Filler precautions: Things you must know before the procedure

Before getting fillers, the first and most important thing to know can be summarized into one key point. The most widely used hyaluronic acid (HA) filler can be dissolved with an agent called hyaluronidase if a problem arises, and whether the clinic is capable of preventing and responding to 'vascular occlusion'—which is the rarest but most feared complication—is the core of safety. Most other precautions are derived from this.

Fillers are treatments that fill in volume in sunken areas to naturally smooth out wrinkles and contours. While the immediate change is attractive, 'where, what ingredient, and who' injects it determines the results and safety. Based on the questions frequently received during actual consultations at Onlif Clinic, this article calmly points out the parts that are easy to miss before and after the procedure.

💉 Fillers, Different Starting from the Ingredients

Not all fillers are the same. Since the duration and whether it can be 'dissolved' depend entirely on the ingredients, HA fillers are the priority if it is your first procedure or for sensitive areas like under the eyes.

HA tends to last shorter in areas with a lot of movement, such as the lips. CaHA, PLLA, and PCL stimulate collagen and last longer, but they are difficult to reverse if you do not like the results. Permanent fillers like PMMA are virtually impossible to remove in case of side effects, so they are not recommended domestically or internationally.

The HA fillers used at Onlif also have different physical properties, ranging from soft domestic products to premium ones with good shape retention. There are products like Belotero that have good skin adhesion to reduce showing through thin areas, and products like Restylane and Juvederm that are strong at defining contours, so it is right to choose according to the area.

📌 Key Summary: Just because they can be reversed, HA fillers are a safe starting point for beginners and sensitive areas.

⚠️ The Most Feared Complication, Vascular Occlusion

The most serious complication of fillers is vascular occlusion. If a filler blocks a blood vessel, it can lead to skin necrosis, and in severe cases, blindness or cerebral vascular invasion. Although it is rare, with an occurrence rate of less than 1%, the problem is that the damage can be permanent.

In particular, the nose, glabella (between the eyebrows), forehead, and nasolabial areas are classified as high-risk areas because they are close to blood vessels leading to the eyes and brain. According to a 2017 paper, the areas where blindness occurred after filler procedures were reported as 60% in the glabella, 25% in the nasolabial folds, and 15% in the nose.

What is crucial at this time is hyaluronidase. If it is an HA filler, it can be dissolved with this agent within a few to tens of minutes, allowing you to catch the golden hour of an emergency response to vascular occlusion. Therefore, 'whether this clinic always keeps hyaluronidase in stock' becomes a practical standard for distinguishing a safe clinic.

If the following symptoms appear during or immediately after the procedure, you must inform the clinic without delay.

• Severe pain, paleness or purple discoloration of the treated area

• Cold sensation, blistering

• Blurred vision, decreased vision, double vision

📌 Key Summary: Vascular occlusion is rare but fatal. Whether hyaluronidase is stocked and the immediate response system are the measures of safety.

🩹 Common Side Effects and Less Common Side Effects

Bruising, swelling, and tenderness are common reactions. They usually subside within 3 to 14 days, so there is no need to worry excessively. However, if the pain gets worse, the skin color changes, or vision problems occur, it is beyond the scope of a common reaction.

There are also less common side effects to be aware of.

• Tyndall Effect: A phenomenon where HA filler appears bluish when injected superficially into thin skin like under the eyes. An error in choosing the injection layer is the main cause, so the skill level of the practitioner is significant.

• Delayed Inflammatory Response: This rarely occurs months to years after the procedure when immunity is lowered, with reported rates of about 0.06% per year. The cross-linking agent ingredients of HA fillers are sometimes pointed out as the cause.

• Biofilm/Nodules: If bacteria form a film around the filler, it can cause delayed nodules or granulomas in the form of chronic infection.

Most HA fillers contain lidocaine to reduce pain. If you have a history of lidocaine allergy, you must inform us before the procedure.

📌 Key Summary: Bruising and swelling usually improve within 2 weeks. Late-appearing nodules can be prevented by avoiding over-injection and sharing your treatment history.

