Hyaluronic acid fillers

What it is

• The FDA says dermal fillers go by several names, including wrinkle fillers and lip and facial fillers.
• A review of studies says hyaluronic acid fillers are widely used in aesthetic medicine.
• The FDA says some dermal fillers are naturally absorbed over time.

Sources: FDA: Dermal Fillers (Soft Tissue Fillers) ↗ · PubMed abstract ↗

What people use it for

• The FDA has approved absorbable fillers for moderate to severe facial wrinkles and skin folds.
• Fillers are also approved to add volume to the lips, cheeks, chin, and back of the hand.
• They are also approved to correct signs of facial fat loss in people with HIV.

Source: FDA: Dermal Fillers (Soft Tissue Fillers) ↗

What the research has found so far

• A review of studies on fillers under the eyes found patient satisfaction was high, with effects lasting 8 to 12 months.
• A review of studies concluded hyaluronic acid fillers are generally safe and effective, with mostly short-lived, mild to moderate side effects.
• A review of studies found severe adverse events were rare.

Sources: PubMed abstract: Dermal Fillers for Tear Trough Rejuvenation: A Systematic Review. ↗ · PubMed abstract ↗

On Hyaluronic acid fillers and aging, PubMed lists 196 trials in people, 233 studies that watched people over time, 15 animal and lab studies. See the counts and searches

Side effects and risks

• The FDA lists common risks as bruising, redness, swelling, pain, tenderness, itching, and rash.
• The FDA says injection into the back of the hand can make activities difficult.
• The FDA says some side effects may appear weeks, months, or years after injection.
• A review of under-eye filler studies found mild side effects including bruising, swelling, blue-gray skin color, and uneven contours.

Sources: FDA: Dermal Fillers (Soft Tissue Fillers) ↗ · PubMed abstract: Dermal Fillers for Tear Trough Rejuvenation: A Systematic Review. ↗

Who should be careful, and drug interactions

• The FDA says safety is unknown during pregnancy, breast feeding, and under age 22.
• The FDA says safety is unknown in people prone to excessive scarring.
• The FDA says safe use with Botox-type products or other treatments has not been studied in a controlled clinical study.
• The FDA says safety of repeated long-term use has not been studied in a controlled clinical study.
• The FDA lists bleeding disorders as a condition to tell a provider about before the procedure.
• The FDA says some fillers contain hyaluronic acid made by bacterial fermentation, which matters for people allergic to bacteria.
• The FDA says some fillers contain lidocaine, which matters for people allergic to local anesthetic.
• The FDA says people with severe allergies or past anaphylaxis should tell their provider.
• The FDA says people with hand joint, tendon, or blood vessel disease should tell their provider when considering hand filler.
• The FDA says removing fillers may be difficult or impossible, especially permanent fillers or those not made of hyaluronic acid.

Source: FDA: Dermal Fillers (Soft Tissue Fillers) ↗

Approval and legal status

The FDA says it has approved dermal fillers for adults 22 and older for specific uses. The FDA says it has not approved any dermal fillers for over-the-counter use. The FDA says needle-free devices are not approved for injecting dermal fillers. The FDA says it has not approved filler use for increasing breast or buttock size. The FDA says injectable silicone is not approved for any aesthetic procedure.

Source: FDA: Dermal Fillers (Soft Tissue Fillers) ↗

What to expect: sessions, results and recovery

• The FDA says patients may need to repeat the procedure over time to keep the effect.
• The FDA says how long the effect lasts depends on the filler material and the injection area.
• A review of under-eye studies found topical numbing was most commonly used.
• The FDA says most swelling and bruising happens soon after injection and many resolve in days to weeks.

Sources: FDA: Dermal Fillers (Soft Tissue Fillers) ↗ · PubMed abstract: Dermal Fillers for Tear Trough Rejuvenation: A Systematic Review. ↗

Roughly what it costs

We don't have prices for this yet.

Questions to ask your doctor

• Is Hyaluronic acid fillers a sensible option for me, given my health and the medicines I take?
• Could Hyaluronic acid fillers interact with any medicine or supplement I already take?
• What side effects should I watch for, and when should I stop or call you?
• How would we tell whether it is helping, and when should we review it?