High Volume HA Butt Fillers and BDDE risk?

Question

I have about 1200ml of HA injected in to my butt. The filler is CE certified, SedyFill- I believe. I’m half way to where I want my butt to be but am concerned this can be toxic considering BDDE in fillers. Is there any reason to be concerned? Should I wait sometime before going in again, I’ve got for 300ml each month for about 4 months now. Thanks in advance.

Ryan A. Stanton, MD · Answer

I have unfortunately had many patients come to me after having their high hopes for buttock/hip augmentation crushed by measly Sculptra results or other "fillers" such as Radiesse, Renuva and Juvederm/hyaluronic acid fillers, etc. Other than the fact that these are not FDA approved for buttock/hip injections, here are some critical points of awareness: 1) they all are temporary, lasting 1 - 1.5 years at very most, but usually not even 6 months, 2) if done correctly dermal fillers are cost prohibitive for 99% of potential buttock/hip augmentation patients. In order to create a significant/noticeable result with a dermal filler, at least 200 mls of active product (not just “total ccs of fluid injected” of which contains mostly saline not Sculptra) must be injected into each buttock cheek for a total of 400 mls. At $1000 per ml, this equates to a minimum price of $400,000.00. Thus if your doctor is recommending to put in ONLY 20 or 40 mls of these fillers you will pay $20,000-$40,000 and get an insignificant miniscule result! (eg. like a “drop in the ocean” effect), 3) Do not let anybody tell you that the product is so special that it's going to magically grow over the following months or years...this just does not happen to any noticeable degree!, 4) dermal fillers, when injected in large quantities, have a relatively high infection rate, guaranteed tendency to migrate away from the original area they were injected into, and almost always stimulate a lot of inflammation with a subsequent and disastrous amount of scar tissue/hardening, and 5) the one very serious complication that can rarely ( less than 1%) happen is "embolism" in which some of the filler gets into the blood stream and travels up into the lungs, heart, and/or brain causing serious problems, including death.

As well, fat transfer to the outer butt and hip dips, especially on lean patients, has a poor survival rate and thus often slighted results.

The only relatively safe, reliable, and permanent option for buttock and hip dip augmentation is with implants.

Hope this all helps you make a better informed decision and saves you a lot of your otherwise hard earned money.

As well, fat transfer to the outer butt and hip dips, especially on lean patients, has a poor survival rate and thus often slighted results.

The only relatively safe, reliable, and permanent option for buttock and hip dip augmentation is with implants.

Hope this all helps you make a better informed decision and saves you a lot of your otherwise hard earned money.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your experience and concerns so openly. It’s completely understandable to feel cautious, especially with larger-volume filler procedures.

Hyaluronic acid (HA) fillers like SedyFill are cross-linked with a compound called BDDE (butanediol diglycidyl ether). This cross-linking helps the filler last longer in the body. In CE-certified products, the amount of residual BDDE is regulated to be extremely low—well below toxic thresholds. That said, the key concern with very high volumes of HA fillers isn’t typically BDDE toxicity, but rather the physical risks: product migration, unevenness, inflammation, infection, or in rare cases vascular compromise.

With 1200 mL already placed and more planned, your body may take longer to adjust and integrate the product. Adding volume gradually, as you’ve been doing, is safer than injecting it all at once, but it’s also wise to allow your tissues time to settle before continuing. Sometimes waiting between sessions can help minimize complications and give a clearer picture of how the filler is behaving in your body.

To sum up: BDDE itself is unlikely to be toxic at the levels present in CE-approved fillers, but the overall volume, placement technique, and long-term tissue effects are the bigger considerations. Your caution is very valid—it’s always best to proceed carefully when working with large filler volumes.

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