A story on MSNBC.com caught the eye of an associate of mine. Her email to me was simple, she included the link to the story and said “This is a little creepy”. At first I read “creepy” as “crepey”(meaning wrinkled skin, questions I get asked about a lot), but a quick look at the content when I clicked through proved she was talking about something else.
A bold headline read: “FDA receives 930 reports of wrinkle-filler issues” and then the subhead drove the needle in deeper, “Some suffer facial palsy, disfigurement and other problems after injections.”
The story went on to explain that “U.S. regulators have received reports of serious and unexpected problems in people treated with wrinkle-fighting injections known as dermal fillers, Food and Drug Administration staff said. The problems included facial palsy, disfigurement and rare but life-threatening events such as severe allergic reactions and anaphylactic shock.”
Okay, now that is creepy, but the way this story was being reported was at best superficial and more sensationalistic than the facts warranted. Although there are risks for any dermal filler (and there are over a dozen different FDA-approved dermal fillers a doctor can select), given the millions of dermal injections performed every year, statistically your risk of problems (especially from an experienced doctor) is incredibly small.
Just in case you don’t know, dermal fillers are natural or synthetic injectable materials that a physician fills a syringe with and then typically injects into a wrinkle, a depressed acne scar, or the lip area to make it fuller or plump out the wrinkle. And the procedure works, and almost always, works really, really well.
But back to the risks and the 930 reports of problems. What went wrong? One of the typical problems with dermal fillers is the potential for lumps or bumps to occur in the injected area, or the material can migrate to areas it wasn’t intended for. These are part of the risks but these potential side effects are often poorly communicated by the physician during the consultation. Instead, all that’s paid attention to are the anticipated positive results, as in no more wrinkles or visible scars.
It is also important to note that of these 930 complaints 739 were from the U.S. and 135 were from other countries including China, South Africa and Brazil with Australia, France, and the United Kingdom reporting the most complications
Some of the complaints were actually minor in nature, including reactions that are expected after treatment such as swelling, redness, bruising, some amount of pain or headache, blistering, and itching, all of which resolve in a few days. What should not happen (and it rarely does) are such occurrences as severe hypersensitivity reactions, serious infection at the injection site, and facial paralysis.
Again, there absolutely are risksyou need to know about to make an educated decision about any cosmetic corrective procedure but the MSNBC.com article made it sound far more ominous for dermal fillers than what the reality is. What you can take away from this report is the reminder that any cosmetic treatment performed by a physician (laser, Intense Pulse Light, Thermage, Fraxel, Botox, etc.) has risks that you need to consider before deciding to move forward or decline having the procedure done.
Here are some basic considerations to think about before you decide to use dermal fillers as a way to deal with stubborn lines around your mouth, the crease that runs from the corner of your nose down to your mouth (called the nasal-labial folds), the frown lines between your eyes, or acne scarring:
- In general, any single dermal filler should not be used to treat all the problems you want corrected on your face. Different fillers offer improved benefits for certain areas compared toothers.
- Some dermal fillers have limited applications, but often doctors who either don’t know better or consider going outside the limitations to be low risk go ahead and inject it in a questionable area anyway.
- Dermal fillers should not be used on people with known sensitivities to the filler material, those with severe allergies, or persons with bleeding disorders.
- Doctors who don’t take a complete medical history risk injecting someone who is a poor candidate for the procedure. If your doctor doesn’t take a complete medical history, find another physician who knows better than to proceed with a dermal injection without this important step completed.
- Never inject skin when it is inflamed or irritated (that means don’t rush from your facial peel or microdermabrasion to dermal fillers).
- Injecting someone who has recurrent or recent herpes breakouts in the area being treated will likely cause an eruption.
- Injecting a patient with a history of keloid scarring, hyperpigmentation, or hypertrophic increases the chances of an undesirable outcome.
- Be aware that some fillers only last about 6-18 months (with the average duration being 9 months to a year) which means that most bumps or lumps would resolve in that period of time. Semi-permanent fillers would result in problems such as these lasting indefinitely or would require being surgically removed.
On a personal note, as someone who has used dermal fillers, I have experienced some minor problems. I chose to use a semi-permanent filler fully aware that any problems could be longer lasting. I elected to take the increased risk because I loathed the idea of having to go back to my physician on a regular basis to get injected again (not to mention the expense). The small bumps and tenderness around my lips have remained for several years. That’s the bad news. The good news is that the fillers really have lasted and look great. In hindsight, would I do it again knowing what I’d be dealing with? Yes. But as I said, knowing the pros and cons is a must before any cosmetic corrective procedure. The final decision is yours.