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What Happens to Filler Over Time – Embracing Natural Aging

Medically Reviewed
Medically Reviewed by Dr. Aurora Kalmanson on
Written by Fillers Editorial Team, plastic surgery specialists.

Dermal fillers, typically made from substances like hyaluronic acid, are injected to restore volume and smooth out wrinkles. Over time, these fillers naturally break down and are absorbed by the body.

How long fillers last can vary based on factors like filler type, injection area, individual metabolism, lifestyle, and environment. While fillers are not permanent, they do not accelerate the aging process; once they wear off, your skin will reflect the natural aging it would have experienced regardless. If you decide to stop using fillers, your skin won’t suddenly sag or worsen. Instead, you’ll gradually see the return of wrinkles and a decrease in volume as the fillers dissipate.

What Happens When You Stop Getting Fillers?

With their temporary nature, fillers eventually succumb to the body’s natural metabolic processes, raising the question of the aftermath following prolonged use.

Gradual Return to Pre-Filler Appearance

Loss of Volume and Definition: As fillers dissolve, the once-volumized areas will lose definition and return to their original state. This transition back may be subtle or noticeable depending on the initial volume added, as well as the skin’s resilience and overall health.

Reappearance of Wrinkles and Folds: With the natural degradation of fillers, the skin’s landscape gradually shifts back to its initial state, accompanied by the return of wrinkles and folds. These creases in the skin, which were once plumped up by filler, become evident again. This reappearance is not an acceleration of aging, but rather a re-emergence of the natural lines and skin contours that the fillers had once temporarily concealed.

Potential Skin Improvements from Past Filler Use

Residual Collagen Stimulation: It’s not all about loss; there can be lasting positives from having had fillers. Many clients experience ongoing benefits from the subtle collagen stimulation that occurred during the filler’s presence. This might manifest as an enhanced skin texture, even after the filler itself has been metabolized, contributing to a slightly improved baseline in skin quality compared to pre-filler days.

Improved Skin Quality and Hydration: Aside from the boost in collagen, clients may notice enduring improvements in the skin’s hydration and overall quality post-filler. These improvements could be the result of both the physical effects of the fillers and the enhanced skin care regimes that clients are inspired to follow during their time with fillers.

Adjusting Expectations and Embracing Natural Aging

Understanding the Limitations of Fillers: Recognizing that fillers are a temporary measure for cosmetic enhancement is fundamental. They offer a window of opportunity to enjoy refined aesthetic features but are not a fix for the perpetual march of time. Acknowledging the point within which fillers operate encourages realistic expectations and satisfaction with the results.

Complementary Treatments and Skincare Routines: As the filler fades, other non-invasive treatments can step into the limelight. From high-quality skincare products to procedures like chemical peels and microneedling, there are numerous adjunctive options. Such strategies can further maintain and enhance the skin’s appearance, working synergistically with past filler use to support a gracefully aging appearance.

The Gradual Breakdown of Fillers

Fillers are temporary enhancements due to the body’s natural ability to break them down over time. Understanding this process provides insight into the expected lifespan of filler results.

How the Body Metabolizes Fillers

Enzymatic Degradation of Hyaluronic Acid: Hyaluronic acid fillers face gradual dissolution through enzymatic degradation. This process involves natural enzymes in the skin, such as hyaluronidase, which systematically disintegrate hyaluronic acid chains. Initially, the injected filler binds water, adding plumpness and volume. Over time, these enzymes split the bonds within the filler substance, diminishing its capacity to retain water and leading to the gradual fading of the filler’s effect. This predictable degradation allows physicians to estimate when the patient might require a follow-up treatment.

Phagocytosis of Filler Particles: Apart from enzymatic action, phagocytosis plays a crucial role in the metabolism of dermal fillers. In this process, the body’s immune cells, known as phagocytes, identify, overtake, and break down the filler particles. This is the body’s natural defense against foreign substances but is also a standard response to filler materials, which are designed to be biocompatible and eventually resorbable. The speed at which phagocytosis occurs depends on several factors, including filler composition and the individual’s immune system activity.

Timeline of Filler Breakdown

Initial Swelling and Settling (1-2 weeks): Post-injection, patients often experience an initial phase of swelling, where the treated area may appear more volumized than the final result. This swelling typically subsides within the first couple of weeks, settling down to reveal the true outcome of the filler’s application. This period is crucial for the filler to integrate with the surrounding tissue and stabilize.

