When you think about how the face ages, most people probably first think about skin starting to sag and droop. In fact, science has shown that the aging process affects every layer of our faces — from the skin to the underlying fatty soft tissue, muscle and even bone. The relationship between these layers affects the overall appearance of the face, from the forehead down to the jawline.
Plastic surgeons use a variety of approaches to restore youth to the face. Some of these approaches require surgery. But injectable dermal fillers offer a non-surgical, minimally invasive alternative to restore three-dimensional volume and shape to the face. Fillers work in a more nuanced way that focuses on each of the delicate facial features and the entire face as a whole.
In certain situations, plastic surgeons can also use fillers as an alternative to surgery to:
- Address facial asymmetry
- Improve scars
- Restore lost facial volume (fullness) caused by some health conditions
- Change certain facial features, like nose shape
Learn all about the pros and cons of dermal fillers to decide if they may be right for you. Then talk with a board-certified specialist to learn more about your options.
What Are Fillers Made Of?
There are lots of different filler materials to choose from. The most natural filler material is your body’s own tissue. In this method, plastic surgeons transfer fat from one area of your body to another (called an autologous fat transfer or fat grafting).
Besides using your own fat, there are 2 main categories of filler materials: biodegradable fillers and permanent fillers.
Your body gets rid of biodegradable fillers slowly over time. These include:
- Hyaluronic acid
- Collagen
- Calcium hydroxylapatite
- Polylactic acid
Since biodegradable fillers disappear with time, you can experience the results without committing to permanent changes to your face. Of course, this also means that you’ll have to get repeated injections to maintain the results. If you’re happy with the results from a biodegradable filler, you can also talk with your surgeon about switching to permanent fillers.
Permanent fillers stay in your body forever. These include:
- Polymethyl-methacrylate microspheres
- Hydrogel polymers
- Silicone
Each of these materials works a bit differently and has different risks and benefits. That’s why it’s very important to see a specialist. Look for a plastic surgeon who has training and experience using fillers in the face area you’re targeting and for the condition you’re treating.
What Happens When You Get Dermal Fillers?
First, your doctor will ask you questions about your medical history, including any chronic conditions, infections, prior surgeries or medicines you take. They’ll also ask if you’ve ever had an allergic reaction to any medicines, implants or injections.
Your doctor will also ask about your personal goals and expectations about how you’ll look after the procedure. Then they’ll do a physical exam to make sure the procedure is right for you.
The injections usually only take a few minutes. Your doctor will use special injection techniques to minimize pain during the injections and lower the risk of infection. But it’s possible to occasionally feel temporary minor discomfort during the procedure.
Immediately after the procedure, your doctor may ask you to avoid massaging the area to prevent the fillers from shifting position. It’s typically safe to use makeup or other skin products again within a day of the injections.
What Are the Possible Risks and Side Effects of Dermal Fillers?
The most common side effects include bruising, swelling or skin irritation where you got the injections. Your doctor may recommend that you temporarily stop taking certain medicines to lower the risk of bleeding or bruising.
There’s also a risk that the filler could block a blood vessel in your face. This happens if the filler is accidentally injected into a blood vessel or when the filler presses on a vessel. This can lead to partial or complete deterioration or even death of the skin area supplied by that blood vessel. This complication would need evaluation and possible treatment from a surgeon.
The most serious risk of injectable fillers is vision loss. Vision loss after filler injections is rare, but it’s important to be aware of this possible risk. This can happen when the filler material gets into one of the blood vessels in your face and travels to the artery that supplies the eye.
If you have vision loss right after an injection, your doctor can try several methods to fix it. But these methods aren’t always successful, and more research is needed to find out how effective they are. In some cases, vision loss from filler injections is permanent.
Some complications can take longer to happen, particularly with permanent fillers. Other complications include:
- Filler material migrating to a different part of your face
- Chronic irritation
- Infection
If you have these complications, you may need surgery to remove the filler material. You may also need surgery to remove permanent fillers if you’re not happy with how they look.
Remember, you can lower your risk of complications by choosing a board-certified plastic surgeon with experience using dermal fillers.
What’s the Average Price for Dermal Fillers?
Filler injections are a cosmetic procedure, so insurance usually doesn’t cover them. You would typically need to pay the entire price out of pocket, and it’s important to discuss pricing options up front with your doctor. Many plastic surgeons offer financing plans that may make fillers more affordable.
According to the 2020 statistics from the American Society of Plastic Surgeons, here’s the average price per syringe for each type of filler:
- Hyaluronic acid (like Juvederm, Perlane, Restylane and Belotero): $684
- Calcium hydroxylapatite (like Radiesse): $717
- Polylactic acid (like Sculptra): $853
- Polymethyl-methacrylate microspheres (like Bellafill): $1,058
- Fat grafting: $2,508
It’s important to keep in mind that these are average costs per syringe, and most people need multiple syringes to get the results they want. Prices can also vary widely depending on the doctor and the exact procedure.
Where Can I Get Dermal Fillers?
Many people offer cosmetic services and show images of their results online and on social media. But it’s very important to research the provider before you get any procedure. Always choose a board-certified plastic surgeon with experience in the procedure you’re getting. You can find a licensed plastic surgeon through the American Society of Plastic Surgeons or the American Society for Aesthetic Plastic Surgery.
Never buy dermal filler materials yourself or try to self-inject dermal fillers. This is very dangerous and can lead to serious complications.
And make sure that you only get fillers that are approved by the U.S. Food and Drug Administration (FDA). The FDA has only approved certain types of dermal fillers — and only for use in certain parts of the face and the backs of the hands. Fillers are generally not FDA-approved for use in some parts of the upper face or in the breasts, buttocks or feet. FDA regulations change often, so ask your doctor about the latest guidance.
Bottom Line: Are Dermal Fillers Worth the Costs and Risks?
Fillers offer a minimally invasive way to change certain aspects of your face’s appearance. But remember that injectable fillers can only address the soft tissues. They may give your face a more youthful volume and shape, but they can’t change the deeper structures or certain features of your face (which would require surgery). And while they’re less invasive than surgery, fillers can still cause serious complications.
The best way to prevent serious complications is to talk with a board-certified plastic surgeon to find the right options for you.
Resource Links:
- “Better Results in Facial Rejuvenation with Fillers” via Plastic and Reconstructive Surgery – Global Open
- “Treatment of Soft Tissue Filler Complications: Expert Consensus Recommendations” via Aesthetic Plastic Surgery
- “Practical Approach and Safety of Hyaluronic Acid Fillers” via Plastic and Reconstructive Surgery – Global Open
- “Facial Rejuvenation With Fat Grafting and Fillers” via Aesthetic Surgery Journal
- “Dermal Fillers Cost” via American Society of Plastic Surgeons
- “FDA-Approved Dermal Fillers” via FDA
- “Dermal Fillers (Soft Tissue Fillers)” via FDA
- “Choosing a Plastic Surgeon for Dermal Fillers” via American Society of Plastic Surgeons
