been reports in the Canadian literature, one study where they had 20 patients who were injected with Evolence in the lips and they developed <em>nodules</em> that had to be surgically removed,&rdquo; said Dr. Lisa Zdinak, who has a practice on East 74th Street. &ldquo;So I took that off my palette. I used it in the nasolabial folds, but when I read that I couldn&rsquo;t use it in the <em>lips</em>, I thought, &lsquo;Why am I even bothering with this?&rsquo; I have H.A.&rsquo;s!&rdquo; (Evolence enthusiasts counter that Evolence Breeze, a thinner form of the filler currently being used in Europe for lip-plumping, will likely be F.D.A.-approved in the near future).<span>&nbsp; </span></span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">&ldquo;It&rsquo;s late on the scene, to be honest with you,&rdquo; said Ariel Ostad, a dermatologist on Lexington Avenue. &ldquo;Everybody&rsquo;s already so comfortable with hyaluronic acid. And then the fact that it&rsquo;s <em>pig</em>.&rdquo;</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">But the substance&rsquo;s defenders grunt at such criticism. &ldquo;It&rsquo;s been used for several years in Europe and Israel; they&rsquo;ve shown that there&rsquo;s little correlation between sensitivity to collagen and sensitivity to Evolence,&rdquo; said Dr. Mauro Romita, a Fifth Avenue plastic surgeon who added that the product is currently his number one choice for the nasolabial region.</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">Dr. Paul Lorenc, a Park Avenue plastic surgeon who led<span>&nbsp; </span>Evolence&rsquo;s F.D.A. approval study, touted the fact that 76.5 percent of pork-injecting patients in his study were still showing notable improvement after one year, as opposed to our cow-plumped sisters of yesteryear, whose volume shrank in just three months. Moreover, Dr. Lorenc said, Evolence flows more easily through the syringe than do H.A.&rsquo;s, resulting in less of a chance of &ldquo;over-correction,&rdquo; as he called it.</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">As expendable income seems to be drying up in inverse proportion to patients&rsquo; ravenous appetite for filler, Evolence&rsquo;s long-term prospects are anyone&rsquo;s guess. &ldquo;I think it will come down to pricing and marketing,&rdquo; said Dr. Sobel. &ldquo;In my opinion, a lot of the injectibles are similar.&rdquo; </span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">Tell that to Laura, 49, a limousine company sales rep, bartender and enthusiastic recent Evolence convert who works in Long Island City. &ldquo;It&rsquo;s outrageous,&rdquo; Laura said. &ldquo;It&rsquo;s not, like, <em>drastic</em>, but people will just say, &lsquo;You&rsquo;re looking <em>good</em> these days!<em>&rsquo;</em>&rdquo; </span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">But does it ever give her pause that she has our porcine friends to thank for this? &ldquo;If you just say the word, &lsquo;I have <em>pigs</em> in my cheeks &hellip;&rsquo;&rdquo; she said. &ldquo;But no one knows. It is what it is. I don&rsquo;t really care.&rdquo;</span></p>
<p class="emailtagline" style="text-align: left" align="left"><em><span style="letter-spacing: -0.1pt">mbryan@observer.com</span></em></p>
]]></description>
		<content:encoded><![CDATA[<p><img class="alignleft" src="http://nyoobserver.files.wordpress.com/2011/06/l_bryandarrick-e-antell_0.jpg?w=255&h=300" />Over the past few years, age-conscious Manhattanites have filled their faces with all kinds of crazy stuff, from Botox to hyaluronic acids to fat from their own saddlebags. But recently, Jennifer, a slender 50-year-old who works on Wall Street, decided to plump up her cheeks with a new collagen called Evolence, made from pig tendons, that she had seen advertised on television. &ldquo;They mentioned that Demi Moore supposedly used it for laugh lines,&rdquo; she said. &ldquo;They <em>intimated</em>. And that kind of did it for me.&rdquo;</p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">Jennifer was untroubled by the barnyard origins of Evolence, which arrived on the market in September 2008 but has yet to become a buzzword on the society circuit. &ldquo;I heard in the media that it was derived from the pig and it sounded rather gross to me, but then they elaborated that we have similar tissue,&rdquo; she said breezily. </span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">And so on Monday, March 2, Jennifer arrived at the Park  Avenue office of Darrick Antell, a plastic surgeon. Dr. Antell&rsquo;s nurse wiped the makeup from the patient&rsquo;s cheeks and applied a topical anesthetic; the doctor himself then injected a single syringe of whitish substance into her cheeks via a tiny 30-gauge needle. The entire procedure took 15 minutes and cost $700. Jennifer rode the subway immediately back to work afterward.</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">&ldquo;I <em>love</em> it!&rdquo; she enthused, calling from her office several days later. &ldquo;I&rsquo;m getting looks. &lsquo;Oh, your skin looks great.&rsquo; I think it&rsquo;s because the cheekbones are a little more defined. It&rsquo;s kind of subtle.&rdquo; There has been no bruising and no swelling&mdash;common, if typically short-lived, side effects of hyaluronic acid injections&mdash;just a minor, lingering pain to the touch. She even went back for another syringe the next day. &ldquo;I just thought it looked so pretty,&rdquo; she said.</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">&nbsp;</span></p>
