What Filler Can I Use After Recently Using Aquamid?

We are seeing many longterm problems associated with permanent fillers in our office. Complications from silicone biopolymers, Artefill, Bellafill, PMMA, and biopolimero should be addressed by an expert in the field.  

In my practice, I specialize in the removal of Bellafill and Artefill injections, in addition to silicone biopolymers, from the face and body. Initially, treatments are non-surgical with corticosteroids and immune modulators. If unable to be corrected, we can also perform surgery in some cases. 

Patients should undergo biometric screening, clinical assessment of Karamanoukian Grade of Soft Tissue Reaction, and ultrasound examination. 

Silicone biopolymers can also be removed from the body if there are signs of migration or inflammation. All of these filler-types should be removed as early as possible. 

Lastly, our office is conducting ongoing studies of plasma-assisted corticosteroid application, which allows for diffusion of the treatment medication in superficial tissue without causing atrophy. 

Best, 

Dr. Karamanoukian 

Realself100 Surgeon

Hello and thank you for the question.

The best option for management of wrinkles above the lips would be a hyaluronic acid, such as Juvederm Ultra or Restylane.  In experienced hands, these injectable fillers produce excellent results for correction of lip wrinkles.  Excessive use of these fillers or too superficial of an injection may lead to the Tyndall Effect which leaves a classic bluish hue in the underlying skin. 

Regarding the use of an injectable filler following previous treatments with Aquamid, at a month you should be safe to undergo treatments with an alternative filler such as a hyaluronic acid. Since Aquamid is considered a permanent filler, subjecting the previously treated area to new treatments may increase your chance of infection. I would recommend discussing these issues with your clinician so that you may better understand the risks and benefits of proceeding with a secondary treatment.

Kindest Regards,

Glenn Vallecillos, M.D., F.A.C.S.