What Are the Long Term Effects of Using Hyaluronic Acid Fillers?

Question

If hyaluronic acids (juvederm, restylane, radiesse) are injected to the cheeks / face for over 20 years or more, what are the possible side effects? Are there studies for the use of these fillers for that long to determine their safety in long-term use?

Stephen Prendiville, MD · Answer

Before I discuss potential long term effects, I think its is appropriate to define what hyaluronic acid is. Hyaluronic acid is a substance that is found in our bodies in the intra-and extracellular matrix. It is form of antigen-free tissue glue, if you will. Therefore, hyaluronic acid is naturally broken down in the body without adverse effects. Hyaluronic acid has been used for years in cartaract surgery and was FDA approved for cosmetic use (Restylane) in 2004. To date, there is no information to suggest that long term aesthetic use of hyaluronic acid gels has any detrimental effects. Radiesse is made out of calcium hydroxylapatite, a substance found naturally in our bone structure. Similarly, there is no information that would suggest adverse effects of long term use.

Hadley Claire King, MD, FAAD · Answer

Hyaluronic acids and other dermal fillers have different properties and different injection requirements, resulting in different associated risks and long term effects. Overall, dermal fillers have a relatively low risk of adverse side effects. A 2013 study published in the journal of Clinical, Cosmetic and Investigational Dermatology presented an overview of adverse events associated with dermal fillers in aesthetics. The study concluded that all dermal fillers have the potential to cause complications, but “Serious adverse events are rare” and the “majority of adverse reactions are mild and transient, such as bruising and trauma-related edema.” Some of the adverse reactions may be associated with the material itself, but the majority of adverse reactions is “related to volume and technique,” and most serious adverse events “are avoidable with proper planning and technique.” Meaning, the skill and expertise of the person performing the injections is very important and very influential on the long term effects of a dermal filler. So, one of the best way to lower your risk of adverse side effects is to refer to a skilled medical professional who specializes in cosmetic injections.

For a study detailing the rare occurrences of adverse side effects associated with foreign body reactions (adverse reactions to the actual material injected with dermal fillers,) an article published in Clinical Interventions in Aging notes that “Although hyaluronic acid-based dermal fillers have a low overall incidence of long term side effects, occasional adverse outcomes, ranging from chronic lymphoplasmacytic inflammatory reactions to classic foreign body-type granulomatous reactions have been documented.” The article expounds on these long-term adverse events and might offer you some valuable information.

So although rare, long term side effects and adverse reactions are possible. However, not all long term effects from dermal fillers are negative. In fact some dermal fillers have long lasting effects that are very positive. While the majority of the aesthetic benefits of dermal fillers dissipate over time, injectable volumizers may provide lasting anti-aging effects by stimulating the body's natural collagen and elastin production.

What Are the Long Term Effects of Using Hyaluronic Acid Fillers?

Answers (2)

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