“Filler fatigue” is a new buzz word. Everyone has their theory of what it means. Plastic surgeons are stating that with time, repeated dermal fillers won’t give the desired outcome and cause the “fatigue.” Social media claims that overloading with fillers will stretch the skin and cause “filler fatigue.” Dermatologists deny that “filler fatigue” is a real thing altogether. Boston dermatologist Dr. Kaminer insists that in an adequately treated patient, the concept that a filler “can stretch out the tissues under the skin, essentially accelerating the aging process” is simply untrue.
On the other hand, radiologists and other medical image specialists do not feel the “filler fatigue,” but they see it. Radiologists commonly recognize uncomplicated injectable fillers on medical images. Imaging is usually performed for a medical reason ( not esthetics). And patients do not regularly disclose cosmetic use of fillers before the medical test ( magnetic resonance imaging (MRI), CT/ PET scan, or ultrasound).
One of the earliest dermal fillers, for example, silicone, is designed to be permanent. Permanency is the main reason why dermal silicone filler has lost its place. Facial fat compartments as depicted by routine MRI. So is dermal silicone. And since the Food and Drug Administration (FDA) considers injectable facial fillers a medical device, silicone dermal filler is a permanent and dangerous medical device. Do not forget to mention to the radiologist.
Luckily a new generation of dermal fillers is designed differently. Today, doctors opt for hyaluronic acid (HA) fillers. The promise of hyaluronic acid — it is temporary. Things go wrong; no one will need to remove it; the body reabsorbs the fillers in 24 months period. First two years, the HA fillers can be detected by high-frequency ultrasound or MRI, according to research.
The long-term duration of the volumizing effect of HA fillers is maintained up two years. If a touchup is desired, after 18 months, smaller volumes should be added, think scientists from the Department of Cosmetic Science at the University of Hamburg.
And the newest technique is micro depot intradermal injections. European dermatologists use a new HA fillers technique to give an evenly gentle lift to the entire surface of the face and neck. They reported using relatively small volumes spread over a larger surface. Visually skin looks improved right after the procedure; however, every fourth patient did require a touchup after only 45 days. Surprisingly, patients satisfaction continued to increase at six months mark, suggesting new collagen formation. The study was funded by a sizeable pharmaceutical company manufacturing dermal fillers.
We strive to look younger, fresher, healthier. The number of dermal filler procedures is growing. And imaging specialists are deepening the expertise about visual assessments of dermal fillers on medical imaging.