Filler injections

Treatment Overview

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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 goes away over time. There are many kinds of injectable fillers, including:

• Human collagen made in a lab (CosmoDerm, CosmoPlast).
• Hyaluronic acid (Restylane, Hylaform, Captique). The hyaluronic acid draws fluid to the treated area.
• Bovine collagen (Zyplast, Zyderm). You need an allergy test 4 weeks before treatment.
• Human collagen from human tissue (Cymetra).
• Fat cells harvested from your body (autologous fat).

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

For some fillers, your skin is first numbed with a local anesthetic. (Collagen fillers have a numbing medicine mixed in with them.) 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 Treatment

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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

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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

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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.

• Bovine collagen (Zyplast, Zyderm). The effect lasts about 2 to 3 months.
• Human collagen made in a lab (CosmoDerm, CosmoPlast). The effect lasts about 2 to 4 months.
• Hyaluronic acid (Restylane, Hylaform, Captique). The effect lasts about 3 to 6 months.
• Human collagen from human tissue (Cymetra). The effect lasts about 3 to 4 months.
• Fat cells harvested from your body (autologous fat). The effect can last for months to years.

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

Risks

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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, another 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.

What To Think About

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If you have a lot of herpes zoster or herpes simplex outbreaks, a filler injection could trigger a flare-up. If you have several herpes outbreaks per year, your doctor will want you to take an antiviral medicine before having a filler injection.

Each syringe of filler costs several hundred dollars. Costs vary, depending on the type of filler. Talk to your doctor ahead of time about how many you will use, how often, and at what cost. Health insurance is unlikely to pay for this treatment.

Complete the special treatment information form (PDF) (What is a PDF document?) to help you understand this treatment.

Credits

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Author	Kathe Gallagher, MSW
Editor	Kathleen M. Ariss, MS
Associate Editor	Pat Truman
Primary Medical Reviewer	Patrice Burgess, MD - Family Medicine
Primary Medical Reviewer	Martin Gabica, MD - Family Medicine
Specialist Medical Reviewer	James D. McMahan, MD, FACS - Plastic and Reconstructive Surgery
Last Updated	August 25, 2006