Clinical use of injectable bovine collagen: a decade of experience.

Bovine collagen has long been recognized as a safe, highly biocompatible material. In 1981 and 1985, two injectable fibrillar suspensions of purified bovine dermal collagen, Zyderm and Zyplast collagen implant, were commercially launched in the USA for use in soft tissue contour irregularities. Since that time more than 750 000 patients have been treated with Zyderm and/or Zyplast collagen implants internationally. Adverse reactions to bovine collagen implants occur in a small percentage of treated patients. The most prevalent adverse reaction is localized hypersensitivity at treatment sites, occurring in 3% of skin tested patients and 1 to 2% of the treated patients. These reactions resolve with time as the implant material is resorbed by the host. Circulating antibodies to bovine collagen can be demonstrated in the sera of a majority of patients (90-100%) with local hypersensitivity. These antibodies are specific for bovine collagen and do not cross react with human type I, II or III collagen. Although the presence of a humoral immune response to bovine collagen can be associated with localized symptoms of hypersensitivity, antibodies to bovine collagen can also be demonstrated in the absence of any clinical manifestation.