These cosmetic injections are some of the most performed procedures in beauty clinics around the world (next after Botox). The so-called temporary fillers have been entitled as the best wrinkle filler, and the safest method to increase volume in the face. Since they contain Hyaluronic acid that is non-permanent. But are they really as good and safe as the manufacturers want us to believe they are?
Well, temporary fillers may have fewer complications compared to the semi-permanent and permanent fillers. But they do come with a lot of risks and side effects scaling from the more common swelling and lumps, all the way to blindness as the worst-case scenario.
Something else you need to be aware of is that fillers can stretch out your skin and accelerate aging. And, ironically, they have just been found to not be as temporary as believed. This post will tell you all you need to know about temporary dermal fillers made of Hyaluronic acid.
Below is what I’ll cover. And you can jump to any part by clicking on the subheadings.
- What are temporary fillers? And how do they work?
- Are temporary fillers safe? – What are the side effects?
- Can fillers move? – And what are the consequences?
- How long do temporary fillers last? – The real truth
- Filler fatigue – How fillers affect your skin over time
- How to remove fillers – Hyaluronidase side effects and risks
- Why I personally would never do cosmetic injections
What are temporary fillers? And how do they work?
There are many different kinds of dermal fillers. But today, the most commonly used is the one that is made out of Hyaluronic acid. This kind of filler has been stated to last for about 6-12 months and is therefore considered to be temporary. That estimation is about to change since they’ve recently been shown to last a lot longer. But I’ll get back to that.
The purpose of these kinds of cosmetic injections is to either fill out wrinkles or scars or to cause more volume in certain places of the face. In other words to smooth the face or/and sculpt it by changing the form of certain areas.
Lip augmentation, as well as cheek injections, are two of the most popular filler procedures. Other common places where people get injections are the jawline, the nose, and the chin.
The largest brands when it comes to these kinds of cosmetic injections are Juvederm, Restylane, and Boletero. So these all have Hyaluronic acid as a base.
With the other kinds of dermal fillers (such as collagen, poly-L-lactic acid, calcium hydroxylapatite, and even silicon). the side effects and risks are many more. So most clinics are using them less and less already. Therefore, in this article I will only address the temporary fillers made of Hyaluronic acid.
Is this kind of Hyaluronic acid really natural?
Now the argument you will hear from everyone advocating these kinds of filler treatments is that Hyaluronic acid is an all-natural ingredient. And that it’s a part of our skin already.
While it’s true that we do have natural hyaluronic acid in our skin, the fillers DO NOT contain the same kind of molecules that we produce within our bodies. Instead, temporary fillers contain cross-linked molecules. And these do come with complications that I will get back to.
The reason these filler molecules are cross-linked is that otherwise, they wouldn’t last longer than a few days. Instead, they can last a lot longer. Not just the claimed 6-12 months, but actually for several years. Read my section “How long do temporary fillers last? – The real truth” to learn more.
Are temporary fillers safe? – What are the side effects?
The most common side effects of doing these kinds of cosmetic injections are bruising, pain, and swelling. And in a small percentage of patients there can also be prolonged swelling, nodules (even several months after the injection), infections, and allergic reactions.
Another side effect that is not that uncommon is called the Tyndall effect. This is when some people get a bluish hue of their skin (due to scattering of the light) after being injected with fillers of Hyaluronic acid.
Now, let’s move over to the more serious side effects and risks that can happen. I will point out that the ones I’m about to mention are not common. But they do occur, even with very experienced practitioners. And you should be aware of them as part of your evaluation regarding this cosmetic treatment.
The most serious complications are called vascular occlusions, which means blockage of a blood vessel. This situation can lead to both necrosis (tissue death) and blindness. Let’s start with blindness.
Yes, fillers can cause blindness
So as mentioned, filler injections, of any kind, can lead to the blockage of a blood vessel. And if that vessel happens to supply blood and oxygen to the eye, the result will be a severe loss of vision. A situation also described as retinal artery occlusion (RAO).
Again, this is not a common side effect. But it has occurred, for at least a couple of hundred victims. And personally, I can not think of anything worse than losing my eyesight.
One of the review studies I looked at found 190 cases of blindness (due to filler injections) between the year 2000 til 2018. And this only included articles published in the English language. In other words, the number of cases could potentially be much larger.
