Filler Injections: What to Know Before You Decide

Filler injections are a popular cosmetic treatment. According to statistics, around 3 million Americans choose this treatment every year. What are fillers, are they safe, and what should you keep in mind before, during and after the injections? Let Luna answer these questions in the article below.

What are filler injections?

The filler injection method (dermal fillers) is a non-surgical cosmetic procedure. A filler is injected beneath the skin to smooth out wrinkles and restore the face, and can even correct facial imperfections, address signs of aging for a more youthful look, and slim the face. (1)

A filler treatment takes about half an hour and recovery is very quick. Results are visible immediately and last from several months to a few years, depending on the injection site and the quality of the dermal filler.

What filler injections do

Collagen and HA are both components of the skin, and both help keep it youthful and healthy.

Acting like a glue, collagen holds all the body's tissues together and is a building block for bones, skin, muscles, tendons and ligaments. Other parts such as blood vessels, the cornea and teeth also contain collagen. Over time, however, as the body ages, we gradually lose collagen. When the skin loses collagen, it becomes thinner, less elastic and starts to sag.

HA can hold a large number of water molecules around it, which keeps the skin plump and glowing. When skin is dry and dehydrated, it becomes wrinkled with fine lines. HA in the dermis also helps with tissue repair. That's why the FDA has approved HA as the main ingredient in dermal fillers injected into areas that have lost volume, to rejuvenate the skin.

General benefits of filler injections:

• Add volume to the treated area and correct sagging.
• Fill in imperfections and make the face more balanced.
• Smooth facial wrinkles and restore a youthful look.
• Plump up the skin and slim the face.

Who is this treatment for?

The U.S. Food and Drug Administration (FDA) states that suitable candidates for filler injections are people aged 22 and over who want to use dermal fillers to: (2)

• Improve moderate to severe facial wrinkles.
• Add fullness to the lips, cheeks, chin, under-eye hollows, jawline and the backs of the hands.
• Restore facial fat loss in people with HIV.
• Correct acne scars on the cheeks.

How safe are filler injections?

This is a safe cosmetic treatment when performed correctly. However, you should carefully choose a reputable clinic and a highly qualified, skilled doctor to keep the risks as low as possible.

Here are the FDA's warnings about unapproved uses of dermal fillers:

• The FDA advises against injecting fillers into the breasts, buttocks or the spaces between muscles for large-scale body contouring or enhancement, as this can lead to serious injuries, including long-term pain, scarring, infection, permanent disfigurement and even death.
• Do not use needle-free injection devices to inject filler into the skin. These devices usually rely on high pressure, making it hard to control where the filler goes, and can cause serious injuries. In some cases they have even caused permanent damage to the skin, lips and eyes.
• Avoid buying and using fillers sold directly to the public. These fillers are not strictly tested and may be contaminated with chemicals or disease-causing viruses.

Types of fillers

There are many types of dermal fillers, including synthetic fillers (made from man-made materials) and fillers made from substances found naturally in the body; you can also use your own fat. However, fat grafting is still not widely used and is not very effective, especially compared with semi-natural fillers, so it is rarely chosen.

Below are some synthetic fillers commonly used on the market:

• Hyaluronic acid (HA) is an acid the body produces naturally. It hydrates the skin and makes it softer. As we age, the body produces less hyaluronic acid. Results from HA injections usually last 6 – 12 months.
• Calcium hydroxylapatite (CaHA) is a filler substance found in human bones. Its results typically last about a year. Cosmetic dermatologists often use CaHA fillers for deep wrinkles.
• Poly-L-lactic acid (PLLA) is a substance that helps the body produce collagen. Cosmetic dermatologists often use PLLA to smooth deep facial wrinkles. Its results can last more than 2 years.
• Polymethyl-methacrylate microspheres (PMMA) consist of collagen and tiny beads that sit beneath the skin, adding volume and firming the skin.

