Shocking Revelation: Dermal Fillers Do Not Break Down as Advertised

Recent studies are revealing that dermal fillers may not break down every 6-9 months as aesthetic companies have long claimed.

Wait...what? Recent studies are revealing that dermal fillers may not break down every 6-9 months as aesthetic companies have long claimed. For someone like me, with over 20 years of experience in the aesthetic industry—including working for giants like Galderma (Restylane/Dysport), launching PRP/microneedling treatments, and reintroducing short-pulse Nd:YAG lasers—this isn't surprising. I've dedicated my career to helping physicians and skincare practitioners understand the benefits of high-quality skincare and the importance of branding their own skincare lines to ensure the success of their medical practices, medical spas, and skincare sales.

But these new findings hit close to home for me. As an athletic female with a lean build, I’ve faced unique challenges in the aesthetic sales world. Being a woman in this industry is tough enough, and it doesn’t help that aesthetic providers often judge us based on our appearance. I've heard it all—"You need filler in your face," "Your eyes look too hollow," "You should get filler in your temples."

My hesitation towards fillers began as I watched countless women in the industry transform their faces. Initially, fillers can look fantastic, and a little bit can do wonders if that's what someone wants. But over time, I saw many women become almost unrecognizable due to overuse. These beautiful women seemed obsessed with filling their faces, which made me question the safety and longevity of these products.

It became clear that fillers were not fully breaking down, leading women to add more filler on top of the old, unresolved material. What we now refer to as "pillow face" is something I noticed years ago, which made me question why companies kept encouraging doctors to buy more and more vials. This realization prompted me to avoid fillers altogether, despite the fact that my company offered a stipend for free filler treatments to promote the product. I eventually concluded that the filler companies were at fault for not adequately informing physicians about the true breakdown process of these treatments.

Studies have found that hyaluronic acid, the key ingredient in many fillers, is hydrophilic (water-loving) and may persist in the skin far longer than advertised.

This blog explores the concerning new data regarding the breakdown of facial fillers. Studies have found that hyaluronic acid, the key ingredient in many fillers, is hydrophilic (water-loving) and may persist in the skin far longer than advertised.

Understanding the Hidden Realities of Dermal Fillers: What You Need to Know

Shocking Revelation: Dermal Fillers Do Not Break Down as Advertised

In recent years, the aesthetic industry has seen a surge in the popularity of hyaluronic acid-based dermal fillers. These products promise a quick and effective way to enhance facial features, reduce wrinkles, and achieve a youthful appearance. However, new studies suggest that the narrative around fillers may not be entirely accurate. Contrary to what many aesthetic companies claim, fillers do not always break down within the advertised 6-9 months.

HA hydrophilic (water-loving) nature also means that it can retain water and potentially remain in the skin for much longer than initially thought.

The Science Behind Hyaluronic Acid Fillers

Hyaluronic acid (HA) is a naturally occurring substance in the skin that attracts water, helping to keep the skin hydrated and plump. When injected as a filler, HA can provide immediate volume and smoothness. However, its hydrophilic (water-loving) nature also means that it can retain water and potentially remain in the skin for much longer than initially thought1.

Long-Term Effects and Accumulation

Studies show that HA fillers can persist in the skin far beyond the expected duration2. This prolonged presence can lead to complications, especially if more filler is injected on top of the existing material. Over time, this accumulation can distort facial features, resulting in an unnatural appearance that may require surgical intervention to correct3.

Industry Protocols and Misconceptions

Many aesthetic companies have established protocols recommending filler injections every 6-9 months. This frequency is based on the assumption that the filler fully breaks down within this period. However, the reality is that residual filler can still be present, leading to overfilling and potential complications4.

Duration of Different Types of Fillers

Hyaluronic Acid (HA) Fillers: These are the most commonly used fillers and are generally advertised to last between 6-9 months. However, research indicates that HA fillers can persist in the skin for much longer—up to 12-24 months in some cases5.

Calcium Hydroxylapatite (CaHA) Fillers: These fillers, known for their use in products like Radiesse, can last up to 12-18 months6.

