The advent of injectable collagen for soft tissue augmentation has opened an entirely new area for the dermatologic cosmetic surgeon and for dermatologists who have a particular interest in the cosmetic aspect of our specialty. Patient demand for correction of soft tissue contour irregularities is high and continues to increase daily. The use of injectable collagen with appropriate technique can provide these patients with significant improvement without great cost or significant side effects. In the year following the introduction of glutaraldehyde cross-linked Zyplast Implant, 188 patients were evaluated for soft tissue augmentation with bovine collagen in my clinical practice. Diagnoses varied from facial elastosis to scars due to acne, pox, trauma, and cancer. Some patients desired changes in facial contour (thicker lips; postrhinoplasty defect). Patient satisfaction was high (83% good or excellent results) and side effects were minimal. In our study we found that 3% of patients demonstrated hypersensitivity to the test implant. Treatment with non-cross-linked Zyderm and Zyplast collagens in the patients with a negative skin test resulted in six hypersensitivity reactions (3%). In these patients reactions were not observed at sites treated only with cross-linked collagen and clinical responses appeared to be directed at the non-cross-linked collagen implant sites. With proper treatment technique and patient consultation, the results obtained with injectable collagen fulfill expectations of treated patients.