I'm afraid to get tear trough filler; how could I make sure this wouldn't happen to me?

I was almost 100% sure that I was ready to get tear trough filler; but I keep reading stories that are absolutely terrifying. I have read 100+ stories describing similar adverse reactions to the filler. As a result, people end up looking worse than they originally did, and permanently. It seems that allergies and "biofilm" seem to be the bigger and most common issue. How could I make sure this wouldn't happen to me? Would injecting the filler in my hand (as a test) be a good way?

Doctor Answers 3

Tear troughs, Juvederm and Restylane

The risks of biofilm infection, filler allergies and arterial occlusion are very rare, and yes, they do happen. One can minimise risks by-

1. Seeing a Board Certified Specialist who can handle all potential complications AND perform more complex procedures such as tear troughs.

2. Avoiding fillers if you have sinus or dental problems.

3. The injector taking extra care to be as sterile as possible during the procedure

4. Following post up instructions.

5. Using time tested products such as Restylane or Juvederm VOLBELLA (Juvederm comes in different forms depending on which part of the World you are in. In the UK, Asia and Australia Volbella is the Juvederm equivalent of Restylane).

All the best

Dr Davin Lim 
Laser and aesthetic dermatologist
Brisbane, Australia. 


Brisbane Dermatologist
4.7 out of 5 stars 62 reviews

Complications from fillers

Hi Monika. Thank you for your question. 

While all medical procedures do carry risk, placement of dermal fillers is a common and very safe procedure with a low rate of complications. In order to minimize your risk of having a complication and maximize your likelihood of having a favorable outcome, I recommend that you only get treated by a well-trained and experienced dermatologist or plastic surgeon. Best of luck, Dr. Frucht.  

Corey Frucht, MD, PhD
Santa Barbara Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Avoiding complications with fillers

Allergies and biofilm (a type of infection) are not common and are no more common in the tear troughs than elsewhere.  All but one of the fillers approved in the USA were approved without allergy testing because the risk is so low.  The risk of biofilm is not well understood but appears to be reduced by avoiding other procedures that can cause bacteria to enter the bloodstream in the weeks before and after filler injection such as dental work.  It is also crucial that you let your physician know if you have had a recent oral or skin infection.  Finally, filler should never be injected through skin that has not been prepped with antiseptic cleansers.  Since a biofilm could theoretically happen with any one of multiple injections, a 'test' on your hand wouldn't be helpful.

Ultimately, you need to find a core cosmetic physician who is expert at doing aesthetics, discusses the risks and benefits with you clearly and follows the best standards of practice.  Take a look at the American Society for Dermatologic Surgery website for more information.

I hope that answer was helpful.  Best of luck!

Heidi A. Waldorf, MD
New York Dermatologist
5.0 out of 5 stars 9 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.