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Dermal fillers improve facial wrinkles, depressions and other problems by injecting substances such as hyaluronic acid, and the effect lasts for 6 to 24 months. Although common side effects such as swelling and bruising usually subside on their own in the short term, choosing an experienced doctor can reduce the risk.
Overview
Approximately 15 million dermal filler injections are performed worldwide each year, of which hyaluronic acid products account for as much as 70%. This data shows that the incidence of side effects of hyaluronic acid fillers is only 0.02%.
In the US market, the price of hyaluronic acid per milliliter ranges from US$500 to US$1,000, while in the Asian market it may be as low as US$300 to US$700. According to statistics from the American Academy of Dermatology (AAD), in 2022, about 35% of injections will be used to improve nasolabial folds, 25% for lip augmentation, 15% for filling facial depressions, 10% for nose shaping, and the remaining 15% will be distributed on the forehead, chin and other parts.
Taking hyaluronic acid as an example, the standard effect lasts for 6 to 12 months, while poly-L-lactic acid fillers can last for 18 to 24 months. The process of poly-L-lactic acid stimulating collagen production takes 4 to 6 weeks to show. Learn more about how PLLA stimulates collagen here.
More than 90% of filler side effects occur within 24 to 72 hours after injection, with mild swelling and bruising being the most common. Choosing a doctor with more than 5 years of experience and professional certification is key to reducing risks. Market trends show that the global filler market is expected to reach $10 billion in 2028, with a compound annual growth rate (CAGR) of up to 9.5%. A reasonable injection process does not exceed 2 ml per time.
Type
People from 20 to over 60 years old are receiving dermal fillers. According to global statistics in 2022, the use of fillers by people aged 20-30 reached 18%, while the use rate of people aged 40-50 was the highest, close to 45%. The proportion of users over 60 years old is 10%.
The molecular weight of hyaluronic acid fillers is usually between 100,000 and 2 million Daltons.
A standard injection usually takes 15 to 30 minutes, but the total time for preoperative consultation, design and postoperative care can be up to 1 to 2 hours. The doctor designs the injection point and dosage, and the injection volume at each point is usually no more than 0.1 ml.
In Europe and the United States, the average cost of a single injection is $800 to $1,500, while the average price in the Asian market is between $300 and $800. Some high-end brands are usually 20% to 50% higher than ordinary brands.
According to a 2021 study by the American Society of Plastic Surgeons, common side effects include mild swelling (25% incidence), bruising (15% incidence) and mild pain (10% incidence). The incidence of serious side effects, such as vascular occlusion, is only 0.01%. Data shows that there will be about 100,000 hand filler injections worldwide in 2022, a number that has increased by 30% in the past five years.
The dynamic balance injection method completes the injection with a steady pressure of 10 to 15 psi. In South Korea, more than 60% of filler consumers prefer natural, soft effects, while nearly 40% of European and American consumers choose more obvious, three-dimensional improvements. For those curious about Botox’s time to work, check out this helpful guide here.
Operation process
The doctor will evaluate the patient’s face, which usually takes 10 to 20 minutes. Usually 0.5 to 1 ml of filler is required for each nasolabial fold.
Most doctors will apply local anesthetic cream before injection, which requires waiting for 20 to 30 minutes for best results. The concentration of lidocaine is usually 0.3% to 0.5%. For more information on where you should avoid applying numbing creams, visit this link here.
The point injection method is suitable. The injection volume at each injection point is generally controlled between 0.05 and 0.1 ml. During the injection, the needle moves slowly at a speed of 1 mm per second to ensure even distribution.
Doctors usually use blunt needles with specifications of 27G to 30G. The length of the fine needle is usually between 25 and 50 mm. The pressure on the syringe needs to be maintained between 10 and 20 psi.
Injections for nasolabial folds and chins usually go deep into the dermis or even the sub-dermis, which is about 1.5 to 3 mm, while injections for lips and under the eyes stay in the superficial dermis, which is only 0.5 to 1 mm.
The doctor will use gentle massage to help the filler be evenly distributed, which takes about 3 to 5 minutes. The imaging accuracy of the micro-ultrasound device is 0.1 mm.
