How Safe Are Cosmetic Fillers?

How Safe Are Cosmetic Fillers
FDA warnings about unapproved fillers –

The FDA has not approved injectable silicone or any injectable fillers for body contouring or enhancement. The FDA has warned against getting filler injected into the breasts, buttocks, or spaces between the muscles. Using injectable filler for large-scale body contouring or body enhancement can lead to serious injury, including long-term pain, infection, permanent scarring or disfigurement, and even death.

The FDA has not approved needle-free devices for the injection of dermal fillers and warns against using them to inject hyaluronic acid or other lip and facial fillers. The injectors use high pressure and do not provide enough control over where filler will be placed. Serious injuries and in some cases, permanent harm to the skin, lips or eyes have occurred.

The FDA also warns against buying or using lip or facial fillers that are sold directly to the public. They are not FDA approved and may be contaminated with chemicals and infectious organisms. The only FDA-approved dermal fillers are supplied by a prescription for injection by a licensed health care professional using a syringe with a needle or a cannula (a small flexible tubing with a blunt tip that is inserted under the skin).

Are fillers more risky than Botox?

Risks and side effects of dermal fillers – Dermal fillers carry the possibility of more risks and side effects than Botox. Severe side effects are rare. Moderate side effects usually go away within two weeks. However, serious adverse effects have been connected to the use of unregulated, needle-free injection devices for dermal filler procedures.

allergic reactionbruisinginfectionitchingnumbnessrednessscarringsores

In severe cases, long-term swelling of the face might occur. Ice packs can help alleviate temporary numbness and swelling. To reduce the risk of this side effect and others, do allergy testing before getting a dermal filler if it’s recommended for the particular filler.

Is having filler safe?

Abstract – Fillers are generally considered safe. However side effects may happen and hence a practicing dermatologist need to be aware of such side effects, contraindicatons and precaution to be adopted while using fillers. Keywords: Contraindications, fillers, side effects

Is filler bad for you long term?

Common Side Effects of Dermal Fillers – Dermal fillers disrupt sensation in areas of the skin injected. This can interfere with the way muscle moves and you detect feeling. As a result, fillers can change the way your skin senses the environment. Dermal fillers can also lead to:

Vascular Occlusion : When filler is injected into or around an artery, blood flow may be reduced or stopped. Skin may look pale in color and start to turn blue over a period of 24 hours. This is usually painful, and if untreated, the skin may begin to ‘die’ and turn black. Allergic Reaction : If your body is sensitive to the synthetic substance injected. You may experience redness and swelling around the injection area. Inflammatory Reaction : Remember that you are entering a foreign substance into the body and it can irritate your immune system. Long Term Use: Over time, long term use of dermal fillers can result in weakness of the muscles of the face, head and neck. These side effects can have undesirable consequences when swallowing, with vocal cord function and eye movements, including double vision.

What is the safest filler for face?

The Benefits of HA Fillers – Because hyaluronic acid is a naturally occurring substance, and not derived from animal sources, it acts like an inflated cushion when it is injected, supporting facial structures and tissues that have lost volume or elasticity as a part of the aging process.

Because wrinkles and volume loss are the result of a loss of hyaluronic acid due to aging, it makes sense that HA Dermal Fillers would be the appropriate solution.
HA fillers are injected into the deep layers of the skin to replace missing HA, which also brings water to the surface of the skin, making you look more fresh and youthful with supple skin.

Hyaluronic acid based products are considered one of the safest in dermal fillers, particularly those made from synthesized HA, which is made in bacteria instead of using human or animal tissue. While some people may experience temporary redness or swelling after having HA Dermal Fillers, there are very few allergic reactions association with hyaluronic acid, thereby improving its safety.

Hyaluronic acid injections also have better longevity than collagen injections, typically lasting four to six months, during which time you experience fewer wrinkles and plumper, more youthful skin.
And last but not least, HA fillers are actually reversible! This means that, if the patient is unhappy with their results, another injection called Hyaluronidase can be given to the patient, which dissolves the HA fillers and effectively removes the changes made with the dermal filler injections.

Are you interested in having dermal fillers, but want to discuss more with our team of specialists before you decide if it’s the right treatment for you? with our team, and discover the true possibilities of hyaluronic acid dermal fillers for you. : Hyaluronic Acid Fillers: These Dermal Fillers are the Safest

Where do you avoid face fillers?

