Hyaluronic Acid Fillers – Are We Really Giving the Face Back What Time Took Away?

In recent years, hyaluronic acid injections have become one of the most common aesthetic treatments.

Filling lips, emphasizing cheekbones, softening folds around the mouth, and trying to give the face back volume that was lost over the years.

The results are sometimes very impressive, especially when the treatment is done gently and by professional hands.

But there are a few things that I think are important to understand before deciding to inject a substance into the face.

What actually is hyaluronic acid? What is the difference between the substance found naturally in the body and a filler substance injected into the skin? And do we really know what happens to this substance after years?

What is hyaluronic acid?

Hyaluronic acid is a molecule found naturally in our body, among other places in the skin, the joints, and the connective tissues.

One of its interesting properties is its ability to bind water.

In the skin it takes part in maintaining moisture and in the normal functioning of the tissues.

Over the years, changes occur in the amount of hyaluronic acid in the skin and in the way it is organized, alongside changes in collagen, elastin, subcutaneous fat, and the structure of the face.

But here it is important to make a distinction.

The hyaluronic acid found naturally in the body is not necessarily identical to the filler substance injected into the face.

What is the difference between a hyaluronic acid serum and a filler?

When we apply a serum containing hyaluronic acid, the goal is mainly to improve moisture in the outer layers of the skin.

In contrast, fillers are injected into the tissue.

Most fillers based on hyaluronic acid undergo a process called cross-linking, or Cross-Linking.

The process creates bonds between the hyaluronic acid molecules and turns the substance into a more stable gel, which breaks down more slowly than natural hyaluronic acid.

This way it can be used to add volume, change contours, and fill certain areas of the face.

What are the advantages of hyaluronic acid fillers?

1. A result that appears relatively quickly

One of the notable advantages is that a change in the volume and structure of the face can be seen immediately after the injection, although the final result becomes clear after the initial swelling goes down.

2. The possibility of restoring lost volume

Over the years we lose volume in certain parts of the face.

Precise filling can improve the appearance of hollows, folds, and loss of volume, and sometimes create a very subtle and natural result.

3. A treatment without surgery

In most cases the injection is performed in a clinic and does not require general anesthesia or a long recovery period.

However, it is still an invasive medical procedure that has risks.

4. The possibility of dissolving some of the fillers

An important advantage of fillers based on hyaluronic acid is that an enzyme called hyaluronidase can be used to break them down.

But it is important to know that the dissolving is not always immediate, precise, or complete, and sometimes several treatments are required.

So what are the disadvantages?

Here, in my view, begins the part that should receive much more attention.

1. The substance does not always disappear when we think it does

Fillers are sometimes presented as a temporary treatment lasting six months to a year and a half, depending on the product and the injection area.

But imaging studies have shown that in some patients, residues of fillers can be detected even years after the injection.

The duration of persistence depends on the type of substance, the location, the amount injected, and personal factors.

Therefore it is not correct to assume that all of the substance disappears completely after a year.

2. Accumulation and change in the face's appearance

When injections are repeated without assessing how much substance remains in the tissues, accumulation can occur.

Sometimes the result is a swollen, heavy, or less natural appearance.

We recognize this look in some people, when the lips, cheeks, or the area under the eyes look fuller than intended.

Not every such change is caused by migration of the substance. Sometimes it is excess filling, water absorption, edema, or changes in the tissues.

3. Swelling and edema

Hyaluronic acid is able to bind water, and this is one of the properties that make it useful.

But in some cases that same property can contribute to prolonged swelling.

In certain areas, especially around the eyes, filler can worsen edema or create a swollen appearance.

4. Lumps, inflammatory reactions, and infections

Fillers can cause lumps, irregularity in texture, late inflammatory reactions, and sometimes infections as well.

Some of the reactions appear long after the injection.

It is not always possible to predict in advance who will develop such a reaction.

5. Damage to blood vessels – the most serious risk

This is one of the most important risks that anyone considering an injection should know.

If filler is mistakenly injected into a blood vessel, or causes blockage of the blood supply to the tissue, significant damage can occur.

In severe cases, tissue damage and even necrosis are possible.

In very rare cases, blockage of blood vessels connected to the blood supply of the eye can cause loss of vision, and sometimes even a stroke.

These are rare complications, but their severity requires serious consideration.

Therefore it is important that the injection be performed only by a qualified medical professional, with deep knowledge of facial anatomy and experience in treating complications.

Unusual and strong pain, a significant change in skin color, or a vision disturbance after an injection require urgent medical treatment. In case of a vision disturbance or neurological symptoms, one must go immediately to emergency services.

Can the substance be dissolved and the previous state restored?

Not always.

Hyaluronidase can break down fillers based on hyaluronic acid, but does not necessarily cancel every change created following the injection.

If inflammation, a scar, or tissue damage developed, breaking down the filler will not always solve the problem.

In addition, the dissolving process itself can also cause side effects and allergic reactions.

It is also important to know that dissolving with hyaluronidase does not guarantee a solution for blockage of a blood vessel in the eye.

And what about use over many years?

This is the question that interests me most.

We know that fillers can improve appearance temporarily, but there are still gaps in knowledge regarding the cumulative effect of repeated injections over decades.

Does every injected substance break down completely? Not always.

Can repeated injections change the appearance of the tissues? Yes, in some cases.

Does that mean that everyone who injects hyaluronic acid harms her face? Absolutely not.

There are patients who receive good results over years without significant complications.

But in my view, the fact that a treatment is very common is no reason to treat it as a risk-free action.

Do hyaluronic acid fillers prevent aging?

No.

They can soften some of the changes created with age, but they do not stop the aging process.

They do not prevent the natural decline in collagen, do not cancel sun damage, and do not stop the changes in the bones and fat tissues of the face.

It is important to distinguish between aesthetic improvement and prevention of aging processes.

What should be checked before deciding on an injection?

I recommend asking who performs the treatment, which substance is used, whether the product is approved for use in the intended area, and what the practitioner's experience is in treating complications.

It is also worth clarifying whether there were previous injections in the same area, and what the plan is in case of an unwanted result.

And perhaps the most important question is whether we really need the amount of substance being offered to us.

Sometimes a gentle, limited treatment can achieve a better result than repeatedly adding volume.

My daily recommendation

I love aesthetics, and I understand the desire to maintain a fresh appearance even as the face changes over the years.

But I think there is a big difference between caring for the skin and trying to give the face back, again and again, the volume it had in the past.

Not every wrinkle requires filling, and not every hollow is a flaw that needs correcting.

I believe it is important to understand what we put into our body, even when it is a substance that sounds natural and familiar.

Hyaluronic acid is a natural part of our body, but an injected filler is a processed medical product designed to change tissue volume.

That does not make it bad, but it certainly requires us to treat it seriously.

In my view, the right choice is one made from knowledge, from realistic expectations, and from an understanding that aesthetic treatments also have advantages, limitations, and risks.

Because my goal in skincare was never to stop time at any cost, but to maintain myself in the best possible way over the years.

Nurit Rozenblat

With love,
Nurit Rozenblat
OrOrgani

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