This study also presented that 47 % of the cases were attributed to fat injections and 28 % to fillers with Hyaluronic acid. While the rest of the cases included collagen, calcium hydroxylapatite and other fillers.
Another review study I looked at examined articles from the year 2015 to 2018 (also the English language only). And during those three years, the authors found 48 new cases.
What is interesting is that in this study, fillers with Hyaluronic acid were the cause of blindness in 81,3 % of overall cases. This rise is probably due to the fact that Hyaluronic acid has become more and more of a first-hand choice in most clinics.
This study also showed that the injections sites with the highest risk of blindness were the nasal region, followed by, glabella, forehead, and nasolabial fold.
Necrosis – when parts of your face die
Another rare but devastating complication, due to the risk of vascular occlusion after filler injections, is necrosis. This condition is when part of your facial tissue dies, which can cause cosmetic deformities. You can literally lose segments of your face if not treated immediately.
The areas that are most prone to necrosis are the glabella, the tip of the nose, the lips, and the nasolabial fold.
The most serious complications from filler injections are vascular occlusions (which means blockage of a blood vessel). This situation can lead to both necrosis (tissue death) and blindness.
Can fillers move? – And what are the consequences?
So temporary fillers have been believed to be, temporary, and to not move in greater extent from the injection site. But this belief is about to change since it’s just been discovered that so-called temporary fillers actually do move, and they do stay in the face. For many many years.
Recently, with an MRI scan, doctors in Melbourne Australia discovered this on all of the patients examined. They could see that the filler had often moved and stayed in another area of the face. For many years.
For example when someone injects fillers into their lips. The filler is believed to stay for 6-12 months before a touch up is needed. But with the MRI scan, these doctors could see that a lot of the fillers were still there. It had just moved, up to the area between the nose and mouth. And over time, as more touch-ups are being made, that area may start to form the shape of a duckbill.
Another problem with the fillers moving, and staying, is that fillers injected near the eye area, or cheek area, can cause under-eye bags several years later.
How long do temporary fillers last? – The real truth
Well, as mentioned earlier, and as you can read in most places on the internet. The longevity of temporary fillers is claimed to be around 6-12 months. Hence the name. That will need to be revalued though, as discussed above. Because in reality, seen when using an MRI scan, these kinds of dermal fillers can last for years and years.
In the video below you can watch two doctors, Dr. Gavin Chan and Dr. Mobin Master, discuss this subject. They will also show evidence of MRI scans showing what really has happened to the Hyaluronic acid fillers.
I truly recommend you watch this video if you are doing or thinking of doing this kind of cosmetic injections.
So it seems like temporary fillers can do a lot more alterations than intended. Something to be aware of.
The next section will discuss another possible consequence that you need to know. It’s called “filler fatigue”, and might accelerate skin aging.
Filler fatigue – How fillers affect your skin over time
Filler fatigue is a relatively new term (and highly controversial) that many plastic surgeons are warning their patients about. It’s a term that describes the aging effect that fillers can have on your skin if used over time. And especially if used in large volumes.
There is indeed a need for research on this phenomenon. But until all the facts are clear, here are what some experts in the field are saying.
Dr. Andrew Jacono, who is a dual-board-certified and leading facial plastic surgeon in New York, explained to the Huffpost what happens over time when injecting fillers. He said that if used over an extended period of time, fillers will actually stretch out the tissues under the skin. Which will accelerate the aging process.
Another renowned and New York-based cosmetic facial plastic surgeon is Michelle Yagoda. She explains that cheek-fillers leave an enlarged space behind. And that space will need more filler overtime to stay inflated. She also explains that the younger and more elastic skin you have, the longer you may be able to use fillers. But that the stretching still occurs.
Dr. Dan Kennedy, Vice president of the Australian Society of Plastic Surgeons, is also warning about fillers. He told The Sydney Morning Herald that as well as stretching of the skin, excessive use of fillers can result in more long term damage. Including wrinkling of the lip and disturbance of the attachment of the facial fat pads. And to some degree irregularity and aging of the skin.
Until more is known, be really careful if considering using any fillers, including temporary fillers with Hyaluronic acid.
