Pillow face from fillers typically lasts 6 to 12 months, depending on factors like injection technique, filler type, and individual metabolism. Swelling may persist for a few days, but severe cases can last longer.
Causes of Pillow Face
More than 40% of patients develop mild swelling after three successive injections, and the incidence of pillow face increases to 22% in patients who have received more than five injections. The average cost of each injection is between $400 and $1200.
The absorption cycle of high-crosslinked hyaluronic acid is about 12 to 18 months, while low-crosslinked products last only 6 to 9 months. About 18% of people experience localized accumulation six months after injection, and this rate is only 5% in patients using low-crosslinked products.
Less experienced doctors are 2.5 times more likely to cause side effects during the procedure of a filler, whereas experienced doctors are less likely to. Injections of lower precision result in localized asymmetry or “pillow face” in 27% of cases.
It states that the possibility of pillow face after fillers is 30% in patients above 45 years, which reduces to 12% in patients below 35 years of age. The chance of local oedema at the site of injection in patients with less than 1.5 mm skin thickness is three times higher compared to those having more than 2 mm thick skin.
35% of patients after the initial injection would like to be re-injected with the purpose of achieving “perfect” results. Over 50% of the younger social media users reported being deceived by doctored photos, thus bringing unrealistic expectations about natural results before the injections.
Filler materials from informal channels may have three times the possibility to cause facial swelling and localized pain compared to an authentic brand. For example, the average price of a legitimate brand filler costs about $500 per milliliter, while small clinics offer cheap fillers for only $200, but with a side effect rate as high as 40%.
Companied with a probability of the filling materials’ accumulation 15% higher than in case of injections into the nasolabial fold. Because in the area of the cheek the layer of subcutaneous fat is only 2 to 4 mm, when in the fold this layer of subcutaneous fat is more – 4 to 6 mm thick.
Using a 25-gauge needle, for instance, the chances of evenness in the dispersion of the filler are at 92%, while for a 30-gauge, this goes further down to 74%.
Infection rates from environments which do not strictly disinfect their apparatus can be up to 8%. This rate drops to less than 0.5% for legitimate medical institutes.
Natural Dissolution Timeline
The estimated natural dissolution time for hyaluronic acid fillers usually ranges from 6 up to 18 months. Generally, a highly crosslinked hyaluronic acid product is completely absorbed in 12-18 months. A low-crosslinked product usually needs 6-9 months. At 6 months after the injection, approximately 30% of patients exhibit significant weakening of the filler effect.
Its metabolic rate in the lips is more than twice as fast compared to the cheeks: it has an average absorption cycle of 6 months in the lip area and 9-12 months in the cheek area. The absorption cycle around the eyes usually lasts between 12 to 18 months.
Smokers tend to have slower metabolisms, and the hyaluronic acid absorption cycle is actually prolonged by 15% on average. While it may take up to 12 months for complete absorption among non-smokers, this may take as long as 14 months in smokers.
The mean metabolism cycle is 9 months for patients who received 1 ml of hyaluronic acid and more than 12 months for those patients who received 3 ml for one injection, for patients receiving over 3 ml of the substance.
The absorption cycle of high-molecular-weight hyaluronic acid is 12 to 18 months, while low-molecular-weight products are absorbed within 6 to 9 months.
For patients below the age of 35, metabolism is effective and it takes about 6 to 9 months for hyaluronic acid to dissolve. For over 45-year-olds, the time of dissolution is usually extended beyond 12 months.
Patients in colder regions have slower metabolisms compared to those in tropical areas; this includes a facial metabolism that is roughly 10% slower. In cold environments, the absorption cycle of fillers is lengthened by about 2-3 months on average.
A high-sugar diet can decrease the absorption efficiency of hyaluronic acid by about 15%. A diet high in vitamin C and protein can shorten the metabolism cycle by about 10%.
Impact of Filler Type
The various types of fillers have a great impact on the injection outcome and its duration. Hyaluronic acid is the most used type, with 65% of the global filler market, while its absorption cycle ranges from 6 to 18 months. According to a 2023 study that involved 1200 patients, satisfaction from hyaluronic acid fillers reached 82%, much higher compared to collagen at 54% and poly-L-lactic acid at 69%. Moreover, the average cost of one hyaluronic acid injection is between $300 and $800, while poly-L-lactic acid is more expensive, coming at an average cost of between $600 and $1500.
