Introduction to Temporary Fillers: Pros and Cons

Summary and Key Features

Temporary fillers are composed of biodegradable materials, including hyaluronic acid, calcium hydroxyapatite, and poly-L-lactic acid. The physical properties of temporary fillers vary and subsequently can have substantially different aesthetic applications.
- These uses of temporary fillers have expanded beyond their initial introduction as rhytid-reducing products.
The numerous pros of temporary fillers readily outweigh the cons, explaining their emergence and widespread popularity among consumers. Nevertheless, injectors should understand the capabilities, advantages, risks, and limitations associated with temporary fillers.

Introduction

Overwhelmingly, temporary fillers are safe and effective treatments that patients deem worthwhile. The latter is supported by the continuously increasing popularity of filler injections, with millions of injections performed worldwide on an annual basis. The American Society for Dermatologic Surgery 2019 Member Survey shows a 78% increase in soft tissue filler treatments in an 8-year span. It follows almost by definition that the pros must outweigh the cons. Nevertheless, prior to attempting to achieve a specific cosmetic outcome with an individual patient, the pros and cons of temporary fillers must be considered to ensure that an aesthetically successful outcome can realistically and safely be achieved.

History of temporary fillers

The invention of the syringe in 1844 allowed the initial use of filling agents for cosmetic purposes as early as the 19th century. Paraffin and autologous fat were the first agents described, but popular use was severely limited by the common occurrence of adverse events and a general lack of efficacy. It was not until the 1980s that the US Food and Drug Administration (FDA) approved multiple bovine collagen products for use as facial fillers and these techniques began to emerge as acceptable, albeit not mainstream, treatments. Despite their approval, filler injection remained cumbersome and complex, with multiple barriers preventing their widespread adoption among consumers, such as the need for harvesting autologous fat or preprocedural allergy testing in the case of bovine collagen. In 2003, the introduction of biocompatible and manufacturable hyaluronic acid (HA), a temporary filler, ushered in the modern era of filler injections.

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