3D-anatomy of facial dangerous zones – The classical three main dangerous anatomical zones for filler injections referenced in the literature are the glabella and forehead, nasal and labial areas. The understanding of 3D-anatomy is essential to avoid vascular complications. In fact, vessels can travel through tissues at different depths along the same pathway (Figure 1).

How Safe Are Cosmetic Fillers Figure 1: All vascularisation of the right side of the face after skin and superficial fat compartments removal. a. The glabella and forehead area Background

The glabellar area, in particular, has limited or no collateral blood supply. Thus, any obstruction of the blood supply will tend to result in dermal injury. The overall pattern of the zones of injury seen in the glabella is typically vertical and fusiform, due to the orientation of the blood supply.

In the lateral or mid-eyebrow region of the forehead, the zones of injury tend to be triangular in shape, with one point of the triangle inferiorly near the presumed area of obstruction, and spreading in a triangular shape towards the hairline, Several studies have showed that the glabella was the most common filler injection site triggering blindness,

Accidental intra-arterial injection with a filler product may lead to an obstruction of the central retinal artery. The central retinal artery is a very thin branch of the ophthalmic artery; it enters the optic nerve and reaches and supplies the retina.

This embolism is associated with retrograde blood flow, through the anastomoses between the supraorbital, supratrochlear and ophthalmic arteries, provoked by strong pressure exerted on the syringe piston, leading to immediate and nearly always irreversible blindness in the affected eye, The vascular anatomy of the glabella and forehead Ophthalmic artery branches, derived from internal carotid artery, and the frontal branch of the superficial temporal artery, originated from external carotid artery, provide cutaneous blood supply to the forehead, glabella, nose and periorbital region.

The supraorbital, supratrochlear, central retinal and dorsal nasal arteries are some of the branches of the ophthalmic artery (Figure 2). How Safe Are Cosmetic Fillers Figure 2: Vascularisation of the forehead and glabella. The hook holds orbicularis oculi muscle showing the anastomosis between intra and extravascularisation of the orbit. The supratrochlear artery exits the superomedial orbit through the frontal notch, traverses the corrugator muscle and travels upwards deep to the orbicularis oculi and frontalis muscles.

Approximately 15 to 25mm above the orbital rim, the artery pierces these two last muscles to run into the subcutaneous plane,
The supraorbital artery emerges from the orbit through the supraorbital foramen and divides into superficial and deep branches.
The superficial branch runs upwards and pierces the frontalis muscle and galea aponeurotica, 20 to 40mm according to some authors and 15 to 20mm according others above the orbital rim to becoming subcutaneous.

The deep branch runs laterally above the periosteum to supply the pericranium of the superior orbital rim. The supraorbital artery anastomoses with the supratrochlear, angular and dorsal nasal arteries and with the frontal branch of the superficial temporal artery.

Our recommendation This region of 15mm just above the supraorbital rim is thus a high-risk zone because of these blood vessels.
At vertical levels above this area, the subgaleal tissues are low-risk, because they are relatively avascular.
In other words, the lower risk strategy involves injecting deep in the upper forehead (below the galea) and injecting very superficially in the lowest zone, and taking extra precautions in the deep to superficial vascular transition zone.b.

The nasal area Several publications reported the nasal area as the main cause of tissue necrosis and the second cause of visual loss after the glabella zone, The entire nasal area, and in particular the dorsum and radix, are high-risk zones. The rich communication between the external and internal carotid vascular network in these regions constitutes a danger of embolisation towards the central retinal artery (with its risk of blindness) or towards other intracerebral arteries (with the risk of stroke) by retrograde propagation mechanism from the filler injection site. How Safe Are Cosmetic Fillers Figure 3: Vascularisation of the nose with the subalar artery and the lateral nasal artery going to tip. The facial artery (external carotid system), as it passes the nostril, gives off the subalar or inferior alar artery but sometimes the latter arises from the superior labial artery,

Supplying the nasal ala with branches that become more superficial, the subalar artery also participates in the rich arterial anastomotic system of the upper lip,
Because of its anatomical position in the upper third of the nasolabial fold (NLF), the subalar artery constitutes an anatomical danger zone for the filler injections often requested in this area of the face,

In its course towards the medial canthus of the eye along the lateral edge of the nose, the facial artery gives rise to the lateral nasal artery or superior alar artery, which can sometimes branch from the superior labial artery. This artery supplies the dorsum of the nose and nasal ala, and anastomoses with the arterial plexus of the nasal tip,

For some authors, the lateral nasal artery is the main terminal branch of the facial artery rather the angular artery, the latter being a small and thin artery, For others the angular artery is the main continuation of the facial artery. It continues its course in the nasojugal fold above the levator labii superioris alaeque nasi and orbicularis oculi muscles.