Pros and cons of filler injections

1. Pros

• Fillers deliver immediate results.
• The procedure is quick, taking less than an hour.
• Recovery time is minimal compared with other cosmetic treatments.
• Fillers cost less than surgical procedures.
• Results can last several months to a few years, depending on the type of filler.

2. Cons

Filler injections can lead to serious complications, but these are very rare (such as filler being injected into a blood vessel and blocking it). Side effects such as allergic reactions are only temporary.

Even so, here are some risks you should know about before choosing this treatment:

• An asymmetrical appearance.
• Swelling, pain, redness, bruising and bleeding.
• Skin damage, which may cause scarring.
• Infection, which can lead to necrosis in severe cases.
• Lumps or bumps under the skin.
• Numbness.
• Acne-like breakouts.
• Rashes and itching.
• Vision problems after filler injections are rare. However, if you notice them along with discomfort or pain on one side of the body, go to a hospital immediately for prompt examination and treatment.

How long does recovery take?

Recovery time after filler injections varies from person to person and depends on:

• The number of areas treated.
• The type of filler used.
• Your overall health.

Most people can resume their normal activities right after dermal filler injections. However, cosmetic dermatologists recommend pausing exercise or strenuous physical activity for 1 – 2 days.

The filler injection procedure

A dermal filler procedure includes the following steps: (3)

Facial assessment and marking the injection points

• The cosmetic dermatologist examines and assesses your face and skin tone, then marks the points where filler will be injected.

Makeup removal, disinfection and numbing

• The injection sites are cleaned with an antibacterial agent. To reduce discomfort, the doctor numbs the area by cooling the skin, applying an anesthetic cream or injecting an anesthetic directly.

Filler injection

• Each injection site takes only a few minutes. The doctor injects the filler beneath the skin, massages the area, assesses the result and adds more if needed. Depending on the number of areas, the procedure can be completed in 15 – 60 minutes.

Recovery

• After filler injections, you can usually apply an ice pack to reduce swelling and discomfort without needing medication.

CONTACT

Things to know about filler injections

1. Before the injections

• You should have a hospital consultation so a specialist in cosmetic dermatology can advise you thoroughly. The doctor will examine and assess your face, then confirm and mark the points to be injected. The doctor will also recommend a suitable filler and explain the recovery time and possible side effects in detail.
• Note that you should answer the doctor's questions about your medical history, allergies and current medications honestly. Some medications can increase the risk of complications after filler injections.

2. During the injections

• The cosmetic dermatologist will clean the area to be treated and apply or inject an anesthetic. This helps you feel more comfortable during the procedure.
• The doctor will use a fine needle or cannula to inject the filler beneath the skin. Depending on the number of points to be filled, the procedure can take from a few minutes up to an hour.

3. After the injections

• The doctor will clean the injected area again and use techniques to reduce swelling and pain. Swelling, pain and discomfort after the injections are common side effects, but they disappear completely within a few days.
• Results can be seen right after filler injections, but they are not the same for everyone. How long it takes to see results, and how long they last, depends on many factors.

Filler injections are a relatively minimally invasive cosmetic treatment with a simple procedure, high effectiveness and relatively good safety. However, for various reasons, side effects and even dangerous complications can still occur after filler injections. It's best to be well informed about filler injections and to keep these points in mind before, during and after the treatment.

References

1/ Professional, C. C. M. (n.d.). Dermal fillers. Cleveland Clinic.

https://my.clevelandclinic.org/health/treatments/22667-dermal-fillers

2/ Office of the Commissioner. (2023, July 7). Dermal Filler Do’s and don’ts for wrinkles, lips and more. U.S. Food And Drug Administration.

https://www.fda.gov/consumers/consumer-updates/dermal-filler-dos-and-donts-wrinkles-lips-and-more

3/ American Society of Plastic Surgeons. (n.d.). Dermal fillers procedure Steps.

https://www.plasticsurgery.org/cosmetic-procedures/dermal-fillers/procedure