Treatment Overview

Filler injections are a cosmetic treatment used to smooth wrinkles or pitted scars in the skin, usually on the face. They are also used to make the lips fuller. When injected under the skin, a filler raises or puffs up that area. This usually goes away over time. There are many kinds of injectable fillers, including:

• Hyaluronic acid (Restylane, Juvederm, Captique). The hyaluronic acid draws fluid to the treated area.
• Bovine collagen (Zyplast, Zyderm). You need an allergy test 4 weeks before treatment.
• Fat cells harvested from your body (autologous fat).
• Man-made biodegradable polymer (Sculptra).
• Calcium hydroxylapatite (Radiesse).
• Microscopic plastic beads and bovine collagen (Artefill). The plastic beads are made of poly(methyl methacrylate) (PMMA). The collagen goes away over time, but the plastic beads remain under the skin permanently.

Some doctors use fillers that are not approved by the U.S. Food and Drug Administration (FDA). Check with your doctor when deciding which treatment is right for you.

For some fillers, your skin is first numbed with a local anesthetic. Then a cosmetic surgeon or dermatologist uses a needle to inject the filler under the skin. A treatment session takes about 15 minutes. Some fillers are done in repeat sessions a couple of weeks apart.

What To Expect

After a filler injection, expect some pain, redness, swelling, and possibly itching. Swelling may last up to 36 hours. If symptoms start to get worse 1 to 3 days after the treatment, call your doctor. You may be getting an infection.

Why It Is Done

Filler injections are used to smooth scarred, wrinkled, or furrowed skin on the face. Some fillers are also used to add fullness to the lips.

How Well It Works

Depending on the area being treated, the filler, and your body's reaction to the filler, you might have one or more repeat injections.

Different fillers last different lengths of time. Slowly, your body absorbs the filler. This makes the skin go back to its normal state.

• Hyaluronic acid (Restylane, Juvederm, Captique). The effect lasts about 9 to 12 months.
• Fat cells harvested from your body (autologous fat). The effect can last for months to years.
• Man-made biodegradable polymer (Sculptra). The effect can last up to 2 years.
• Calcium hydroxylapatite (Radiesse). The effect lasts about 12 months.
• Microscopic plastic beads and bovine collagen (Artefill). The effect has been shown to last for at least 5 years.^{footnote 1}

As with all cosmetic procedures, the results may or may not be quite what you hoped for.

Risks

Filler injection can lead to problems. Possible complications include:

• Infection. Call your doctor if you have new redness, swelling, or pain after the first day. You may need antibiotics right away.
• Bleeding or bruising. Before a filler injection, avoid alcohol use and stop taking any blood-thinning medicine. This includes aspirin, any other type of nonsteroidal anti-inflammatory drug (NSAID), or vitamin E.
• Allergic reaction, such as rash, hives, swelling, or flu-like symptoms.
• Lumpy skin surface after treatment.

There are rare reports of serious or life-threatening complications after filler injection, including anaphylactic shock, sepsis, blood clot in the retinal artery leading to blindness, skin breakdown (necrosis), and abscess needing drainage.