What happens to the filler after 6mths? Does it flush out or does it get stuck somewhere in your face, making your face chubby?

Question

Where does the filler dissolve too once it wears off? Does it stay somewhere in the face making your face look fat or does it dissolve into your blood and then flushes away?

Mark Glasgold, MD, FACS · Answer

The long term effect and fate of fillers is underestimated in my opinion.  We commonly see patients who are 2 - 3 years after restylane injections to the lower eye return with chronic swelling which we believe is due to changes in the ability of the product to absorb water.  This will respond to hyaluronidase.During facelifts, I routinely find hyaluronic acid products in faces which were injected years earlier.I don't know of any studies which answer the question of what happens to these fillers over time.I have had multiple experiences with granulomas from permanent injectables showing up as late as 10 - 15 years after they were injected.I believe patients may want to be more concerned about the fate of large volumes of facial fillers over their lifetimes and not just over a few years.

Brian S. Biesman, MD · Answer

Hyaluronic acid fillers such as Restylane and juvederm and Belotero are naturally broken down by your body.  These products can induce collagen production so some residual volume correction may persist but the products do eventually break down.

Jerome Edelstein, MD · Answer

Hyaluronic acid will dissolve completely over time. Juvederm is such a filler so you can expect it to go away completely as it's absorbed and processed by your body.Unless there is internal scarring as a result of an unqualified injector, you can expect to not have any permanent results from the injection.

Farbod Esmailian, MD · Answer

Hyaluronic Acid (HA) fillers such as Restylane, Perlane, Juvederm and so forth are the preferred fillers for the lip.  With HA fillers the results may last anywhere from 4 months to 6-8 months, depending on the area.  The filler will not migrate if injected properly and will simply dissolve over time, allowing your lip to go back to its pre-filler natural state.Hope this helps.

Jason Emer, MD · Answer

Some fillers dissolve completely (HA fillers) and some leave behind collagen (Sculptra, Radiesse).  Some are there permanently (Artefill, Fat, Silicone).  I suggest speaking to a cosmetic dermatologist with expeirnece in fillers.  Best, Dr. Emer.

Mehryar (Ray) Taban, MD, FACS · Answer

The answer depends on the type of filler.  Hyaluronic acid gel fillers (such as Restylane, Juvederm, Belotero) get broken down and absorbed over time. Some other fillers may be permanent.

Harold J. Kaplan, MD · Answer

Hi VPM.  Dermal fillers generally are metabolized by the body.  This means the immune system remove the particles of filler over a period of time and the amount of time required for this process determines the "duration" of the product.  There are a couple fillers that are considered permanent because of their makeup, but generally speaking all filler will be dissolved by the body over time.To see examples of before and after photos for our Los Angeles injection patients, click on the link below.

Monika Soni, MD · Answer

Thank you for your question. If you are happy with the filler and do not want to undergo a chin implant, I suggest having Juvederm again. Because Juvederm is temporary, you will need to have touch ups every 6 months to maintain your results. I recommend having a consultation with an expert injector to determine the best treatment plan for you. Best of Luck!

David C. Mabrie, MD · Answer

Hi vpmhomes,
This is a great question, with a somewhat complicated answer. 
The short answer is:To maintain filler results you should repeat the injections at the midpoint of the filler treatment duration.
Here is an example: For fillers like Restylane and Juvederm Ultra that last 12 months you may overlap treatments by 6 months. After the third injection you may find the results lasting even longer. 
Remember of course you are also aging and losing volume over time and may need more filler to maintain the desired look.
The long answer is:Hyaluronic Acid (HA) fillers create and restore volume to the face in 3 ways:
1.     They physical volume of the filler.
2.     The physical volume of the water absorbed by the filler. 
3.     The collagen synthesis that is stimulated by all fillers. 
When HA fillers are injected, depending on the filler, different amounts of water are absorbed and this adds to the volume. 
As the filler is slowly degraded it turns into water and CO2 and is absorbed by the body. 
During the initial months, as the physical volume of the filler decreases, the remaining filler may absorb slightly more water, maintaining the same visible effects of the treatment. 
So at about the midpoint in the duration of the filler enough of the filler will have degraded so there is a visible decrease in the results. 
Finally, some of the newly synthesized collagen will persist even after the filler is gone. 
So in summary:For the first half of the HA filler treatment, the results will look about the same. At the halfway point, the results will visually start to decrease. And because of collagen synthesis some of the visual improvement will remain long term after the filler has been degraded. 
You should consider re-treatments usually at 6 months intervals and should need less volume over time as results start to last longer. 
I hope this information was helpful.
Dr. David Mabrie

Nissan Pilest, MD · Answer

Hyaluronic acid fillers such as Juvederm and
Restylane generally last around 6-9 months. You can rest assured that these
kinds of fillers will not migrate or get “stuck” elsewhere once the life
expectancy has passed. Over the 6-9 months, your body slowly metabolizes the
hyaluronic acid, and is flushed out in the same way that other non-essential substances
are processed through your system. This process is not sudden, but rather
happens at a gradual pace, taking your face naturally back to baseline.

Stimulators such as Sculptra do not volumize by
synthetic material; instead they fill by stimulating your body’s own collagen. The
new collagen produced by Sculptra can last up to two years, and will be
gradually broken down as you age, just as your body does naturally with all
collagen.

Consult with a board certified Dermatologist
to further clarify expectations, and discuss what filler options may be best
for you.

What happens to the filler after 6mths? Does it flush out or does it get stuck somewhere in your face, making your face chubby?

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