user73748324744 :
I work in aesthetics. I agree and disagree.
Fillers imo are the best option right now in place of implants. Fat grafts are better than filler in some areas (midface, under eyes, forehead, temples, etc.,) but filler is better in areas like the chin or jaw than implants or fat. Fillers are generally safe if you go to a good practitioner, but the risk is never zero. They are still a big deal. I disagree that they don’t migrate even with ideal conditions. It is in the nature of filler to expand and migrate, especially in mobile areas. HA filler is basically a cross-linked, water-binding hydrogel, so it is not a rigid implant and not something that stays perfectly “locked” in one exact shape after injection. It can move if the area is mobile (jaw that talks and bites, chin that moves with speaking and expression, etc.) source: https://pmc.ncbi.nlm.nih.gov/articles/PMC9188840/) (source: https://pmc.ncbi.nlm.nih.gov/articles/PMC9285697/). That is why some “expansion” is built into the material itself: HA gels have a measurable swelling capacity, and that swelling affects how much the filler expands at the injection site. (source: https://pmc.ncbi.nlm.nih.gov/articles/PMC9285697/). What people call “migration” is often a mix of the filler just moving through tissue planes, “expansion” because of the hydrophilic nature of the filler, plus ongoing forces like muscle activity, pressure, massage, and gravity acting on a deformable gel. (source: https://pubmed.ncbi.nlm.nih.gov/25650796/) (source: https://pmc.ncbi.nlm.nih.gov/articles/PMC5064200/). It can also look cumulative because HA filler may remain detectable much longer than people think, so new filler may be getting added on top of old filler that never fully disappeared. (source: https://pmc.ncbi.nlm.nih.gov/articles/PMC11250456/) (source: https://pubmed.ncbi.nlm.nih.gov/39015357/). Filler is biocompatible doesn’t mean the body just fully accepts it 100% of the time. It just means it’s less likely to cause a reaction. Fillers can cause inflammation, nodules, and granulomatous foreign-body reactions. (source: https://www.fda.gov/medical-devices/aesthetic-cosmetic-devices/dermal-fillers-soft-tissue-fillers).
2026-04-11 21:35:58