Question regarding fillers. Do you have to do it less often over time if you get them repeatedly?

Thank you for your excellent question. The fillers last longer with multiple
injections. It is not fully understood the mechanism for this phenomenon, but it
is thought to be related to increased collagen production. Some regions of the
face appear to last longer than other areas. Perhaps this is related to the
volume injected or to the amount of activity that part of the face has. I hope
you find this helpful.

In clinical practice we do seem to see that fillers tend to last for a longer period of time when they are repeated before they are completely absorbed/dissolved. Certain areas certainly maintain the correction longer than others (e.g. cheeks, nose, etc.) especially when that region has less facial movement. Try and find a regular practitioner that can evaluate your face periodically and give you the best advice on when and where any tiny amount of filler are required to keep you looking fresh and natural.Best wishes,-Dr. Asaria

Fillers are used to build volume. There is definitely an aspect of the body stimulating its own collagen over time so the short answer is yes. Injections can be lengthened with time in my experience. It does depend on where the material is injected though. For instance, in the lips it seems to go relatively quickly compared to the cheeks. Of course he material also has an effect. Most experienced injectors will be able to give you alll of your options when you come in. Hope this helps. Best of luck,DrC

Hello from Ottawa. Hopefully you are surviving the cold like I am (barely). This is a question cosmetic surgeons and facial plastic surgeons get asked relatively frequently.  Often times there is a slight bit of confusion surrounding this as Botox is thought to behave this way. With Botox, it weakens muscles so over time, the muscles continue to get weaker and thus you need less medication to get the same effect. Think about it like lifting weights, if you stop using your muscles (ie stop lifting weights or get Botox) your muscles become less powerful and thus you don't have as much muscle to treat!This isn't true for fillers. Fillers simply take up space in your skin. However, people may get fillers and they notice it starting to go away 8-12 months later and come back in for some extra. Its not that you need less, its just that the old filler hasn't completely been dissolved yet. This can be a problem as now you set up a schedule where some filler is new, some is old and some is in between. This can cause some people to find the treatment is never perfect as the filler is always in a state of "Flux" shall we say. Everyone is different and some people like this. Feel free to come in and chat here in Ottawa if you ever have any questions,James P Bonaparte, MD, MSc, FRCSCOtolaryngology - Head and Neck SurgeryFacial Cosmetic and Reconstructive SurgeryOttawa, Ontario, Canada

Thank you for your question.  The answer is sometimes, yes, but not always.  This is a similar idea to Botox, although it works by a totally different way.  Fillers can increase your body's production of it's natural collagen, which adds volume.  Thus, over time, you may need less.  Botox on the other hand works by paralyzing muscles and then muscles are paralyzed, they atrophy or thin out.  Less muscle mass, less Botox is needed.

Yes. This is possible. Some fillers stimulate collagen growth that results in long term changes to the injection area. If this does occur you can expect to maintain more volume long term and require smaller amounts of filler in the future. I have seen this happen on occasion but I definitely would not promise this to a patient as it does not always occur. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

In my experience, most patients do not have to get injected as often over time to maintain their results. Data suggests that after placement of a Hyaluronic Acid dermal filler, the injected area does not seem to revert back to its baseline volume. However, every patient is different and a number of factors including what kind of filler was administered, the technique used to perform the injections, the number of treatment sessions the patient has undergone, and more may determine the how much filler they will need in the future to maintain their results.

Yes. There are a couple reason for this:
Hyaluronic acid fillers have been shown to cause your body to create new collagen and elastin, making for thicker, firmer supple skin that needs less support.
As we age, not only are we losing fat and bone volume, but our muscles are getting bigger and stronger in our face. For years they have worked against the resistance of fat and bone, and by the time we’re in our 40s and 50s, they have grown significantly larger. Filler works against these muscles to create resistance and bolster the skin, giving it reprieve from the strong, repeated movements of your facial muscles. This is called Dynamic Discord.

It is quite possible that with time you might need less filler. There are some theories that collagen growth can occur with repeated treatment, however it will not eliminate future treatment requirements.

I do find that the majority of my hyaluronic acid filler patients (juvederm, restylane, Belotero, etc) do not need to do injections as often over time if they do them every 6-12 months to start. I think that the fillers often last longer than expected and I think they help grow new collagen. There are never guarantees but that is what I have noticed over time.