At Cityskin, we have the opinion that permanent dermal fillers are not safe, and as a result, we do not use permanent fillers at our clinic.

What are the risks of permanent dermal fillers?

Risks of permanent dermal filler treatment include:

  1. Injection of the permanent filler into an artery or a vein at the time of injection. This can block the blood vessel and cause death of the skin nearby.
  2. Acute infection – this is infection in the days after treatment.
  3. Late onset infection – we are not entirely sure why this happens, but infection can happen months and years after having permanent dermal filler injected. A 2012 study published in the Clinical Infectious Diseases journal showed infection rates of up to 19% (1) after the use of one brand of permanent dermal filler and complication rates of up to 27% (2).
  4. Granuloma – this can occur months or years after treatment. Granuloma is a non-allergic chronic inflammatory process and is best treated using intralesional steroids.

How to remove permanent filler

Permanent dermal filler is hard to remove. The standard dermal fillers that we use at Cityskin contain hyaluronic acid and can be dissolved using an enzyme which breaks the filler down. This is important in an emergency setting, for example, if filler is inadvertently injected into a blood vessel on the day that you have treatment. Non-permanent fillers can be dissolved straight away using an emergency kit that we have in each of our clinical rooms, allowing blood to flow again to the affected skin. Permanent fillers cannot be dissolved, and the blockage may persist.
Permanent filler does not break down by using the dissolving enzyme and instead is best removed surgically.


References:

  1. Nadarajah JT, Collins M, Raboud J, Su D, et al., ‘Infectious Complications of Bio-Alcamid Filler Used for HIV-related Facial Lipoatrophy’, Clin Infect Dis (2012); 55(11): pp.1568-74.
  2. Salati SA & Al Aithan B, ‘Complications of Dermal Fillers – An Experience from Middle East’, Journal of Pakistan Association of Dermatologists, (2012); pp.22:12-18

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