<p class="MsoNormal"><strong>&lsquo;A HUGE BREAKTHROUGH&rsquo;</strong></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">In the 1980s, we got ourselves shot full of bovine collagen (which required an allergy test several weeks beforehand, never desirable when one is seeking an instant pick-me-up). In the &rsquo;90s, we began freezing our faces with a derivative of the botulism toxin. In 2003 came Restylane, a breakthrough hyaluronic acid (or H.A., as it&rsquo;s known in the trade) derived from bacteria. Nowadays many New York doctors also offer Radiesse, a filler made of synthetic liquid bone, and Sculptra, which was invented to treat the hollow cheeks of H.I.V. patients.<span>&nbsp; </span></span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">But &hellip; pig fat? <em>Oy vay</em>! </span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">&ldquo;It&rsquo;s a huge breakthrough,&rdquo; argued Dr. David Goldberg, a dermatology professor at Mt. Sinai School of Medicine, who will soon publish a study on the use of Evolence in the eyelids; he estimates he&rsquo;s used it on 200 or so patients already. &ldquo;There&rsquo;s nothing wrong with the H.A.&rsquo;s, but the negatives of H.A.&rsquo;s historically have been that there can be a fair amount of swelling, which you don&rsquo;t get from any collagen, including Evolence.&rdquo; </span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">&ldquo;It&rsquo;s easier in some cases to hide from the husband,&rdquo; allowed Dr. Howard Sobel, a Park Avenue cosmetic dermatologist, in an email. </span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">Carol R., 52, an Upper East Sider who has previously been injected with Restylane, Radiesse, Juvederm and longer-lasting silicon, tried Evolence from Dr. Sobel&rsquo;s needle for the first time two months ago. &ldquo;I usually bruise down on my chin no matter <em>what</em> they inject,&rdquo; she said. &ldquo;It gets blue, and then it gets purple. It&rsquo;s not very attractive. You look like either you got punched in the face or you did something. Every <em>woman</em> knows you did something.&rdquo;</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">But with Evolence, Carol exulted, &ldquo;I didn&rsquo;t swell at all!&rdquo; She went out to dinner with two other couples the night of her injection. And it didn&rsquo;t trouble her in the slightest that what was in her face might also have been offered on the menu. &ldquo;I had [bovine] collagen for years,&rdquo; she said. &ldquo;I guess if you could eat bacon, you can put it in your face! And I <em>like</em> bacon!&rdquo;</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">Doctors similarly scoff at the notion that New York women might be wary of using pig fat to achieve a baby face. &ldquo;Oh, come on, when it comes to beauty?&rdquo; said Dr. Francesca Fusco, a much-loved dermatologist who shares offices with Dr. Patricia Wexler. &ldquo;In all the years I&rsquo;ve practiced, nobody&rsquo;s <em>ever</em> said, &lsquo;I&rsquo;m a vegetarian, so I don&rsquo;t want the bovine-based collagen.&rsquo;&rdquo; Indeed, perhaps our fetishization of the greenmarket has made us more inclined to pork up, facially speaking. &ldquo;It&rsquo;s like we have <em>farm-fresh</em> faces!&rdquo; Dr. Fusco giggled.</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">&ldquo;A lot of people would rather have a natural substance derived from a pig than a substance made in some <em>laboratory</em>,&rdquo; Dr. Goldberg said (H.A.s are cross-linked by chemicals; the creation of Evolence entails a patented technology involving sugar, sort of like a closely guarded barbecue-rub recipe).</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">Perhaps Evolence&rsquo;s most surprising characteristic, however, is that it is made in &hellip; Israel, by a company called ColBar Life Sciences, which was purchased by Johnson &amp; Johnson, the squeaky-clean American company widely associated with plump baby faces, in 2006. </span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">&ldquo;We think we have a game-changer on our hands,&rdquo; declared Monica Neufang, a Johnson &amp; Johnson spokeswoman for<span>&nbsp; </span>Evolence, just after returning from the annual meeting of the American Academy of Dermatology in San Francisco, which she called the new brand&rsquo;s &ldquo;coming out.&rdquo; (They had wooed dermatologists with live demonstrations and dinners).</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">Ms. Neufang said that the product had been approved by at least one rabbinical council but that religious patients should consult their rabbis for guidance &ldquo;We do not have rabbis on staff,&rdquo; she said. But: &ldquo;By the time you purify the product, the collagen that results is virtually identical to human collagen.&rdquo; </span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">She admitted that her company has thus far been rolling out its find rather stealthily. &ldquo;Our product injects very differently than H.A.&rsquo;s, and since that is the lion&rsquo;s share of the market, we wanted to make sure we have a robust training program in place for physicians, so we&rsquo;ve really been focusing on that for the first six months,&rdquo; she said. But in the next month or so, get ready to see Evolence <em>everywhere</em>, as the brand targets consumers more directly.</span></p>
<p><!--nextpage-->
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">&nbsp;</span></p>