Poly-L-lactic Acid (PLLA) Fillers: Used in products like Sculptra, these fillers typically last around 2 years as they gradually stimulate collagen production7.

Polymethylmethacrylate (PMMA) Fillers: These semi-permanent fillers, found in products like Bellafill, can last 5 years or more8.

Experienced practitioners can often feel residual filler through palpation, especially if it has formed lumps or nodules.

How to Determine If a Patient Still Has Filler in Their Face

Determining whether a patient still has filler in their face involves a combination of clinical assessment and diagnostic tools:

Palpation: Experienced practitioners can often feel residual filler through palpation, especially if it has formed lumps or nodules.

Patient History: A detailed history of previous filler treatments, including the type of filler and the amount used, can provide insights into expected longevity.

Imaging Techniques: Advanced imaging techniques such as MRI or ultrasound can be used to visualize the presence of fillers. Ultrasound is particularly useful for identifying residual HA filler9.

Clinical Examination: Assessing the treated areas for volume and symmetry compared to baseline photos can help determine if filler is still present.

Start by building a strong foundation through high-quality skincare.

Alternative Approaches: Skincare First

Given these concerns, it's crucial to consider alternative approaches that prioritize skin health and natural aesthetics. Here's how you can navigate a more balanced approach:

Foundation Therapy with High-Quality Skincare: Start by building a strong foundation through high-quality skincare. Using products that promote collagen production and skin hydration can delay the need for more invasive treatments.

PRP and Exosomes: Platelet-Rich Plasma (PRP) and exosome treatments harness the body's natural healing processes to rejuvenate the skin. These options can provide substantial improvements without the risks associated with long-term filler use.

Minimize Filler Use: If you opt for fillers, use them sparingly and ensure that any additional injections are strategically planned to avoid overfilling.

Building Your Own Skincare Brand

One effective way to ensure high-quality skincare for your clients is to develop your own branded line. By doing so, you can control the quality and efficacy of the products you offer, reinforcing your practice's reputation and ensuring that your clients receive the best care possible.

Conclusion

The latest research highlights the need for a more cautious and informed approach to the use of dermal fillers. By prioritizing foundational skincare and alternative treatments like PRP and exosomes, you can help your clients achieve a natural and healthy appearance without the risks associated with excessive filler use.

Click on link below to set up a consultation today with Inspira Skin to brand your own skincare line and provide your clients with the highest quality products tailored to their needs.

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Footnotes:

1. NCBI Study on Long-Term Effects of Dermal Fillers: Review of long-term adverse effects associated with the use of chemically-modified animal and nonanimal source hyaluronic acid dermal fillers - PMC (nih.gov)

2. Critique of Hyaluronic Acid Dermal Fillers: Evaluating hyaluronic acid dermal fillers: A critique of current characterization methods - PMC (nih.gov)

3. Future of Injectables: Injectables of the Future - Future of Xeomin, Filler, and Botox 2023 (harpersbazaar.com)

4. Injectables: What's Next? Injectables What next for fillers and toxins? | PRIME Journal (prime-journal.com)

5. Durability of Hyaluronic Acid Fillers : Review of long-term adverse effects associated with the use of chemically-modified animal and nonanimal source hyaluronic acid dermal fillers - PMC (nih.gov)

6. Calcium Hydroxylapatite Fillers Longevity: Multivariate model for predicting semen cryopreservation outcomes in a human sperm bank - PMC (nih.gov)

7. Poly-L-lactic Acid Fillers Study: Hair Cosmetics: An Overview - PMC (nih.gov)

8. Polymethylmethacrylate Fillers Analysis: Canadian Association of Gastroenterology Position Statement: Use of Cannabis in Gastroenterological and Hepatic Disorders - PMC (nih.gov)

9. Ultrasound Imaging for Dermal Fillers: Dietary total fat, fatty acids intake, and risk of cardiovascular disease: a dose-response meta-analysis of cohort studies - PMC (nih.gov)