Is it true that hyaluronic acid fillers never goes away?

Question

I heard it just flattens and never dissolves. Should I choose Radiesse instead?

Jonathan Kulbersh, MD · Answer

I appreciate your question. Hyaluronic acid is a substance that naturally occurs in the body, aiding in skin hydration. When HA fillers are placed into the dermal structure, the body breaks down the HA over time. It does not remain in the system indefinitely, which is why filler treatments need to be repeated periodically to maintain your positive results. The rate at which the body metabolizes the HA will vary somewhat from patient to patient. The rate is based on how much filler is used, the type of filler, the treatment location, and the speed at which the patient's body dissolves the substance. The body also metabolizes the active ingredient in Radiesse (calcium hydroxylapatite), but does so more slowly. That is why Radiesse tends to last longer than most fillers. Another difference is that Radiesse cannot be manually dissolved like HA fillers. Always work with an experienced, board-certified injector to ensure an optimal outcome with every treatment.

Ryan E. Austin, MD · Answer

Hi, thanks for your question. Hyaluronic acid (HA) is an already naturally occurring substance in the body, that your body will eventually absorb and eliminate naturally. It does get eliminated. It takes anywhere between 6-12 months for your body to absorb and eliminate hyaluronic acid, after which your treated area will return to the way it was before your filler treatment. Radiesse is composed of calcium hydroxyapatite (CaHA). CaHA is also made up of naturally occurring elements in the body (calcium and phosphates) that will eventually be metabolized by your body. Because of the way Radiesse is manufactured, it will take longer for your body to metabolize CaHA, anywhere from 1-2 years as opposed to 6-12 months with HA. Both filler types will eventually be eliminated from your body one will just take longer than the other. Typically, we recommend HA fillers over more permanent fillers because if for whatever reason you had a reaction to your filler or you didn't like your result, HA based fillers are the only types of fillers that can be dissolved with hyaluronidase. Radiesse on the other hand cannot be dissolved once injected. Please speak to your provider if you have any other questions or concerns about dermal fillers.

Irena Karanetz, MD · Answer

Hello, 
Thank you for your question. 
Hyaluronic acid fillers are not permanent. The body typically breaks them down within 6-12 months depending on the specific filler used, consistency (G prime) of HA filler and the location where it was injected.
I hope this helps. Best regards, Dr. Karanetz
Dr. Irena KaranetzFellowship-TrainedBoard Certified Plastic Surgeon

Jason Emer, MD · Answer

no they dissolve over time. radiesse, bellafill, renuva, sculptra, silicone all last long term.  Best, Dr. Emer.

Michael I. Echavez, MD · Answer

Hyaluronic acid fillers do go away over time.  Different hyaluronic acid fillers last different lengths of time though.  There are many different filler products to choose from but sometimes a certain filler will work better on one part of the face than another.

Anshul Gambhir, MD · Answer

Thank you for your question! Hyaluronic acid fillers will eventually all dissolve; however, you can stimulate collagen growth in that area but the filler itself will completely be gone after a long period of time. The only issue with Radiesse is if there is a problem or complication it cannot be dissolved or reversed with hylenex like the hyaluronic acid fillers can. Hope this helps!

Leonard Grossman, MD · Answer

Our bodies constantly produce hyaluronic acid which also gets reused and broken down. When a filler is placed, it too gets broken down by the body. Certain areas such as the under eye area tend to simply retain the hyaluronic acid for a very long period of time in many cases. I hope this helps and good luck from New York City plastic surgery

Robert T. Buchanan, MD (retired) · Answer

It is not true that hyaluronic acid fillers "never" go away. They are composed of hyaluronic acid that is cross linked. This makes it difficult for the body to use it like natural hyaluronic acid since it has to break the cross links before use. Some of the HA is used to make collagen, so, in a sense, not all of it disappears. As an aside, this is similar to what happens with Radiesse, which stimulates the body to make collagen from surrounding natural HA. The way the HA is cross linked determines how long it lasts and the softness, thus where it works best and is used for. Radiesse is very heavy and is useful on the bone to support tissues similar to Juvederm Voluma.