When you start using hyaluronic acid fillers, do you need each time larger and larger dosages since the skin continuous to age?

Doctor Answers 2

Cumulative effect of properly done filler treatments

Dear Nicosia, 

That is a very interesting question! And, you will be pleased to know, has been a sort of "holy grail" for good non-surgical treatment. I can answer your question simply and more elaborately. 

The simple answer would be "No, larger amounts of hyaluronic acid are Not always required for subsequent treatments, If the other factors affecting skin aging are controlled." - that is a big If!

To elaborate on this, here are some basic principles, which I use very successfully in full-face non-surgical lifts to get a bespoke and very natural result that lasts. 

  1. Skin aging is a cumulative process, and after age 35, sometimes called "dermopause" the skin declines faster than it restores itself.
  2. Hyaluronic acid replacement, if done in the correct facial regions where we lose volume with age, has been shown to substantially slow down the rate of skin aging, by improving the collagen content, and in some cases even helping the skin heal from photo-aging
  3. Sun damage (photo-aging) has been shown to cause depletion of collagen below the skin surface, and speed up skin aging. 
  4. Sun exposure, nutrition, emotional factors - all impact the rate of skin aging, and happily we can take steps to optimise all these. 
  5. Unfortunately some patients may have had fillers in less ideal places, for example all along the nasolabial fold, which is rather unnatural and can look distorted in the long term. It can be difficult to sustain this, so they will end up needing more if they wish to persist in the same technique. 
  6. However if you get assessed and treated by an appropriate doctor and have an aesthetic correction, you will actually need the same or less amount of correction later for maintenance. 
  7. A good treatment using a full-face approach will give you a most satisfying result and need less filler to maintain, as long as you are ensuring good sun protection all year round, letting your skin breathe, keeping your exercise moderate (you don't want a "gym-face"), keeping nutrition optimum (no yoyo diets) and hydrating yourself by drinking plenty of water.

Wishing you good luck, and good skin health!



Southampton Physician
5.0 out of 5 stars 6 reviews

HA fillers and aging

The fillers themselves do not cause faster aging.  Over time, as the fat pads in the face lose volume, more filler may be required.  Good skin care products and sunblock help slow the aging of the skin by keeping it healthy.  Tightening procedures like microneedling or laser resurfacing are also helpful.

Suzan McGary, MD
Williamsport Thoracic Surgeon

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