Dr. Dan Kennedy (Vice president of the Australian Society of Plastic Surgeons) warn that excessive use of fillers can cause stretching of the skin, wrinkling of the lip and disturbance of the attachment of the facial fat pads.
How to remove fillers – Hyaluronidase side effects and risks
You will often hear that fillers with Hyaluronic acid are easily reversed if problems occur. Or if you just feel dissatisfied with the result. That by injecting the enzyme Hyaluronidase (Hyalase) the filler will dissolve and you will look just as you did before the treatment.
Well, that is partly true. But this enzyme is actually so powerful that it seems to have caused quite a few people permanent damage.
Initially, it was believed that the enzyme only affects Hyaluronic acid molecules, including your own body-produced ones. Meaning that a temporary side effect of injecting the enzyme is that your own Hyaluronic acid will dissolve as well. Leaving you with a loss of volume that lasts for a few weeks until your body catches up. So in other words, after a few weeks, the only thing that should be lost is the filler itself. Unfortunately, that does not always seem to be the case.
If you search in forums you’ll find countless testimonies from people being devastated after being injected with hyaluronidase. Saying it has left them with loss of volume and sagging skin that they never had before. And that did not approve even after months or years.
And if you search for statements from cosmetic surgeons and dermatologists, you’ll discover there is a diversity regarding whether or not hyaluronidase does make permanent damage or not. Some hold on to the old theory that this enzyme cannot cause permanent damage. While others indeed confirm that it can. One example is Dr. Daniel Ezra, one of the most prominent Oculoplastic surgeons in the UK.
Dr. Ezra explains that the view of fillers being a ‘natural substance’ and easily reversed is outdated. And that patients with hyaluronidase-related damage (often untreatable) are rising.
He also explains that one of the most problematic areas of the face is around the eyes, where the skin is very thin. And the risk of adverse effects is therefore much larger.
Another problem is to get the dosage right. If too high, the risk of doing damage to the extracellular matrix (an important structure that binds cells together in connective tissues) will increase. Which will lead to a gaunt appearance and less appealing skin-texture.
So, temporary fillers may not always be that easily removed after all.
Injected Hyaluronidase seems to cause are rising number of patients permanent side effects according to experts.
- Temporary fillers are made of a cross-linked Hyaluronic acid (not the same kind of molecules that are body-produced) in order to last longer than the regular Hyaluronic acid molecules.
- Common side effects with these cosmetic injections are swelling, pain, and nodules.
- Other side effects that can occur are allergic reactions, Tyndall effect, necrosis, and (in very rare cases) blindness.
- Temporary fillers are not as temporary as believed (6-12 months). Instead, with MRI scanning, they have been shown to stay for several years.
- Temporary fillers can migrate. For example from the lip to the area under the nose, causing the appearance of a duckbill after several lip injections. Or under-eye bags if injections have occurred close to that area.
- Many plastic surgeons are warning about filler fatigue. A term that means that over time, fillers can stretch out the skin, and accelerate skin aging.
- Hyaluronidase is used to dissolve temporary fillers made of Hyaluronic acid. It has been believed to be safe but more and more plastic surgeons are agreeing that it can cause permanent damage to the skin. It should, therefore, be used with extreme caution.
Why I personally would never do cosmetic injections
Personally, I would never consider doing this kind of treatment. Not just because of the risks and side effects discussed in this post. But also, as I discussed in my article about Botox, due to the reason that I want to feel and look natural.
For me, anti-aging is about keeping your skin as healthy as possible, with methods that truly make your skin younger. Instead of using cosmetic injections that will give you a false image of what you look like. Not saying other’s choices are bad or wrong. But I personally believe that having an authentic face will provide you with so much more self-esteem and self-satisfaction than any fake version ever can.
My goal with this blog is to help you get younger-looking skin with natural methods. Such as the right diet, lifestyle, supplements, skincare, etc. For example, read about the 3 fundamental rules to prevent wrinkles, the best anti aging sunscreen, and the skin tightening foods that you need to eat every day.
There are so many proven ways to keep the skin at its best. And as this post (and my previous one about Botox) shows, cosmetic injections can, if used over time, cause damage to your skin and age you faster. So be careful <3
I hope you’ve found this article helpful! Let me know in the comments below if you have any questions. Or if you have any personal experience with these kinds of cosmetic injections that you would like to share.
Until next time, love your skin!