Are fillers dangerous?
If you’re considering treatment with fillers, of course you first want to know if fillers are dangerous. We can be short and sweet about that, because in the right hands – those of an experienced cosmetic doctor – fillers are safe.
In this article, we will describe the safety of fillers and explain why the idea exists that fillers are dangerous. Before we move on to describing the possible dangers of fillers, let’s briefly describe exactly what fillers are.
Fillers in brief
A filler can be used to add volume in and under the skin. Fillers are mainly used for cosmetic purposes, such as reducing wrinkles and improving skin hydration. In the Netherlands, fillers based on hyaluronic acid are most commonly used. This is a substance that occurs naturally in the body and is recreated using biotechnology for application as a filler. There are many different types of hyaluronic acid fillers available worldwide, varying in quality. At Ivy clinics, we only work with high-quality fillers from Bo medical, Merz and other major companies. Fillers based on calcium hydroxiapetite(Radiesse) and poly-L-lactic acid (Sculptra) have a different composition than hyaluronic acid, but can also be injected safely.
Safe fillers
Hyaluronic acid: Hyaluronic acid is a type of sugar (polysaccharide) that is naturally present in the body, such as in the skin and cartilage. It has the ability to bind moisture to itself and swell in gel form, creating a smoothing and filling effect. The hyaluronic acid in fillers is modified (crosslinking) so that the product stays in the skin longer. The effects of a treatment with hyaluronic acid fillers last about 9 to 12 months in areas of the face where there is a lot of movement. Fillers on the cheekbones or under the eyes can remain effective for 1.5-2 years.
Calcium hydroxyapatite: Calcium hydroxyapatite is a type of mineral found in human teeth and bones. To fill wrinkles on the face, calcium hydroxyapatite particles are incorporated into a gel-like solution and then injected into the wrinkle on the face or under the skin. At Ivy clinics, we work with Radiesse; a calcium hydroxyapatite-based filler. The effects of this material last about 18 months. However, calcium hydroxyapatite is visible on x-rays and can potentially blur the image.
Poly-L-lactic acid (PLLA): PLLA is a biodegradable, biocompatible man-made polymer. This material is also widely used in dissolvable sutures. PLLA is a durable filler administered in a series of injections over a period of several months. The effects of PLLA generally become increasingly evident over time (over a period of several weeks) and the effects can last up to 2 years.
Permanent fillers are dangerous though
So the fillers we use at Ivy clinics are safe. Yet there are many people who think fillers are dangerous. This is because of media reports about the many complications that have occurred with permanent fillers. Years ago, when cosmetic medicine was in its infancy, fillers were injected that cannot be broken down by the body. The permanent fillers that were injected included Bio-Alcamid, Aquamid and silicone oil. The doctors who applied these fillers at the time were unaware of the often severe complications that can occur years after treatment such as inflammation, swelling, pain, redness and facial deformity. The use of permanent fillers has therefore been banned in the Netherlands since 2015. Treating, correcting or removing a permanent filler is difficult. The material is often encapsulated by the body. Therefore, if there are no immediate complaints, it is often chosen to leave the product in place. If the permanent filler does cause problems, the product can be removed – often partially – by laser or surgery.
Did you know that the Netherlands is the first country with a special filler complication consultation? The filler complication consultation is held at the Erasmus Medical Center in Rotterdam. People can go there if they experience problems after treatment with fillers.
Allergic reaction to fillers
Hyaluronic acid used to be extracted from cockscombs. As you can imagine, injecting animal protein provoked allergic reactions. Today, hyaluronic acid is manufactured using biotechnology and allergic reactions are rare. Still, there is a small percentage of the population that carries a certain combination in its DNA that increases the likelihood of immune-related reactions to foreign objects (such as breast implants, vaccinations, piercings and, consequently, fillers). In that 1 to 3 percent of the world’s population, filler treatment can cause problems. There is a test on the market that can identify the combination in the DNA, but a good indication of an increased immune response are also autoimmune diseases and allergies. Should you have an autoimmune disorder or suffer from one or more allergies, it is important to discuss this with the cosmetic doctor before treatment. The latter can and will then determine if filler treatment is warranted and discuss a possible alternative treatment such as lipofilling.
Vascular complication
We have already discussed in this article the dangers of permanent fillers and the small chance of an allergic reaction after filler treatment. A vascular complication – blockage of a blood vessel after injection – is not directly related to the product, but mainly to the practitioner’s technique. There are many blood vessels running through the face. When injecting filler into or next to a blood vessel, the blood supply can be reduced or even stopped completely. Untreated, this can lead to necrosis (death of tissue) and blindness. If a vascular complication occurs, it is usually visible immediately and at least soon after treatment. The skin around the injected area often becomes lighter due to the lack of blood circulation and the patient will have more pain than is normal with filler treatment. In the rare case that the blood supply is reduced, this can be remedied by dissolving the hyaluronic acid filler with hyaluronidase. This is an enzyme that rapidly breaks down the hyaluronic acid filler. Recognizing and correcting a vascular complication requires solid experience and knowledge from a cosmetic doctor.
Safe injection under ultrasound guidance
Research has shown that using ultrasound when injecting filler can prevent vascular complications. With ultrasound, we can see exactly where blood vessels run and safely apply the filler where the effect is desired. In addition, in some cases, ultrasound allows us to see where filler has been previously applied and recognize the type of filler. However, sometimes it is very difficult to see. Therefore, we currently only do this at Ivy clinics is specific cases when it is helpful to get the ultrasound in.
Conclusion
Filler treatments at Ivy clinics are safe because we use high-quality products and are experienced in injecting the filler correctly and can prevent and remedy vascular complications. Since we believe everyone should be able to make an informed choice, we are transparent about the possible risks of cosmetic treatment. We hope that with this article we contribute to that informed choice.
SAFE
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- A-BRAND FILLERS
- EXPERIENCED COSMETIC DOCTOR
- INJECTING WITH ULTRASOUND
NOT SAFE
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- PERMANENT FILLERS
- POOR QUALITY FILLERS
- INEXPERIENCED PHYSICIAN OR UNQUALIFIED PRACTITIONER