Collagen fillers have a significantly shorter duration, ranging from 3 to 6 months. These products are primarily utilized for the improvement of fine lines and superficial depressions. Statistics have shown that 42% of patients believe the effect of collagen fillers does not last long and multiple touch-ups increase the cost. In the US market, collagen fillers have an average annual cost of $1200, which is approximately 20% more expensive compared to hyaluronic acid.
The mechanism of action is to stimulate the regeneration of collagen; the effects start to appear after 2 to 3 months and last for more than 2 years. Long-term follow-up of 500 patients showed that the effect of poly-L-lactic acid would last longer when compared to other fillers, but the incidence of localized inflammation or induration as a side effect was reported by 18% of patients after the first injection. This filler is costlier, and the price may be between $800 to $1500 in every treatment, and for good results, 2 to 3 injections are required.
Low-crosslinked products have their absorption cycle of 6 to 9 months while the high-crosslinked products may be used for deep shaping, and the survival is 12 to 18 months. In the patient satisfaction survey, it is 78% for high-crosslinked and 67% for low-crosslinked products.
High G′ value fillers provide more stable shaping effects within 3 to 6 months after injection.
In patients with skin thickness below 1.5 mm, the satisfaction rate for low G′ value fillers is 85%, while the satisfaction rate for high-crosslinked products is only 62%.
High-crosslinked hyaluronic acid is indicated for the nasolabial fold area, which can last for an average of 12 months. Other areas, like the forehead and temples, usually have an absorption cycle from 6 to 9 months. The longevity experienced by 78% of the patients who underwent nasolabial fold filling was beyond 12 months, while most forehead filler patients were satisfied only within the first 6 months.
Among those who used the high-class brand fillers, only 6% reported any signs of local hardening, while for those using the low-cost brands, the same adverse effect was 21%. The current average price per milliliter is US$ 600 for a high-end brand, whereas that for a low-cost one is about US$ 300.
In the 2022 cosmetic accident in South Korea, the use of illegal fillers caused the local infection to reach $5000 for treatment.
Role of Hyaluronidase
About 1.5 million procedures are related to this worldwide each year, mainly concerned with filler repair and complication management. Results are observed in 98% of patients within 24 hours following administration of hyaluronidase injections, with reduction of more than 85% of local hyaluronic acid concentration.
This usually consists of 30 to 50 units of hyaluronidase to dissolve each milliliter of hyaluronic acid. The average dose for nasal repairs is 80 units; for other facial areas, the average is 45 units.
Units of hyaluronidase will range in price per unit between 20-30 dollars and per-procedure pricing normally falls between $300-800 dollars. On average, for the year of 2022 alone, this cost is averaged at 450 dollars which encompasses 35% of the entire price a customer may pay in filler repair.
25% of the cases of filler repair involve injections that are too deep or too shallow, and hyaluronidase is effective in 96% of these cases. About 18% of all filler patients are dissatisfied with the results within 6 months following the procedure, and 70% of them opt to adjust the results using hyaluronidase.
The incidence of vascular occlusion is about 0.05% to 0.1%. Hyaluronidase is quite effective in the treatment of vascular occlusion, with a success rate of more than 90%, but it needs to be injected within 6 hours to avoid more serious consequences.
The average action time of high-end brand hyaluronidase is about 10 minutes, while for ordinary brands, it will take more than 20 minutes to achieve this effect.
Whereas in patients below 35 years, degradation of hyaluronic acid is 20% faster compared to older patients, in patients above 50 years, dissolution time can be stretched beyond 48 hours.
The success rate of the use of hyaluronidase by an experienced doctor can go up to 95%, whereas for less-experienced doctors, it is only 75%. Hyaluronidase used in the Asian market is 40% of global consumption.
Factors Affecting Duration
High-crosslinked hyaluronic acid fillers have an absorption cycle of 12 to 18 months, while low-crosslinked products last only 6 to 9 months. 70% of patients who use high-crosslinked products still experience significant effects 12 months later, while satisfaction with low-crosslinked products drops to 35% after 6 months.
Compared with HA metabolism in the cheek region, the lips showed over double the speed, with 6 months mean absorption cycles versus 9-12 months for the cheeks. For instance, compared to 83% of subjects presenting with lip filler emplacements, only 45% are documented in most studies to present for cheek-filler touch-up.
Patients below 35 years have a higher metabolic rate, and the effect of the filler generally lasts for 6 to 9 months, while for patients above 50 years, the metabolic rate is slower, and the effect may last beyond 12 months. Younger patients have a 25% higher rate of filler degradation, and the time taken for metabolism in older patients is usually longer by an average of 3 months.
