Recently, I encounter many patients suffering from the side effects of fillers.

Early this year, Product B of Manufacturer A and Product D of Manufacturer C caused a high rate of side effects. However, side effects were not observed in clinical studies conducted soon after market release. I wonder if the processing technology has been compromised since the release. However, Product D’s rate of side effects has gone down and it seems that the manufacturer has revamped their processing technology. Products F of Manufacturer E continues to have problems. This product has increasing rates of tissue response and granuloma leading to aspiration or surgical tissue removal (There is limitation to revealing the names of the products and manufacturers. Please direct personal inquiries to me).

Fillers with poor safety profiles can cause serious side effects and doctors should practice caution to prevent tissue response. Filler manufacturers should address any safety problems arising from use of their products. Side effects related to filler procedures are attributed to the doctor’s lack of skills but continuous reports of side effects will be recognized as the problem of the product. For the time being, the product may avoid being blamed but continued tissue response and granuloma can lead to a class action suit.

HELIOSⅡ/LOTUSⅡ/HYPERION – Manufacturer: LASEROPTEK(www.laseroptek.com)

On the other hand, there are filler products that I evaluate to be excellent. CUTEGEL, (BNC Korea), Cleviel (Pacific pharma), and Ellanse (JW Pharmaceutical) are among these products. Especially, Ellanse has good longevity. However, caution is still needed with these products. Ellanse is produced by mixing filler particles into the carrier gel for facilitating injection. Injected particles last for 2 years but the carrier gel is absorbed early. The biggest issue here is whether the desired shape emerges after absorption of the gel. The manufacturer claims that the gel is replaced by body tissues. However, the human body has a strong tendency to restore the original shape. I worry that the treated area will lose volume before the ingrowth of new tissues. Fillers last longer in areas requiring reconstruction such as cheeks that have low pressure. Another problem is that correction is not possible after the first injection. HA fillers that can be dissolved with Hyalase have the advantage of reversing the effect. However, Ellanse cannot be easily reversed and requires a lot of caution during treatment. When carefully injected, Ellanse can bring desired longevity.