How To Manage Complications With Dermal Fillers

Everything in life has some risks. Dermal fillers are no different. The good news is that over 90% of the time, issues with dermal fillers go away on their own within a few days of treatment. It’s easy to resolve most other issues. The fact is, you’re more likely to be injured in a car accident on the way to work than suffer a serious injury from our dermal fillers.

Buildings rarely burn. But we go through fire drills, anyway. For the few people caught in a burning building, they’re glad the fire drills helped them know what to do. That’s why it’s important that you read this information even though the risks are so small.

Here, we will discuss what dermal fillers are and how they work. Then we will cover how to handle mild issues that won’t go away. Last we’ll deal with the most serious issues that require immediate treatment

What Are Dermal Fillers?

Dermal fillers are gel-like substances we inject into the soft tissue under your skin to add volume where needed. Your healthcare professional skillfully targets where each injection goes.

There are a variety of substances used as fillers. Some of these include:

  • Hyaluronic acid (Juvéderm and Restylane)
  • Calcium hydroxylapatite (Radiesse)
  • Polyalkylimide (Aquamid)
  • Polylactic acid (Sculptra)

It’s easy to reverse Juvéderm and reverse Restylane should anything go wrong. That’s why they’re the most popular fillers for first-time patients. Some patients want longer-lasting fillers after they see they have no issues with hyaluronic acid fillers.

Your body naturally produces hyaluronic acid. To reverse the effects of hyaluronic acid fillers, your clinician needs only inject Hylenex, and the filler dissolves. Hylenex contains the hyaluronidase enzyme.

How Do Dermal Fillers Work?

Dermal fillers add volume to the soft tissue underneath your skin. These fillers can fight the signs of aging, such as wrinkles and lines. But they’re not only an anti-aging treatment.

Dermal fillers can contour your face to increase attractiveness. For example, people preferring a stronger jawline may use dermal fillers to add volume to the chin area.

Natural fillers lose their effect over time and maintenance treatments are necessary. Some synthetic fillers are permanent and that makes them harder to reverse. Hyaluronic acid is the only filler that can be reversed with a simple injection.

Reasons Some Patients Want To Reverse Their Dermal Filler Treatment

There are many reasons a patient may want to reverse dermal filler treatments. The reason can be as simple as they received the exact look they wanted without complications, but later decided they didn’t want to look that way.


If you don’t like how you look, you have every right to want it changed back to the way it was. With Hyaluronic acid fillers, you can easily reverse the process with Hylenex. But for Radiesse and Sculptra, there is no injection to dissolve the solution.

Since both Radiesse and Sculptra require maintenance treatments, undesirable outcomes will go away on their own if you decide not to maintain the filler. But that takes time and most people prefer not to wait. In such cases, steroid shots and/or additional filler injections sometimes solve the problem.

Aquamid is a permanent synthetic filler. The results will not go away on their own. And, it’s difficult to reverse the effects. Since hyaluronic acid fillers are easy to reverse, it’s a good idea to use these for your first time. That way, you can quickly change it if you don’t like it.

Incorrect Placement

An expert must handle the placement of the injections. Otherwise, the results won’t look natural.


We’ve all seen celebrities that took cosmetic procedures too far. The result is an unnatural look. That isn’t what you want. So you must use an expert clinician. Too much filler is as bad as no filler at all.

Asymmetrical Results

Studies show facial symmetry is a primary indicator of beauty across all cultures. This fact has been true throughout history. If you have asymmetrical results, it’s a good idea to have the treatment reversed.


Lumps are not uncommon with dermal filler treatments. They usually go away on their own within a few days after treatment.

Discoloration, Also Known As Tyndall’s Effect

If your clinician doesn’t inject the filler deeply enough, it could lead to discoloration. As the gel settles just under the skin, light refracts through the gel, giving you a dark blue color. This refraction is called Tyndall’s effect. Though rare, this problem is most likely to occur in the thin skin underneath the eyes. Again, if you use a hyaluronic filler, Hylenex can reverse this condition.

Infection or Granuloma

Infections are a serious issue. Anytime there’s a break in your skin, there is a risk of infection. It doesn’t matter if the puncture is from a flu shot, a scrape after falling from a skateboard, or a dermal filler treatment. Infection is a rare case where immediate Hylenex injections aren’t the best solution.

That’s because the dissolution of the hyaluronic acid may cause infected material to spread throughout the body. That means your doctor must use Hylenex with an antibiotic. Or, the infection must heal before Hylenex injections.

Granulomas are another issue to contend with. Your healthcare provider must treat these small areas of inflammation.

Emergency Arterial Occlusion

This partial or full artery blockage can lead to a stroke. This happens most often during the procedure. Patients would feel severe pain immediately, but the anesthetic may mask the pain. Other symptoms include:

  • Blanching
  • Skin color changes
  • Blue/gray appearance in the affected area
  • Infection

This is extremely rare during the procedure and delayed onset arterial occlusion is even rarer. It is an emergency. Hylenex is usually available if this occurs during the procedure. But you’ll still need additional medical treatment. If you’re at home when this happens, it’s time to get to the emergency room or call 911.

What You Can Do To Minimize Complications

With issues like dissatisfaction with the results, it’s best to return to the clinic where you received the dermal filler. But you may not want to return to that clinic. If not, find another clinic or find a doctor that’s trained with Hylenex injections.

For the more severe dermal filler complications mentioned, you’ll need immediate medical treatment. That means the emergency room.

Just like a plane before takeoff, we have informed you of the emergency measures to take in case of a water landing. Now, it’s time to take off for your destination. And that destination is a more attractive and youthful appearance.

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