When prescribed by a properly qualified and trained doctor and injected in an appropriate medical setting, U.S. FDA-approved temporary dermal fillers are extremely safe.
Risks include hematoma or blood pooling beneath the skin, and although rare, infection and necrosis or skin loss is possible. An unsatisfactory outcome is also a risk. The greatest risk occurs when dermal fillers are injected by someone who is not properly qualified to perform injections. Semi-permanent and permanent fillers may carry a risk of clumping (the particles form a granuloma or lump that can be felt or seen beneath the skin). Particles may also migrate or displace from the injection site. Injection of an anti-inflammatory may help to improve minor clumps or swelling. More significant conditions of clumping or granuloma may require surgery.
Only dermal fillers derived from animal sources have a risk of allergy. This is something your doctor should explicitly cover during your consultation and the informed consent process. If necessary, a patch or allergy test can be performed on your inner arm. Injections will be scheduled several weeks later, after the risk of allergy has been evaluated. Zyderm, Zyplast and ArteFill are derived from bovine (cow) sources.
One advantage of most injectable treatments is that they are temporary. If you don't like the results they will diminish in time. A hyaluronic acid based filler like Restylane, Juvederm or Perlane can be more rapidly diminished (in weeks rather than months) with the injection of a substance called hyaluronodase in the treatment region.
Dermal fillers should not be used to rejuvenate the hands, injected into the breasts or injected into any part of the body other than the face. In select cases, a scar, cellulite dimple or other limited depression can be treated with a U.S. FDA-approved dermal filler for temporary improvement.
Dermal fillers for cosmetic purposes should not be administered to anyone under 18 years of age.
Hyaluronic acid fillers, like Restylane and Juvederm, are appropriate for skin of color as these are colorless gels that should not be visible under the skin or alter the skin color.
In the first few days after injection, the treated area may feel a little firm; however, this should rapidly improve. In general, a dermal filler should not be felt under the skin. However, there is the risk with semi-permanent or permanent fillers of particles clumping together and forming a granuloma that may be felt or seen under the skin. This risk is increased if a dermal filler was not properly injected.
Your own fat can also be used as a dermal filler. Substances that are not specifically approved as dermal fillers for cosmetic purposes and substances that are not properly branded, named and defined as dermal fillers approved by the FDA risk your health and your beauty.
No. While additional brands of injectables may be approved by the U.S. FDA, if you are offered a "generic" or "cheaper" solution to any U.S. FDA-approved dermal filler, you should refuse. There are no less costly alternatives proven safe or effective.
Read consumer experiences with dermal fillers at RealSelf.com