Does hyaluronic based fillers gradually absorb away little by little?

Question

Does hyaluronic based fillers gradually absorb away little by little from the first month until it reaches a year or does the absorption start when it reaches the 6-12 month mark and dissolve suddenly at that point? Not really understanding how this works. Thank you.

Michael P. Morrissette, DDS, FACS · Answer

Unfortunately with all hyaluronic acid fillers, they begin to resorb soon after injection. Based on their composition, some fillers last longer than others. Also, the location in which the filler is placed can affect the longevity.  If you are interested in a more permanent solution silicone facial implants are an excellent option. Fat grafting using todays techniques can also provide a permanent solution in some cases, though I have found that in the lips, fat will resorb in a similar fashion to HA fillers. Autogenous fat provides the most natural feel and look. Good luck

Jason Emer, MD · Answer

Fillers will dissolve gradually. Each filler has different lengths of longevity. Volbella is considered a long lasting filler and is good for creating a full, symmetrical lip. Implants or fat are alternatives. See an expert. Best, Dr. Emer

Mehryar (Ray) Taban, MD, FACS · Answer

It usually dissolves gradually from the time it is injected. The rate of absorption varies based on the type of filler and where on face it is injected. For instance, fillers around the eyes last much longer than in the lips.

David C. Mabrie, MD · Answer

Hi cll12345,
  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

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question cll12345. Fillers are
used to restore lost volume in and enhance the appearance of the face. Fillers are slowly degraded over time. Studies have been performed where observers look at photographs of patients after a treatment over time to determine the effects. Most of these studies demonstrated that the results are best for the few months, then slowly decrease over time. Some fillers last longer than others. For example the newer ones using Vycross technology (Voluma, Volbella, and Vollure) last longer than products such as Juvederm, Restylane, and Belotero. Please
consult with a doctor for specific recommendations.  Good luck!

Shaun Patel, MD · Answer

Great question. The longevity of hyaluronic acid based dermal fillers varies based on the type of filler used and where it is injected on the face. Typically, fillers last longer in the cheeks then in the lips because the lips experience much more motion. Sculptra, a poly-L-lactic acid based filler, has one of the longest durations of action because it works by stimulating your skin to produce more of its own collagen. Filler results degrade gradually over time. Typically patients need maintenance treatments at 6-12 months intervals after having achieved full correction with a filler.

Anna Avaliani, MD · Answer

Hello and thank you for your great question. HA fillers differ in their duration based on the type of filler, the amount injected and also where it is injected. On Average the range is between 4- 24 months. The product is being gradually absorbed by the body over some time. You never want to wait until the entire product is absorbed and should be on a maintenance regimen every 12 months or so.  The first injection appointment is really about replacing the volume lost and the subsequent appointments are about maintaining that look. You break down the product and you also get older each year, which you have to take into account as well. This is a gradual process which varies from person to person.  You should get an expert consultation to be able to address your concern and ideally build the treatment plan for you.

Rebecca Baxt, MD · Answer

Hyaluronic acid fillers have varying times of duration. Some are FDA approved for up to one year and others longer. I find it variable from patient to patient and in different area of the face. HA has been shown to help grow new collagen so I do find after you've done it more than once that It can start to last even longer.

Does hyaluronic based fillers gradually absorb away little by little?

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