📋 Before the Procedure, What to Prepare and Discontinue

Half of the preparation before the procedure is 'disclosure'. Please inform us of any medications you are taking, allergies, past filler history, infections, or pregnancy without exception. In particular, what filler you received and where previously is directly related to preventing delayed nodules.

Ingredients that interfere with blood clotting increase the risk of bruising and bleeding.

• Anti-inflammatory painkillers such as aspirin and ibuprofen

• Health functional foods such as Omega-3, Vitamin E, and Ginkgo Biloba extract

It is recommended to discontinue these ingredients 7 to 14 days before the procedure. However, do not stop taking anticoagulants or antiplatelet agents prescribed by a doctor at your own discretion. You must consult with the prescribing medical staff.

If you are considering lip fillers, you must check your history of herpes simplex virus (HSV/cold sores). Since the virus can be activated, taking preventive antiviral medication is considered if you have a history.

📌 Key Summary: Do not stop prescribed medications arbitrarily, discontinue health functional foods and anti-inflammatory painkillers 1 to 2 weeks prior, and be sure to share your previous filler history.

🕐 How to Manage Post-Procedure Care

Immediately after the procedure, the volume is visible right away, but it looks different from the actual shape due to swelling. Evaluating the final shape is appropriate 1 to 2 weeks later when the swelling has subsided. As a rule, it is better to watch the progress rather than dissolving it immediately just because you do not like it.

Avoid the following for 24 to 48 hours after the procedure.

• Drinking alcohol, strenuous exercise

• Sauna, hot baths

• Strong massage

There are also things to keep in mind for each area. After nose fillers, avoid pressure from glasses for 2 weeks; after forehead fillers, refrain from pressing down with a hat for about a month; and after lip fillers, it is good to reduce stimulation with straws or your tongue.

Even if you feel clumping or migration, do not massage it arbitrarily at home. Since the position can be displaced, it is safer to have it evaluated at the clinic.

📌 Key Summary: Judge the shape 1 to 2 weeks later, refrain from drinking alcohol, saunas, and strenuous exercise for two days, and be careful with pressure on each treated area.

💡 Relationship Between Fillers, Botox, and Other Procedures

It is easy to confuse, but fillers and Botox have different principles. Fillers supplement volume to fill in sunken areas, while Botox relaxes muscles to soften expression lines. Since their purposes are different, they are often performed together or used separately as needed.

If sagging is prominent, fillers alone have limitations. In this case, it is more natural to consider procedures with strengths in lifting, such as thread lifting, or non-surgical elasticity procedures such as ultrasound (HIFU) and radiofrequency (RF) together. It is commonly misunderstood that 'fillers sag down,' but in many cases, it is not filler migration but a decrease in skin elasticity due to aging.

Onlif aims for a non-surgical approach that restores the skin's natural balance, rather than incisional plastic surgery. This is why we design treatments by dividing areas that need volume with fillers and areas where elasticity is key with lifting-line procedures.

Using a cannula (a blunt-tipped needle) can reduce some risks of bruising and vascular damage. However, it should not be misunderstood that cannulas completely prevent vascular occlusion.

📌 Key Summary: Fillers for volume, Botox for muscular wrinkles, and lifting for sagging. Combining them according to your concerns yields a natural result.

🏥 How to Choose a Clinic

In the end, safety comes from people and the environment. When choosing a clinic, check the following:

• Whether they use genuine products approved by the Ministry of Food and Drug Safety (MFDS)

• Whether they always keep hyaluronidase in stock in preparation for vascular occlusion

• The practitioner's skill level and experience with approach by area

• Infection prevention systems such as disinfection and sterilization

Onlif designs fillers harmoniously by looking at the overall facial proportions through 1:1 facial analysis, and adheres to the principles of genuine products, precise dosage, and infection prevention systems. Based on the thought that one person cannot do everything perfectly, we operate by assigning doctors to the procedures they do best in each field. We aim for natural volume that does not mask your original charm, rather than standardized results.

📌 Key Summary: Genuine approved products, hyaluronidase in stock, skill level, and hygiene. These four are the baseline for choosing a clinic.

❓ Frequently Asked Questions (FAQ)

Does dissolving hyaluronic acid filler completely return it to its original state?