While running towards the inner angle of the eye, the angular artery runs just below the tear trough, and then passes between the two insertion heads of the depressor supercilii muscle, becoming deeper, and finally anastomosing with the dorsal nasal artery, a branch of the ophthalmic artery.

In the literature, several authors have reported that the facial artery most often ends near the base of the nasal ala, where it may divide into the subalar artery and the lateral nasal artery in other studies, the most common findings were those in which the facial artery ends in the lateral nasal artery.

The dorsal nasal artery, branch of the ophthalmic artery (internal carotid vascular network), emerges from the orbit and gives off a collateral branch to the lacrimal sac before dividing into two branches: (i) one anastomoses with the angular artery and (ii) the other runs along the nasal dorsum.

Rich anastomoses with the supratrochlear, contralateral nasal dorsal and lateral nasal (a branch of the facial artery) arteries supply the nasal bridge and nasal dorsum, Our recommendation Since the vascular network of the nose is superficial, and beneath the dermis, filler injections should be performed deep to the musculoaponeurotic layers, in the preperichondrial and preperiosteal planes to avoid injury or cannulation of vessels.

It is recommended to inject small amounts of fillers with extreme caution in patients with previous rhinoplasties since the anatomy could have been modified and the residual sclerosis makes the vessels less mobile in their environment which increases the risk of being cannulised,

When injecting, block distal vascular flow with your non-dominant hand.c. The labial area Small amounts of filler typically only affect the lip itself. Larger volumes can cause serious degrees of obstruction because of retrograde (proximal) flow to the facial artery. Typical patterns of injury involve the upper and lower lip and the ipsilateral nasal area.

Several normal variants of the superior labial artery have branches, either single or paired, to the nose. Thus some injections of the upper lip can paradoxically show an injury to the nose as a result of one of these branches (the columella, alae, or both), How Safe Are Cosmetic Fillers Figure 4: Vascularisation of the labial area with the inferior and superior labial artery coming from the facial artery. The inferior labial artery arises from the facial artery, generally at the level of the labial commissure, but higher or lower in certain cases,

It passes behind the depressor anguli oris muscle and enters the lower lip travelling between the mucosa and orbicularis oris muscle along the level of the lower lip vermilion-cutaneous border towards the midline to anastomoses with its homologue from the opposite side,
The superior labial artery branches from the facial artery generally at the labial commissure, superior or inferior to the latter.

It runs towards the midline between the orbicularis oris muscle and the mucosa usually superior to the vermilion border, at a depth of about 3 to 7.6mm to skin, until just before approaching Cupid’s bow where it becomes inferior to the border, It anastomoses with its counterpart and forms a rich arterial arch.

Several superficial ascending branches (to the skin) and deep ascending branches (to the mucosa) arise from this network, including the septal arteries, located on either side of the philtrum to anastomose with the subalar and columellar arteries. Our recommendation The labial arteries travel in the region of the red lip posterior to the wet-dry line.

Typically, the vessel is more often found within the orbicularis oris muscle within the central third of the lip. The artery is relatively close to the mucosa (particularly in the lateral thirds), and thus it is clearly in the high-risk zone whenever filler is injected into the area posterior to the wet-dry line in efforts to evert the lip.

What areas to avoid with facial fillers?

Maximising safety in the danger zones – Knowledge of the facial anatomy is essential to a safe and effective injection. As evidenced by numerous studies, the facial vasculature has many variations and can be found in various tissue planes, depending on location within the face.

Anticipating the depth and course of vessels allows practitioners to develop techniques to avoid intravascular injection, vascular injury, and/or compression, the authors note.
With a thorough knowledge of the depth and the location of the vasculature within each zone, practitioners can tailor their injection techniques to prevent vessel injury and avoid cannulation.

