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Going for plastic surgery fillers? Prepare for the unexpected.

Why do some people end up unrecognizably weird after plastic surgery? Because our body is alive.

If you think that filler materials stay where they are injected, think again. If you think that filler materials are “inert,” think again. Even when you hear is “hyaluronic acid,”  hyaluronic acid is degraded too quickly by the body to be useful. What will be injected in you is a very different chemical: a hyaluronic acid modified by other chemicals, preventing your skin enzymes from breaking it down. Hence, it’s not hyaluronic acid anymore! Linking agents include 1,4-butanediol diglycidyl ether, divinyl sulfone (DVS), and 2,7,8-diepoxyoctane.  Not that natural, right?

Other common fillers:

  • Calcium Hydroxylapatite (CaHA), advertised as a bone analog. CaHA microparticles are suspended in a carboxy-methylcellulose gel. 
  • Poly-L-lactic Acid (degradable). PLL microparticles are mixed with sodium carboxy-methylcellulose and mannitol. 
  • Polymethylmethacrylate (PMMA), is injected as micro balls, that may also contain collagen
  • Polyacrylamide
  • Silicones
  • Autologous fat injections (fat from your body is injected in your face)

When injected, any filler will cause inflammation and lead to the formation of scar tissue. The final results will depend on your genetics, the chemical composition of the filler, and luck.

What’s the problem?

You can have your doctor inject hyaluronic acid-based fillers in strategic places all over the face — around the temples, under the eyes, in the buccal hollows, and around the jawline, the mouth, and lips. Hyaluronic acid derivatives will not be recognized by your body and may lead to allergic reactions and even immune disorders. Also, they may be degraded in a disorganized manner changing the shape of the face you thought you had.

Another filler used sometimes is collagen; it’s immunologically benign, resistant to proteolysis, and a natural substrate for cell adhesion. In theory, collagen is the ideal biomaterial for soft tissue augmentation. When bovine collagen is used, it can lead to an immune response. In China, placental collagen is used instead. Why such “ugly” sources of collagen? The collagen needed for injection should be insoluble, and we can’t make insoluble human collagen in vitro.

Fats obtained from elsewhere in your body are less likely to lead to problems, but they can still migrate or disappear, leaving you with another mess to deal with. Migration is more noticeable when the filler is injected below the eyes or in the lips.

Think before you sign under the “small print” form: somebody makes up that (small?) % of bad results. You may be it. Just like Simon Cowell and Madonna are.


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