Injecting hyaluronidase can break down HA filler within a few to tens of minutes. Generally, it returns close to the state before the procedure, but it can vary depending on tissue reaction or individual differences, so an accurate judgment requires medical consultation.

How long do swelling and bruising last after the procedure?

Bruising, swelling, and tenderness are common reactions and usually subside within 3 to 14 days. However, if pain intensifies, skin color changes, or vision abnormalities occur, you must notify the clinic immediately.

Why are nose fillers and glabella fillers particularly dangerous?

These two areas are close to blood vessels leading to the eyes and brain, so the risk of blindness or tissue necrosis is relatively high in the event of vascular occlusion. According to papers, blindness occurred in 60% of glabella cases and 15% of nose cases, classifying them as high-risk areas.

What medications and health functional foods should I stop before the procedure?

Anti-inflammatory painkillers like aspirin and ibuprofen, and Omega-3, Vitamin E, and Ginkgo Biloba extract increase the risk of bruising, so it is recommended to stop them 7 to 14 days prior. However, do not stop prescribed anticoagulants arbitrarily; consult with the prescribing medical staff.

Can I get fillers while pregnant or breastfeeding?

It is not recommended during pregnancy or breastfeeding because there is insufficient safety data. As a rule, you must disclose whether you are pregnant or breastfeeding before the procedure.

Why does under-eye filler look bluish?

If HA filler is injected superficially into thin skin, the Tyndall effect can occur, where it appears blue due to light scattering. Since the choice of injection layer is often the cause, it can be adjusted with hyaluronidase if necessary.

Can I get lip fillers if I have a history of cold sores?

If you have a history of cold sores, the virus can be activated by the procedure, so taking preventive antiviral medication is considered. It is safe to proceed after disclosing your history and consulting.

Why are permanent fillers not recommended?

Permanent fillers like PMMA are not recommended domestically or internationally because it is virtually impossible to remove them even if side effects occur. Reversible HA fillers are considered a relatively safer choice.

Hyaluronic Acid Filler, Good Things to Check Before Choosing a Clinic

Even for the same procedure, the results and recovery process differ depending on where, by whom, and how it is performed.

Asking these questions directly during the consultation will help you make a decision.

• Is this a place that performs that procedure frequently? — Each clinic has different procedures they focus on. Check if it is a place that regularly performs hyaluronic acid fillers.

• Can I verify the products and equipment used? — Ask if you can verify the product name and whether it is genuine (whether it is an imported approved product, and if there is an unboxing verification process) during the consultation.

• Do they explain the cost breakdown? — Rather than just hearing the total amount, you should hear an explanation of what product is used, how much, and on which area to make an informed decision.

• Do they design by looking at the whole face? — Even for the same procedure, the injection location and amount differ depending on facial shape, skin condition, and left-right asymmetry.

• Do they explain adverse reactions and the recovery process first? — A clinic that informs you of possible adverse reactions and coping methods along with the expected changes is better to make a decision.

• Is there a way to follow up after the procedure? — Check if the timing for checking progress, how to contact them if there is an issue, and the criteria for a return visit are set.

This is how Onlif Clinic performs hyaluronic acid fillers

• We divide responsibilities — Based on the belief that a single doctor does not handle all procedures, Onlif divides and assigns responsible doctors by field for medical treatment.

• We verify products and equipment together during consultations — We guide you through the products used and the unboxing verification process during the consultation.

• Costs are guided along with the plan after diagnosis — Since the area, volume, and scope differ for each person, we explain what costs how much together.

• We design by looking at the overall balance of the face — We view the face through three axes: texture, balance, and signals of youth, and make plans in a direction that tidies up parts that obscure the original impression rather than changing the shape.

• We discuss adverse reactions and the recovery process first — Along with the changes that can be expected, we guide you through individual differences, possible adverse reactions, and coping methods before the procedure.

• We monitor the progress after the procedure together — If verification is needed during the recovery period, we provide guidance on return visits and communication channels.

If you are considering hyaluronic acid fillers, it is best to first check what is possible and what is difficult in your current state.

An accurate diagnosis and treatment plan can only be determined through an in-person consultation. Find out through a consultation at Gangnam Onlif Clinic.