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Hyaluronic Acid Dermal Fillers

The Facts

  • Hyaluronic acid fillers are injectable gels that are used to restore volume to the skin, improve facial lines, wrinkles and folds as well as to enhance facial contours. 

  • This effect will be noticeable immediately after injection with full results seen in 14 days. 

  • Fillers are temporary and can last anywhere from 6 to 18 months depending on the type of filler used, the location injected, and the number of syringes used.


  • Neuromodulators like Botox and Dysport require a prescription from a Medical Doctor. 

  • Although the use of neuromodulators has become common for treatment of lines and wrinkles in aesthetics, they are only approved by the FDA for use on the glabella and crows feet. Use other places on the face is considered an acceptable “off label” use. 

  • Common applications include: Glabella, Crowsfeet, Forehead, Marionette lines, chin, lips. 

  • The application takes about 15 minutes. 

  • The effects last 3-4 months

  • The goal is relaxation of the muscles to reduce movement and wrinkles about 80%.

Possible Side-effects

  • Discomfort: Most patients will feel some discomfort associated with the treatment. This discomfort is usually temporary during the procedure and localized within the treatment area. There can be some tenderness to the localized area for up to two weeks after the procedure.

  • Redness and Swelling: After treatment most patients can expect to have redness or swelling to the areas injected. This common side effects typically lasts 2-3 days post treatment and can last upwards of 2 weeks.

  • Bruising: Due to many vessels underlying the skins surface, bruising can be a common side effect that can last up to 7-14 and be substantial in size and colour depending on the area injected.

  • Small Nodules: While the filler is settling into the tissue you may be able to feel some non-tender nodules under the surface of the skin. This is usually temporary and can last up to 2 weeks. In some cases, the nodule can last indefinitely.

  • Herpes Simplex Reactivation: Herpes Simplex Virus (cold sore) eruption may result in cases where filler is injected in a treated area that has previously been infected with the virus. This is typically true in the case of lip fillers.

Adverse Risks

  • Asymmetry: All faces are not perfectly symmetrical, and although we strive to create balance, in some cases, Hyaluronic acid filler can move from the site of injection when under pressure and this can result in facial asymmetry.

  • Keloid Scarring: Although rare, scarring is a possibility due to the disruption to the skin’s surface and/or abnormal healing. Scars, which can be permanent, may be raised or depressed, and scarring could lead to loss of pigment or increased pigment (“hypopigmentation/hyperpigmentation”) in the scarred area.

  • Pigment Changes: Although rare, during the healing phase, the treated area may appear to be darker. This is called PIH (“post inflammatory hyperpigmentation”). PIH occurs more frequently with darker colored skin, after sun exposure to the treatment area, or with patients who already have a tan.

  • Infection: Every time you are injecting through the skin there is a chance that there is a portal of entry for infection.

  • Allergic Reaction: Patients can be allergic to the hyaluronic acid and have varying allergic responses to it.

  • Efficacy: Because all individuals are different, it is not possible to completely predict who will benefit from the procedure and how long the filler will last. Some patients will have very noticeable improvement, while others may not fall within the expected outcomes.

  • Arterial/Venous Embolism: An extremely rare adverse event that occurs when the gel is injected into a blood vessel and can result in severe skin breakdown or temporary or permanent blindness

Post Treatment Care

  • Keeping the skin clean, especially for the first 48 hours, you may apply makeup gently after 6 hours. 

  • The gel is quite moveable for the first several days, keep the area relaxed after treatment and avoiding massage or manipulation of the area. Try to sleep on your back.

  • Avoiding strenuous physical exercise, hot tub, saunas, facials, alcohol and or aspirin/ NSAIDS for 24 hours after treatment.

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