Injectable Fillers

Q: Dr. Eppley, I am interested in getting injectable fillers for nasal folds and vertical mouth lines  I am allergic to many things and wanted to find out how common are allergic reactions and can a test be done prior to the actual full procedure?

A: The majority of injectable fillers today use hyaluronic acid-based materials (synthetic sugars) that are also present in many tissues of the body. Because of their very low risk of hypersensitivity reactions, skin testing has never been recommended or advised with their use in first time patients. This is quite unlike that of the now defunct bovine collagen injectble filler products (Zyderm and Zyplast) from the 1980s and 1990s. That being said the risk of hypersensitivity reactions (aka allergic reactions( is not zero although it is less than 1%.

When in doubt or in a patient with a lot of known allergies it can be convincingly argued that a skin test should be done before even a hyaluronic acid-based injectable filler is done. If there is any doubt or concern, I always perform a skin test which is simple and easy to do. It is done just like a TB test.

Dr. Barry Eppley

Indianapolis, Indiana