1. Patients are often anxious about their upcoming treatment but are pleasantly surprised to find that there is minimal to no discomfort. We apply a topical anesthetic prior to treatment, and a gentle injection technique is used to minimize discomfort.nn2. Mild bruising and/or swelling is common after filler treatment but typically resolves within one to two weeks. Patients are advised not to undergo treatment if they have an important event around the corner.nn3. Patients should try to avoid aspirin, ibuprofen, or any other medication/supplement that may promote bleeding prior to treatment.

While results can vary, filler may last six to twelve months. Some patients experience filler longevity for longer than 12 months. The duration of filler correction depends on the type of filler, the facial area treated, the injection technique, and the rate that the patient‘s tissues break down the filler.

Facial fillers fall into two categories: hyaluronic acid and biostimulatory. Hyaluronic fillers are based on a naturally occurring sugar found in the skin that help to promote hydration and support, but they are more stable in order to resist degradation. Biosimulatory ‘fillers’ are not actually fillers, but they do accomplish a similar effect through the stimulation of new collagen formation. While hyaluronic acid fillers create an immediate result, these biostimulatory agents are associated with a delayed response, since collagen deposition is not immediate. Through skillful planning, execution, and judgment, facial fillers can create safe, long-lasting, and natural appearing results.

There is significant variability in the longevity of facial fillers, which can depend on type of filler, anatomic region, and other patient related factors. Since hyaluronic acid fillers are cross-linked in the manufacturing process, they are highly stable and more resistant to degradation compared to natural hyaluronic acid found in the skin. Actual longevity is thought to be far longer than what was originally thought, which was based on artificial longevity assessments that were assumed following time-limited FDA clinical trials.

Facial filler injection pain and discomfort is easily managed, but is highly dependent on the injector. There are a number of facial numbing creams available, but some are more effective than others. At GreeneMD, we use a specially formulated numbing cream that we have found to be more effective than others we have encountered. The most important way to minimize discomfort is with a gentle technique that only comes with skill and experience.

During the procedure, patients should feel comfortable, with minimal pain. Following completion, patients are given specific instructions for aftercare. There should be no pain after the procedure, but there may be very mild soreness if any bruising occurred. Bruises tend to be easily managed, and can be minimized with a cold pack. While most of the swelling dissipates within 24-48 hours, the final result is typically seen at 14 days.

Most side effects associated with facial fillers are mild and are expected consequences of treatment, such as mild swelling and bruising. Some slight asymmetry from swelling is also to be expected, but this tends to correct rather quickly. Uncommonly, certain areas of the face can be more prone to swelling, sometimes prolonged. This can be avoided with appropriate filler selection and proper technique. A common example is the use of cannulas in the tear trough, which are associated with a much higher risk of prolonged edema. More serious complications like ischemia and necrosis can be prevented by avoiding certain high risk anatomic areas and with expert technique. Experienced injectors are able to detect the rare ischemic event, and can treat this by dissolving the filler.