Dermal fillers have rapidly become one of the most popular non-surgical aesthetic treatments around the world. Known for their ability to smooth lines, restore volume, and sculpt facial features, fillers offer quick results with little to no downtime. However, while generally considered safe, dermal fillers do carry risks—some mild and temporary, others rare but more serious.
This article outlines the potential complications associated with dermal fillers, aiming to inform prospective clients and help them make educated, confident choices.
💉 What Are Dermal Fillers?
Dermal fillers are injectable substances used to add volume, enhance facial contours, and reduce signs of ageing. The most common fillers are made from hyaluronic acid (HA), a naturally occurring sugar in the body that retains moisture and adds plumpness to the skin.
Other types include:
- Calcium Hydroxylapatite (e.g., HArmonyCA)
- Poly-L-lactic acid (e.g., Sculptra)
- PMMA (e.g., Bellafill)
Each filler type comes with its own benefits and risk profile. While hyaluronic acid fillers are temporary and dissolvable, others are more long-lasting and may require different management if complications arise.
✅ Common, Temporary Side Effects
Most filler treatments involve only minor and short-lived side effects, which typically resolve on their own. These include:
1. Swelling
Mild swelling is normal and expected after treatment, especially in areas like the lips or under the eyes. It usually subsides within a few days.
2. Bruising
Because fillers involve needle insertion, bruising can occur at the injection site. This typically fades within 5–7 days and can be concealed with makeup after 24 hours.
3. Redness or Tenderness
The injection area may feel slightly sore or appear red for a short period after treatment. These effects are usually minimal and temporary.
4. Small Lumps or Irregular Texture
Minor bumps can develop under the skin as the filler settles. These often smooth out naturally, though massage (as advised by your practitioner) may help in some cases.
These mild reactions are part of the body’s normal healing response and rarely indicate a problem.
⚠️ Less Common Complications
While rare, certain complications can occur and may require follow-up care (the images used are not of my clients but for information/education purposes )
1. Filler Migration
Filler can occasionally move from the injection site to nearby areas, leading to puffiness or uneven appearance. This may resolve over time or require dissolving the product.
2. Tyndall Effect
If filler is injected too close to the skin surface—especially in thin-skinned areas like the tear troughs—it can cause a bluish tint. This is known as the Tyndall effect and is treatable with hyaluronidase.
3. Persistent Lumps or Nodules
In some cases, small lumps may remain under the skin and feel firm to the touch. These are typically harmless and may be managed with massage, time, or dissolving agents.
🔵 Late-Onset Nodules
Late-onset nodules are firm lumps that appear weeks or even months after treatment. They may be due to a delayed immune reaction or a bacterial biofilm forming around the filler. These nodules can occasionally become inflamed or tender. Treatment may include antibiotics, steroids, or hyaluronidase to dissolve the filler. While uncommon, they highlight the need for ongoing communication with your practitioner—even long after the initial procedure.
🚨 Serious Risks: Rare but Important
Although rare, some complications from dermal fillers can be serious and require urgent medical attention.
Here at Radiant we are available 24/7 post treatment to ensure that you can access advice and support at any time.
1. Vascular Occlusion
The most significant risk is vascular occlusion, which occurs when filler is accidentally injected into or compresses a blood vessel, restricting blood flow. Symptoms include:
- Severe pain
- Blanching (white or grey skin)
- Skin that turns dusky or dark
- Delayed healing or tissue breakdown
If untreated, vascular occlusion can lead to tissue necrosis (skin death) and permanent scarring. Early treatment with hyaluronidase can often reverse this effect, underscoring the importance of choosing a skilled injector who can recognise and manage complications immediately (again, these images are not of my clients!)
2. Blindness
Though extremely rare, blindness has been reported in cases where filler entered arteries connected to the eye, especially when injected in high-risk areas like the nose, forehead, or between the brows. This devastating complication emphasises why injections should only be performed by medically trained professionals with detailed knowledge of facial vascular anatomy.
3. Infection
While sterile technique is standard, any breach in hygiene or skin integrity can lead to infection. Signs of infection include:
- Persistent redness and warmth
- Swelling that worsens after 48 hours
- Pain or pus formation
- Fever or feeling unwell
Most infections respond well to oral antibiotics, but more serious cases may need drainage or other interventions.
4. Granulomas
Granulomas are firm, inflamed lumps that form when the body mounts an immune response to the filler. These may develop months after treatment and are treated with steroids, antibiotics, or filler dissolution, depending on the case.
🧠 How to Minimise Your Risk
The good news is that most dermal filler complications are preventable. Here’s how to reduce your risk:
✅ Choose a Qualified Medical Practitioner
Select a licensed and experienced medical professional—such as a doctor, nurse, or prescribing practitioner—who specialises in injectables. They will have in-depth knowledge of facial anatomy and physiology, pharmacology, and have access to and a working knowledge of emergency drugs. Please see my article on the importance of finding the right practitioner.
✅ Attend a Full Consultation
Your provider should take a full medical history, assess your goals, and explain risks, product choice, and outcomes. This is also the time to discuss allergies, medications, and previous aesthetic treatments. Please see my article on the initial consultation.
✅ Know the Product Being Used
Ask your practitioner what type of filler is being used and ensure it’s a licensed, CE-marked or FDA-approved product. Avoid unbranded or discounted alternatives. Here at Radiant we only use Juvederm (Allergan).
✅ Follow Aftercare Instructions
Post-treatment care helps reduce inflammation, bruising, and risk of infection. Typical advice includes avoiding alcohol, exercise, heat, and makeup for 24 hours.
✅ Recognise Warning Signs
Educate yourself on signs of serious complications, including unusual pain, skin colour changes, worsening swelling, or vision changes. Contact your clinic immediately if any of these occur. Here at Radiant we are available 24/7 post treatment to ensure that you can access advice and support at any time.
👩⚕️ Final Thoughts: Fillers Are Safe—With the Right Care
Dermal fillers can deliver beautiful, natural-looking results and restore confidence when administered correctly. Millions of people enjoy safe outcomes every year. However, like any medical procedure, fillers come with risks that deserve respect and consideration.
By choosing a qualified injector, using reputable products, and understanding the possible side effects, you can protect your health and ensure the best possible results from your treatment.