Filler treatment safety

Ways you can minimise risk and increase your odds of a pleasing result and overall treatment safety include:

• Not letting cost be your guide or deciding factor: It is likely that some serious compromises have been made if the filler treatment costs far less than an above-board specialist would normally charge for a treatment. The skill of the provider, as well as the quality of the product are vitally important. The risk for sometimes irreversible complications is higher with an inferior set of skills and product quality, and not worth the risk when it comes to your face, and overall health.
• Be wary of a treatment not offered in a medical setting with sterile instruments: It is strongly advisable to only commit to a treatment that is done in a medical setting and not in homes, hotels, spas or even resorts, regardless of the professional who may be performing them. If, for instance, you suffer an allergic reaction, medical facilities (a sterile environment) run by trained medical professionals may be necessary to safely treat the problem that arises and reduce further medical complications. A filler treatment should be regarded as more of a medical procedure than a simple cosmetic treatment at your local beauty salon.
• Know what you are being injected with and where it’s come from: Is the filler approved and has it been purchased directly from the maker? If your doctor, dermatologist or plastic surgeon isn’t forthcoming about this type of information, it is best not to take a chance. There have been reports of industrial-grade silicone and even baby oil being used as ‘filler’ treatments.
• Use sunscreen: Used daily, a sunscreen can help to preserve the effects of the filler and protect against post-inflammatory pigment changes (which can often happen due to the needle sticks caused by injections).
• Discontinue blood thinners at least 10 days before treatment: These include aspirin, nonsteroidal anti-inflammatories, vitamin E or warfarin.

Risk factors and complications

Filler treatments are relatively quick and simple, but there are some disadvantages. Some of these can include:

• A risk of an allergic reaction (hypersensitive reactions): In severe cases, this has resulted in anaphylactic shock, which requires immediate medical assistance (it is regarded as a life-threatening emergency).
• Non-hypersensitive reactions: These can include ecchymosis, beading, cysts, abscesses, bacterial infections and herpes (trauma to skin where the virus is present but dormant can cause it to flare-up).
• Skin cells may die (necrosis): This is very rare but can happen if wrinkle fillers are not used properly.
• The formation of tiny bumps under the skin on the face or hand (some bumps may be permanent, and can be both seen and felt. In rare cases, these can be surgically removed.)
• Inflammation, swelling, itchiness, rash and bruising at the injection site (this can last up to a few weeks)
• Migration (movement) of filler material from the site of injection.
• Leakage or rupture of filler material at the injection site or through the skin, which can occur as a result of a tissue reaction or infection.
• Difficulties with performing every day activities: This can happen when a filler is injected into the back of the hand.
• The Tyndall effect (a bluish skin discolouration which can last for several months)
• Scarring (which can be permanent)
• Blindness or vision impairment, stroke and nerve paralysis: This is also rare but can happen if fillers are inadvertently injected into blood vessels. Signs to be aware of include changes in vision, symptoms of stroke, blanching (white or pale appearance) of the skin, or unusual pain during or shortly after the treatment.
• Disfigurement (caused by synthetic fillers that include lab-made substances)
• Sores at the injection site, and open or draining wounds

Immediate medical attention will be required if you experience:

• Unusual pain
• Vision changes
• White appearance of skin near the injection site
• Signs of a stroke (sudden difficulties with speaking, numbness, weakness in the face, arms or legs, difficulties walking, severe headaches, face drooping, confusion and dizziness)

Fillers that tend to have longer-lasting effects are typically those that cause more side effects or complications. Not every filler is right for every type of wrinkle. Generally, the filler with the least amount of risk and best result comes from using the correct type for the right purpose.

It is highly advisable to only have fillers injected by a board-certified doctor, dermatologist, plastic surgeon or otolaryngologist with ongoing, specialised training. Severe side effects and complications are mostly seen in instances where an inferior product, sub-standard process or unqualified technician handles the treatment.

The safety of fillers is not entirely known when used during pregnancy, while breastfeeding or in people under the age of 18, as well as for those who are prone to keloids (excessive scarring) and / or hypertrophic scars (thick scarring). A specialist may advise against treatments if any of the aforementioned are applicable to you.

If needles tend to make you feel like you will experience some degree of pain, you can take comfort in knowing that many are often mixed with lidocaine (a mild anaesthetic, also often used by dentists), which will help to minimise any discomfort. A numbing cream is also often applied to help reduce any effects of discomfort or pain in the area being injected.