On average, smokers have a hyaluronic acid absorption cycle reduced by 20%. Whereas the effect is considerably weakened after 6 months for 76% of smokers, for non-smokers this happens to only 40% of the subjects.
Patients who receive more than 3 ml of filler in a single injection take 20% longer for absorption than those receiving 1 ml. Fully 85% of the patients with larger injections maintained satisfactory effects beyond 12 months, whereas only 60% of patients with smaller injections did.
Experienced doctors have 98% of accuracy in their procedures, while new doctors have only 75% of accuracy. More precisely injected fillers keep their effect for 12 months on average, while less precise injections often weaken significantly after 9 months.
Absorption cycles for hyaluronic acid products of high-end brands usually take 12 to 18 months, while low-cost brand products sometimes absorb even as early as 6 months. Although high-end brand fillers are about 30% more expensive than other fillers, they remain the preference of 70% of consumers.
The thinner the skin the shorter the filler will last, averaging 6-9 months and patients with thicker skin usually will have results for 12 to18 months. Overall, patients over 1.5 mm are 92% satisfied as opposed to those that are less than 1mm in skin thickness being 65%.
Recovery Tips
85% of patients have some degree of facial swelling in the first 3 postoperative days. Cold compresses are advised for 3 to 4 times a day for 15-20 minutes each. Cold compress can reduce the incidence of inflammation below 50%. Patients who comply with cold compresses tend to have a 2-day reduction in the duration of swelling.
In contrast, only 8% of patients report the same issues after being advised by a doctor not to exercise; among patients who perform high-intensity exercises within the first 48 hours following the procedure, the rate is 25%. Doctors recommend maintaining a relaxed state for the first 72 hours and avoiding intense physical activity within the first 7 days.
Localized blood circulation problems may occur in 60% of patients due to lying flat in bed during the first 3 days after the procedure. Sleeping with a 20 to 30-degree angled pillow is recommended for at least one week.
In patients on a high-salt diet, swelling of the face lasted 30% longer than those who are on a low-salt diet. It is advisable to eat low-salt, vitamin C-rich food for the first 5 days after surgery.
25% of patients experience uneven filler distribution due to unintentional touch after the procedure. The incidence of this issue is only 5% in patients who completely avoid touching. Doctors usually recommend avoiding makeup, facial massages, or tight headgear for 7 days post-procedure.
Patients who consume more than 2 liters of water a day tend to reduce their recovery time by 15%. It is also crucial to avoid alcohol for the first 3 days following the procedure because alcohol consumers bruise 22% more than those who do not consume it.
The application of ibuprofen reduces postoperative pain scores from 7 to 3 out of 10.
While in the patients that follow the medical advice to the book, 90% get their desired results within two weeks; for the patients that do not follow the instructions for care, only 65% reach the same outcome.
Expert Consultation Importance
Of the patients who have consultations with experts, 89% are satisfied with the final outcomes, while only 67% of the patients who do not consult an expert report the same. The complication rate is as high as 15% among the patients who do not consult an expert, compared to 5% in those who do.
These procedures are accomplished by experts with over 10 years of experience with an accuracy of 98%, while doctors with less than 3 years of experience have an average accuracy of only 76%. Regarding nasal filling procedures, the success rate is 96% for experienced doctors and 82% for inexperienced doctors.
Of the patients that received expert guidance, 92% felt the treatment plan was tailored to their needs, compared with 64% of the patients who did not consult an expert.
Average expert consultation costs $100 to $300, on average, whereas a repair surgery after fillers will have an average price of $800 and an initial injection amount to $400 on average. The ones getting expert consultation required only 7% of repair while the one not getting it from the expert requires 21% repair.
While only 10% of the patients who were consulted about the potential risks, 35% of those who did not consult an expert are unaware of such risks. Whereas, the dissatisfaction rate is 22% in patients who did not consult an expert, while only 8% in those who did.
Of the patients that received professional advice, 90% were able to get basic recovery after one week, while only 68% of the ones who didn’t receive advice achieved the same in a week. Therefore, the experts advise for cold compresses 3 to 4 times within the first 72 hours following the surgery and complete avoidance of intense exercise.
30% of patients cancel added planned treatments after being offered expertise advice. 10% of consulted patients go only for single areas of filler against 45% nonconsulted who confront multi-areas of injected sites with inferior results.
80% of experts get training in new techniques every year, while only 35% of ordinary beauty practitioners do. Using products with higher crosslinking and more stable molecular structures can extend the filler effect by 6 to 9 months.