Residual unreacted BDDE in lip filler?

Question

Hi there, I’ve been trying to do my own research but I know I’m missing context. Is there any concern with residual unreacted BDDE (used for crosslinking) left in the final product of lip filler? Or is there a lip filler that contains less BDDE like restylane vs Juvederm?

Anna Chacon, MD, FAAD · Answer

This is an excellent and insightful question — and I appreciate your attention to the chemistry behind your treatments.

BDDE (1,4-butanediol diglycidyl ether) is a common crosslinking agent used in most hyaluronic acid (HA) dermal fillers to stabilize the HA and prolong its longevity in tissue. While it is true that BDDE is a synthetic chemical, the amount of residual unreacted BDDE present in FDA-approved fillers is extremely minimal — usually well below 2 parts per million (ppm) — and is rigorously tested for safety and compliance.

Here are a few key points:

Regulatory standards ensure that any residual BDDE in dermal fillers is non-toxic and biocompatible at the levels permitted.

The risk of harm from residual BDDE is considered negligible, and there have been no large-scale clinical issues linked to it in approved fillers.

If you're looking for fillers with less BDDE, you may want to consider Restylane products, as they tend to use slightly lower degrees of crosslinking compared to Juvederm, though the actual BDDE content in both is low and within safe margins.

Newer technologies, like Vycross (Juvederm) or XpresHAn (Restylane Refyne/Defyne), may differ in HA particle size and flexibility, but the BDDE usage remains minimal and regulated.

In summary, while the concern is understandable, residual BDDE in reputable fillers is not considered clinically significant or harmful when used appropriately. Always ensure your filler treatments are performed with FDA-approved products by trained professionals.

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. When it comes to lip fillers, BDDE (butanediol diglycidyl ether) is used as a crosslinking agent to improve the longevity and stability of hyaluronic acid. There are valid concerns about residual unreacted BDDE in fillers, as it can potentially cause adverse reactions in some individuals. However, reputable manufacturers conduct rigorous testing to ensure that the levels of residual BDDE in their products are within safe limits. Regarding the amount of BDDE, different brands may use varying formulations. Generally, Restylane products have been noted to have lower levels of BDDE compared to some Juvederm formulations, but this can vary by specific product line and formulation. I hope this helps and best of luck!

Residual unreacted BDDE in lip filler?

Answers (2)

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