Stable Period (3-6 months): After the swelling has diminished, the filler enters a stable period. During these months, the filler maintains its form and effect, providing the sought-after aesthetic enhancement. It’s a phase of enjoyment for patients as the treatment benefits are at their peak, displaying the intended improvement without any significant breakdown or reduction in volume.

Gradual Dissipation (6-18 months): As the body’s natural processes continue to metabolize the filler material, patients enter the gradual dissipation phase, characteristically spanning 6 to 18 months after injection. During this period, the effects of the fillers slowly diminish as the substances are broken down and absorbed. Patients often notice a gentle lessening of volume and a more subdued definition in treated areas. To maintain their results, individuals may opt to schedule maintenance treatments after assessing the outcomes with their provider.

Factors Accelerating Filler Breakdown

High Muscular Activity in Treated Areas: Fillers in high-mobility areas, such as around the mouth and between the eyebrows, are subject to accelerated breakdown. The continuous muscle movements in these regions can accelerate the metabolism of injected materials, leading to a faster dissipation of results. It’s crucial for both patients and practitioners to recognize that treatments in these dynamic areas may require more frequent touch-ups compared to areas with less muscular activity.

Exposure to UV Radiation and Environmental Stressors: Everyone’s skin faces daily challenges from UV radiation and pollution, which can prematurely degrade filler material. UV rays in particular have the potential to break down the skin’s collagen and elastin fibers, which indirectly affects the longevity and appearance of fillers. Individuals who spend significant time in the sun or in polluted environments may find their fillers losing volume more quickly due to these external aggressors.

Smoking and Alcohol Consumption: Smoking and excessive alcohol intake are known to speed up the aging process and similarly influence the lifespan of dermal fillers. Nicotine constricts blood vessels and inhibits blood flow, potentially diminishing the skin’s ability to maintain the integrity of fillers. Alcohol’s dehydrating effects and its impact on the body’s inflammatory pathways can also compound the breakdown of filler materials, affecting overall aesthetic outcomes.

Frequently Asked Questions

Can fillers migrate to other parts of the face over time?

Filler migration is rare but can occur, particularly if injected improperly or in excessive quantities. Proper technique minimizes this risk.

Do fillers stretch out the skin and cause sagging?

Generally, fillers do not cause the skin to stretch or sag. However, overuse could potentially lead to stretching and should be monitored.

Is it true that fillers can last for several years in some cases?

Yes, some types of fillers can last several years but vary based on the filler type, treatment area, and individual factors.

What happens if I don't dissolve my fillers and let them wear off naturally?

Fillers will naturally dissolve and be absorbed by the body over time, with the treated area gradually returning to its pre-filler state.

Will my wrinkles look worse after stopping filler treatments?

Wrinkles will not worsen after stopping filler treatments; the skin will simply return to its natural aging process.

Is it possible for fillers to cause long-term damage to the skin?

When administered correctly, fillers are unlikely to cause long-term skin damage, but risks can increase with improper technique or overuse.

Are there any alternative treatments to fillers for maintaining a youthful appearance?

Alternatives to fillers include laser treatments, chemical peels, botox, and maintaining a healthy skincare routine.

Conclusion

Embracing fillers as part of a beauty routine involves understanding both their capabilities and limitations. While they offer temporary aesthetics benefits and can stimulate natural collagen production, moderation and professional oversight are key to maintaining skin health and natural-looking results over time. As the trend toward non-surgical enhancements grows, so does the importance of informed choices and skincare practices.

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References:

Wongprasert, P., Dreiss, C. A., & Murray, G. (2022). Evaluating hyaluronic acid dermal fillers: A critique of current characterization methods.

https://onlinelibrary.wiley.com/doi/10.1111/dth.15453

Kalmanson, O. A., Misch, E. S., & Terella, A. (2022). Hyaluronic acid fillers may be longer-lasting than previously described: A case report of delayed filler-associated facial cellulitis.

https://www.jprasopen.com/article/S2352-5878(22)00043-2/fulltext

Funt, D., & Pavicic, T. (2013). Dermal fillers in aesthetics: an overview of adverse events and treatment approaches.

https://www.dovepress.com/dermal-fillers-in-aesthetics-an-overview-of-adverse-events-and-treatme-peer-reviewed-fulltext-article-CCID

Dr. Aurora Kalmanson

Always Consult a Medical Specialist

The information provided in this blog is for informational and educational purposes only and should not be interpreted as personalized medical advice. It's crucial to understand that while we are medical professionals, the insights and advice we provide are based on general research and studies. They are not tailored to individual health needs or conditions. Thus, it is essential to consult directly with a healthcare provider who can offer personalized medical advice relevant to your specific situation.