<p class="MsoNormal"><strong>&lsquo;RED AND BUMPY&rsquo;</strong></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">But even in an era when dissecting the work done on celebrity faces is all but public sport, and everyone from George Clooney to Debbie Harry admits cosmetic &ldquo;enhancement&rdquo;&mdash;brawny tennis player Lindsay Davenport is even the spokesperson for Juvederm!&mdash;might Evolence&rsquo;s feed-lot beginnings invite increased scrutiny of our beauty addiction?</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">Julie, a 36-year-old doctor (though not a dermatologist) in Manhattan who had a Restalyne injection several years earlier, tried Evolence three months ago. &ldquo;It still looks good!&rdquo; she said the other day, calling from her office. &ldquo;I didn&rsquo;t have really bad lines to begin with, but it smoothed them out, gave it more of a fresh look.&rdquo; She equated it to &ldquo;a polish, like the top coat on your nail polish.&rdquo;</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">A reporter wondered what she thought of the product&rsquo;s porcine origins.</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">&ldquo;I didn&rsquo;t know that,&rdquo; Julie said. &ldquo;But thanks a <em>lot!</em>&rdquo;</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">She is Jewish, she added, albeit nonreligious. &ldquo;I don&rsquo;t really eat pig, so the fact that it&rsquo;s in my face isn&rsquo;t <em>thrilling</em>,&rdquo; she said. &ldquo;But I guess if you&rsquo;re doing something like this, you&rsquo;re probably not too concerned about those kinds of things anyway.&rdquo;</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">Karen, 58, of the Upper East Side, was more concerned about the adverse reaction she experienced after her first Evolence injection last month, which kept her close to home for about a week. &ldquo;I&rsquo;ve had a lot of fillers,&rdquo; she said. &ldquo;If you get a bruise, that&rsquo;s one thing, but I was very red and bumpy.&rdquo;</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">Her concerns were echoed by several New York doctors who are not yet sold on the swinish collagen du jour. &ldquo;There have been reports in the Canadian literature, one study where they had 20 patients who were injected with Evolence in the lips and they developed <em>nodules</em> that had to be surgically removed,&rdquo; said Dr. Lisa Zdinak, who has a practice on East 74th Street. &ldquo;So I took that off my palette. I used it in the nasolabial folds, but when I read that I couldn&rsquo;t use it in the <em>lips</em>, I thought, &lsquo;Why am I even bothering with this?&rsquo; I have H.A.&rsquo;s!&rdquo; (Evolence enthusiasts counter that Evolence Breeze, a thinner form of the filler currently being used in Europe for lip-plumping, will likely be F.D.A.-approved in the near future).<span>&nbsp; </span></span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">&ldquo;It&rsquo;s late on the scene, to be honest with you,&rdquo; said Ariel Ostad, a dermatologist on Lexington Avenue. &ldquo;Everybody&rsquo;s already so comfortable with hyaluronic acid. And then the fact that it&rsquo;s <em>pig</em>.&rdquo;</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">But the substance&rsquo;s defenders grunt at such criticism. &ldquo;It&rsquo;s been used for several years in Europe and Israel; they&rsquo;ve shown that there&rsquo;s little correlation between sensitivity to collagen and sensitivity to Evolence,&rdquo; said Dr. Mauro Romita, a Fifth Avenue plastic surgeon who added that the product is currently his number one choice for the nasolabial region.</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">Dr. Paul Lorenc, a Park Avenue plastic surgeon who led<span>&nbsp; </span>Evolence&rsquo;s F.D.A. approval study, touted the fact that 76.5 percent of pork-injecting patients in his study were still showing notable improvement after one year, as opposed to our cow-plumped sisters of yesteryear, whose volume shrank in just three months. Moreover, Dr. Lorenc said, Evolence flows more easily through the syringe than do H.A.&rsquo;s, resulting in less of a chance of &ldquo;over-correction,&rdquo; as he called it.</span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">As expendable income seems to be drying up in inverse proportion to patients&rsquo; ravenous appetite for filler, Evolence&rsquo;s long-term prospects are anyone&rsquo;s guess. &ldquo;I think it will come down to pricing and marketing,&rdquo; said Dr. Sobel. &ldquo;In my opinion, a lot of the injectibles are similar.&rdquo; </span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">Tell that to Laura, 49, a limousine company sales rep, bartender and enthusiastic recent Evolence convert who works in Long Island City. &ldquo;It&rsquo;s outrageous,&rdquo; Laura said. &ldquo;It&rsquo;s not, like, <em>drastic</em>, but people will just say, &lsquo;You&rsquo;re looking <em>good</em> these days!<em>&rsquo;</em>&rdquo; </span></p>
<p class="text" style="text-align: left" align="left"><span style="letter-spacing: -0.1pt">But does it ever give her pause that she has our porcine friends to thank for this? &ldquo;If you just say the word, &lsquo;I have <em>pigs</em> in my cheeks &hellip;&rsquo;&rdquo; she said. &ldquo;But no one knows. It is what it is. I don&rsquo;t really care.&rdquo;</span></p>
<p class="emailtagline" style="text-align: left" align="left"><em><span style="letter-spacing: -0.1pt">mbryan@observer.com</span></em></p>
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