Studies have shown that the complication rate during the operation of experienced doctors is less than 1%, while the rate of untrained operators may be as high as more than 10%. Although the incidence of severe vascular embolism is only 0.01%,
After the injection, the patient usually needs to stay in the observation room for 10 to 20 minutes. The doctor will remind the patient to avoid high temperature, alcohol and strenuous exercise in the next 24 to 48 hours. The full recovery period is usually 7 to 14 days, and the stabilization effect of hyaluronic acid fillers generally gradually appears 1 to 2 weeks after surgery.
Risk/Benefit
According to a 2023 safety report from the U.S. Food and Drug Administration (FDA), the overall complication rate for dermal fillers is less than 1%, with common minor side effects including swelling (about 30%), bruising (about 25%), and mild pain (about 15%). These reactions usually resolve on their own within 48 to 72 hours, while more serious complications such as vascular occlusion or tissue necrosis occur in less than 0.01%.
The effects of fillers are usually visible immediately after injection, and more than 95% of patients are satisfied with the improvement after surgery. After hyaluronic acid injections into tear troughs, the degree of depression is reduced by an average of 70% to 80%, while the depth of nasolabial folds is improved by 50% to 60%.
For example, the cost of a single injection for nasolabial fold treatment is usually $500 to $1,500, but the effect can last for 6 to 12 months, with a monthly cost of only $40 to $125, which is much lower than the long-term cost of high-end skin care products with the same anti-aging effects. For longer-lasting fillers such as poly-L-lactic acid, the effects can last for 18 to 24 months, further reducing the average monthly cost.
In clinical trials, hyaluronic acid fillers have shown high safety. A 2021 study involving 3,000 subjects showed that more than 99% of patients did not experience serious complications, and the average duration of side effects such as swelling and bruising was 2 to 3 days. The study also found that some patients will experience weakened effects within 3 to 6 months after injection due to faster metabolism. This situation is more common in people with high metabolic rates or frequent exercise, accounting for about 15%.
People under 30 usually have less collagen loss, and the effects of filler injections can last even longer than 12 months. For people over 50, the support effect of the filler may need to be supplemented once every 6 to 9 months to maintain the ideal state.
More than 80% of patients reported a significant increase in self-confidence after injection, and about 60% of them believed that facial rejuvenation improved the quality of their social interactions. For patients who experience swelling or bruising after injection, applying cold compresses and avoiding strenuous exercise can shorten recovery time by 30% to 50%.
Recovery
According to a 2022 study involving 1,200 patients, about 85% of people experience mild swelling within 48 to 72 hours after injection, and 60% of them experience local bruising. About 10% of people may experience a longer recovery period of 10 to 14 days. For more information on common effects, you can learn more here.
Doctors recommend avoiding any facial massage or touching the injection site within 24 hours after surgery, and sleeping in a supine position for at least 3 to 5 days.
Studies have shown that using cold compresses can shorten the duration of swelling by 30%. Each cold compress is recommended to last 15 to 20 minutes and repeat every 2 to 3 hours. The temperature of the cold compress should not be too low, generally kept at 5 to 10 degrees Celsius.
The incidence of bruising is close to 20% to 30% in patients who have injected fillers. It is recommended to use ointments containing vitamin K or arnica extract 2 to 3 times a day for 3 to 5 days. This adjunctive treatment can speed up the bruises by 20% to 40%. Data show that patients who increase their vitamin C intake after surgery have skin that heals 10% to 15% faster than the average person.
In terms of exercise, doctors recommend avoiding any strenuous activity within 48 to 72 hours after the injection. A study of 500 patients found that people who followed a completely static recovery within a week after surgery had a 50% lower complication rate, while resuming high-intensity exercise too early may shorten the effect of the filler by 10% to 20%.
Studies show that hyaluronic acid metabolizes fastest in the first week after surgery, and about 10% to 15% of the filler may be naturally absorbed. Doctors may recommend a supplemental injection within 4 to 6 weeks after the first injection.
About 5% to 10% of people may experience mild anxiety in the first two weeks after surgery. Some data show that more than 80% of patients will be more satisfied with the filler effect. Gentle heat is usually recommended to help collagen production after surgery, but the wait is usually 7 to 10 days.