Can Hyaluronic (HA) Filler Injections Ever Be Permanent?
Q: Dr. Eppley, One week ago I had a syringe of Juvederm injected injected under my eyes. So far, the results are not fantastic but at least It did not create bags, as I often read in “horror stories”. Maybe I look less tired. I know I won’t go for a touch up, I had a bruise which freaked me out and “perfection is the enemy of good”. But I m wondering… Does this HA create any long term side effect such as lumpiness or swelling months after the injection? Also based on your experience, how long does it really last? Because my injector said it could last for 3 to 5 years because there is no hyaluronidase in this part of the face (!!). And if people get treated again, it is because they have aged, the filler won't disappear. What do you think? Does HA under the eyes ever get broken down by the body? Thank you very much.
A: The information you have received about the longevity of Juvederm or any HA (hyaluronic-acid based) injectable filler is erroneous. No form of HA is permanent and they all eventually go away by the absorption of water which breaks down the filler. How long they last depends on the concentration of the HA in the filler and how it is cross-linked. It is true that they do seem to last longer in the lower eyelid/periorbital region, perhaps up to 12 to 18 months but definitely not three to five years. One of the real advantages of an HA filler is that it is a natural material as the body is composed of lots of HA material in its tissues. Thus there are no known untoward effects of repeated HA filler injections such as accelerated aging or tissued damage. Age also does not seem to play a role in how quickly or slowly any particular HA material persists.
Dr. Barry Eppley