Hyaluronic Acid Injection

Treatment details: Hyaluronic Acid Injection

Filler was delivered in small aliquots and moulded after each pass rather than left as one bolus, which keeps the surface even and lets the shape be judged while it is being built. A photograph taken in the same sitting always flatters the result a little: there is injection swelling, and at some points a small amount of local bleeding, and neither reflects where the face will sit in two weeks. I ask patients not to form a view on the shape before then. Gels of this class usually hold for around nine months to a year in the face and longer where there is less movement. At review the volume can be reduced with hyaluronidase instead of waiting for it to break down.

Injection leaves swelling and small red puncture marks for several days, and bruising that can take one to two weeks to clear, more so in patients on blood thinning medication or fish oil. Tenderness and a firmness that can be felt under the finger are usual early and normally soften within a month. Asymmetry, visible lumps, movement of the gel away from where it was placed and overcorrection all occur and may need adjustment or dissolving with hyaluronidase. Swelling that appears months later, nodules and rare low grade inflammatory reactions have been reported. The serious risk is gel entering or pressing on an artery, which can cause skin loss or, very rarely, loss of vision.