Filler Safety Essentials

Dermal fillers are injectable cosmetic products, and safety is the first question to settle before booking. The U.S. Food and Drug Administration regulates dermal fillers as medical devices, and it reports that, as seen in clinical trials, the effects of most FDA-approved dermal fillers are temporary because they are made from materials that the body eventually breaks down and absorbs. That temporary quality is part of why timing matters, since a filler you choose in one season is a decision you may revisit as it wears off. The sources below point to a licensed provider and a medical setting as central to safety.

Risks, settings and the evidence

The U.S. Food and Drug Administration advises working with a licensed health care provider who is experienced in injecting dermal fillers, knowledgeable about fillers, anatomy and managing complications, and who tells you about the risks and benefits before you receive treatment. The American Academy of Dermatology says having a filler injected in a non-medical setting can be extremely dangerous, and that you should never get a filler injected at a non-medical spa, a party, a salon or someone's home.

On side effects, the U.S. Food and Drug Administration says most of them, such as swelling and bruising, occur shortly after injection and many resolve in a few days to weeks, though in some cases side effects may emerge weeks, months, or years later. The U.S. Food and Drug Administration calls accidental injection into a blood vessel the most serious risk, because filler that enters a blood vessel can cause skin necrosis, stroke, or blindness. It says the chances of this happening are low, but the resulting complications can be serious and may be permanent.

The evidence is not only cautionary. The American Society for Dermatologic Surgery reports a study of 7,659 patient outcomes spanning 11 years for three board certified dermatologists, published in a February 2022 journal issue, that identified only four serious adverse events between January 2009 and August 2020, all of which resolved after treatment without long-term effects. The American Academy of Dermatology calls filler treatment one of the safest cosmetic treatments available, and says dermatologists today safely treat people of many ages and all skin colors.

Removal can mean another procedure. The U.S. Food and Drug Administration cautions that if you want fillers removed or reduced because of side effects, you may need additional procedures to reduce the filler or surgery to remove it, which carry their own risks, and that it may be difficult or impossible to remove some filler materials.

Safety, the visit and lip lines

• How Safe Are Dermal Filler Injections: a closer look at the risks the sources describe and how to judge a provider.
• What Happens During a Filler Treatment: a walk through the treatment visit so nothing in the room is a surprise.
• Softening Vertical Lip Lines: how fillers are discussed for vertical lines around the lips, and what to ask before choosing them.

The dermatologic surgery society's piece Are Dermal Filler Injections Safe and a plastic surgery society's overview of dermal fillers are good companions to these guides.

What to ask the injector

Read the safety guide first, then the walkthrough of a treatment visit. Ask a licensed clinician who will inject, what product is used, where the treatment will take place and what to do if something feels wrong. Ask about timing too: if side effects can emerge weeks or months later, how does the season you book in fit with follow-up?

Nothing here replaces a clinician's advice.