Specifically, the six danger zones are the glabellar area, temporal region, lip and perioral area, nasolabial fold area, nasal area and the infraorbital area.

How often is it safe to get fillers?

Rejuvenate Your Face Easily and Quickly – Dermal fillers are great for anyone looking to restore the smooth and youthful shape of their face. Although some last for two years, others need to be repeated every 4-6 months for best effects. If you’re having several areas of the face treated, you might have to visit us more often.

When you get in touch and book an initial consultation, your provider will be able to estimate how frequently you should come to the clinic.
It’s important to remember that fillers are technique-sensitive, so you should always visit a specialised clinic.
This not only prevents infections and side-effects, but it also allows you to achieve the amazing results this treatment promises.

Who should not get Botox or fillers?

Who Should Not Get Botox? – Not everyone is a good candidate for Botox. If you are in poor general health, your skin is very thick or you have existing muscle weakness in the proposed injection site, you may not be a good candidate for Botox. Patients with sensitive skin may experience an allergic reaction at the injection site.

If you feel that you have particularly sensitive skin, you may want to consider having an allergy test performed prior to your Botox treatment.
People who may have allergic reactions to the ingredients used in Botox or are currently taking aminoglycoside antibiotics should not get Botox treatments done.

If you also have any infections at the proposed injection site, you should inform your doctor.

How long do fillers last in your face?

Different products for different places – As these procedures grow in popularity, so do the number of products available for injection. Each of these products differs in its thickness and specific qualities. This is why it is critical to choose a board-certified plastic surgeon to fully evaluate your facial anatomy and choose a product and injection technique to give you the natural results you desire.

Noninvasive facial rejuvenation is truly an art form, and plastic surgeons rely on a variety of different products to achieve the desired look. For loss of structure and support, such as in the cheeks, forehead and temples, your doctor may choose a thicker product to provide the most support for your tissue.

These injections are often performed deeply atop your bone for maximum effect. The perks of these deeper injections are that they are often less painful, cause less bruising and last longer than other types of injections. Deep injections may last as long as 12 months, and newer products on the market may last up to two years.

For my patients, once we have injected an area and my patient is very happy with their results, I will consider moving on to a longer-lasting product for subsequent injections to maximize the length of their results. For lines and wrinkles closer to the skin, your doctor may choose a thinner product to fill in the contour and smooth the skin.

These products may be metabolized more quickly and will last for 6-12 months. In areas of the face with more movement, such as the lips, for example, the constant movement of muscles breaks down and dissolves the filler at a faster rate, and fillers tend to go away quicker in these more active areas.

What happens to fillers after years?

Over time, as facial movement increases in areas like the lips or cheeks, it causes the filler to break down and dissolve at a quicker rate. This makes the filler disappear faster in more active areas of the face.

Who should not get Botox or fillers?

If you feel that you have particularly sensitive skin, you may want to consider having an allergy test performed prior to your Botox treatment.
People who may have allergic reactions to the ingredients used in Botox or are currently taking aminoglycoside antibiotics should not get Botox treatments done.

If you also have any infections at the proposed injection site, you should inform your doctor.

Which is safer Botox or Juvederm?

Fast facts – About:

Juvéderm and Botox are used to treat wrinkles.Juvéderm is made of hyaluronic acid (HA), which plumps up the skin. Botox injections temporarily relax facial muscles.

Safety:

Both treatments can cause temporary pain and discomfort.Serious, but rare Juvéderm risks include loss of blood, scarring, and allergic reactions.Botox may cause headaches and droopy skin. More serious, but rare complications include paralysis and toxicity.

Convenience:

Juvéderm and Botox are relatively quick treatments, taking just minutes to complete. Larger areas of skin can take longer based on the number of injections needed.While convenient, this doesn’t mean you shouldn’t skip out on a licensed medical doctor to perform these treatments — make sure you see a dermatologist or surgeon for your injections.

Cost:

Juvéderm is slightly more expensive, with an average cost of $600 per injection.Botox is charged less per unit, but you need multiple units (sometimes 20 or more) depending on the area of treatment. This can cost an average of $550 total.

Efficacy:

While both treatments are considered effective, Juvéderm works quicker and lasts longer. Botox can take a few days to take effect and the results wear off after a few months.You will need follow-up treatments to maintain your results, no matter which treatment you choose.