Australian doctor, Dr Gavin Chan, noticed patient's hyaluronic acid (HA) fillers were not dissolving at the six-to-twelve-month mark as the manufacturers claimed but instead – especially in the tear trough – MRI imagery revealed HA dermal fillers were hanging around for as long as 12 years and were being mistaken for puffiness or eye bags. Not only that they were found to migrate from where they were originally injected, sitting there for longer than expected too.
We asked an Etre Vous Expert to break down temporary HA dermal fillers – and tell us how long they really take to dissolve in the body…
What is hyaluronic acid ?“HA is a glycosaminoglycan (a type of sugar) that exists naturally in our extracellular matrix,” explains Etre Vous Expert and Clinical Director at Ashley Aesthetics, Dr Emmaline Ashley.
Our own HA helps joints move smoothly like oil on a creaky door, and prevents bones from grinding against each other, thus preventing pain and injury. It also holds up to 1000 times its weight in water helping to keep skin well hydrated, flexible, plump and smooth.
With all these benefits it makes sense that according to Ashley, “we have been using it in various fields of medicine safely for a long period of time. Most famously, as the primary component of dermal fillers.”
How do temporary HA fillers work?“Fashioned into a clear gel, HA dermal fillers are generally used to add or replace lost volume, and sculpt the face, “shares Ashley. But they are also used to plump and smooth scars, rejuvenate the hands, reshape ear lobes and smooth cellulite dimples.
How do temporary HA fillers dissolve in the body?‘They are considered temporary fillers because our tissue naturally contains a certain amount of an enzyme known as hyaluronidase, which will break down hyaluronic acid over time. Depending on the type of filler used and its location, clinicians are usually able to give patients a rough estimate of the length of time they should get out of a treatment: ranging from six months to two years.”
However, there are a variety of other factors at play when it comes to the body naturally dissolving HA dermal fillers, and these will ultimately impact the length of time they remain in the body. These include a patient’s individual metabolism and lifestyle factors like smoking and exercise – both of which speed up its breakdown.
What makes HA fillers last longer?If your body is slow to metabolise HA filler it will last longer; skincare that boosts hydration and has anti-inflammatory properties will also slow down the rate at which you break down your filler. Plus, filler also lasts much longer in areas with less movement. But why some people’s HA filler can last for up to 12 years is largely unknown.
However, “it is important to note that so far the studies examining HA filler longevity in patients consist of extremely small sample sizes or case reports, and that these findings cannot be extrapolated to the general population," warns Ashley.
Can HA fillers be removed?Generally, most of us would be thrilled not to have to top up our filler for years – if it’s been injected by a skilled practitioner and we’re happy with the placement. However, if you’ve over injected, your filler isn’t dissolving at the same rate in various areas of the face leading to visible asymmetry, and you don’t want to re-inject. But if your filler has migrated or left you with puffiness and eye bags, then there is a way to dissolve it.
Cue injectable hyaluronidase. “It’s most commonly injected as hyalase,” shares Ashley. “Since everyone has different levels of hyluronidase, HA fillers can be fully dissolved by injecting hyalase into the areas where your filler persists. But hyaluronidase can cause allergic reactions, making it a last resort that should never be taken lightly, or treated as a casual, easy fix. And if used, it should be administered by a medically trained prescribing clinician.”
Are changes permanent?“Potentially changes can be permanent. This is especially the case if areas have been overfilled and/or filled incorrectly, or additional filler added on top of existing filler,” explains Ashley.
People notice this most in the lip area where overfilling can cause the skin to stretch irreversibly. And because how long your HA filler lasts can be unique to your own physiology, changes while not always permanent, can veer into the semi-permanent category.
The takeawaySo, it seems there is a lot we don’t know about why HA dermal fillers can last far longer in some people than in others. “But we do know that for serious complications or long-lasting filler, we can dissolve this with externally injected hyaluronidase,” reassures Ashley.
With all this in mind, it further highlights how important it is to see a medical practitioner who has lots of experience, doesn’t over fill, and for you to be totally sure that you’re happy to change your appearance for (possibly) longer than ‘advertised’.
Emmaline Ashley, Aesthetic Doctor
I'm Dr Emmaline Ashley, the founder of Ashley Aesthetics. I'm passionate about beauty, wellness and science. I wanted...Book with Emmaline Ashley