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What Can Go Wrong with Dermal Fillers? Side Effects and Complications of Fillers

Table Of Contents

Dermal fillers are one of the most popular minimally invasive aesthetic treatments worldwide, and it’s easy to understand why. They can restore volume, soften wrinkles, and enhance facial features without surgery. For many people, fillers offer a straightforward way to refresh their appearance and feel more confident.

At the same time, it’s natural to wonder, “What can actually go wrong with dermal fillers?”

The honest answer is that dermal filler side effects exist on a spectrum. The most common reactions are mild and temporary, such as swelling, bruising, tenderness, or redness at the injection site. These effects typically appear within the first few hours or days and resolve on their own with proper aftercare.

More serious complications are rare, but they can occur. These may include delayed lumps, persistent asymmetry, infection, or, in very uncommon cases, vascular complications. Some issues show up immediately, while others may develop days or even weeks after treatment, which is why ongoing awareness and follow-up matter.

Understanding both the common and uncommon risks helps you make informed decisions. In the sections below, we’ll walk through potential side effects, explain why they happen, and outline what to do if a concern arises, so you feel prepared and supported as you consider or plan your dermal filler treatment.

Common Side Effects of Facial Dermal Fillers

It’s normal to have some reactions after getting facial fillers. But while these effects are common, they still need attention.

In general, most aftercare tips are the same for everyone. However, it’s still best to consult your aesthetic injector before taking any action to ensure the advice is tailored to your specific treatment and skin needs.

To give you an idea of what these side effects are and what you can possibly do about them, here’s a quick breakdown.

1. Bruising

Bruising occurs when the needle punctures small blood vessels under the skin, resulting in a patch of discoloration. It often appears purple, blue, or yellow and typically occurs within a few hours of treatment.

What to Do

On the first day, use a cold compress for 10 to 15 minutes at a time, repeating every few hours. Skip alcohol, aspirin, and other blood thinners for a few days since they can make bruising worse and slow healing.

2. Swelling

Swelling is a natural response to both the filler and the injections. It can make the treated area look puffier than expected, especially on the lips or under the eyes. It typically peaks within 24 to 48 hours and then begins to decline.

What to Do

Apply a clean ice pack wrapped in a cloth to the area for short intervals. For the next day or two, sleep on your back with your head slightly elevated and avoid strenuous workouts to minimize blood flow to the face.

3. Redness and Tenderness

It’s common to see redness or feel warmth around the injection points. This phenomenon happens as the skin reacts to the tiny punctures and the filler adjusts in place. Tenderness may last anywhere from a few hours to a couple of days.

What to Do

Keep the area clean and avoid applying makeup until the redness has subsided to reduce the risk of irritation or infection. Do not touch or rub the area, as these actions can introduce bacteria or move the filler before it sets.

4. Pain or Sensitivity

Mild discomfort is normal, especially if several injections were done or if the lips were treated. You may experience tightness, throbbing, or a dull ache, but the discomfort should subside as the tissue heals.

What to Do

You can take acetaminophen (Tylenol) if needed. Avoid ibuprofen, aspirin, and blood-thinning medications, as they can worsen bruising. If the pain becomes stronger or spreads, contact your healthcare provider.

5. Lumps or Bumps

You might feel small, soft lumps under the skin after treatment. These complications can happen if the filler is placed close to the surface or spreads unevenly. Usually, they smooth out on their own as the filler settles.

What to Do

Do not massage the area unless your injector instructs you to. Doing it incorrectly can exacerbate the problem. If the bumps persist after a few weeks, your provider may suggest a quick fix, such as dissolving the filler with hyaluronidase.

6. Itching or Mild Rash

Some people notice mild itching or tiny red spots after treatment. This can be caused by the injections or by skincare products applied afterward. It’s usually harmless unless it worsens or spreads.

What to Do

Use a fragrance-free, gentle moisturizer to calm the skin. If you experience severe swelling, hives, or spreading redness, contact your healthcare provider immediately. These symptoms may indicate an allergic reaction that requires urgent medical attention.

7. Slight Asymmetry

Immediately after treatment, your face may appear uneven or slightly off. Such discomfort is often due to swelling, natural facial differences, or slight variations in the placement of the filler. It usually improves with time.

What to Do

Wait at least 2 weeks before judging the final result. Fillers need time to settle and even out. If asymmetry persists, your provider can make minor adjustments during a follow-up appointment.

8. Infection

Although uncommon, infection can occur after dermal filler injections if bacteria enter the skin through the injection site. This risk may be higher if the skin was irritated beforehand, aftercare instructions were not followed, or sterile technique was compromised. Symptoms can appear within days and may worsen rather than improve.

What to Do

Contact your healthcare provider if you notice increasing redness, warmth, swelling, pain, or drainage at the injection site. Early treatment with appropriate medical care can prevent more serious complications.

9. Vascular Occlusion

Vascular occlusion is a rare but serious complication that happens when filler is unintentionally injected into or compresses a blood vessel, restricting blood flow. Symptoms may include sudden pain, blanching or discoloration of the skin, or changes in skin temperature near the treated area.

What to Do

Seek immediate medical attention if you experience severe pain, unusual skin color changes, or worsening symptoms shortly after treatment. Prompt intervention by a trained provider is critical to minimize tissue damage and protect skin health.

10. Allergic Reaction

Allergic reactions to dermal fillers are rare, especially with modern formulations, but they can still occur. Symptoms may include itching, swelling, redness, hives, or rash beyond the injection site. Reactions can appear shortly after treatment or develop over time.

What to Do

Mild reactions may resolve on their own, but worsening swelling, hives, difficulty breathing, or spreading redness require urgent medical evaluation. Always inform your provider of known allergies during your consultation.

11. Migration

Filler migration occurs when the injected product shifts away from the original treatment area. This can result in puffiness, uneven contours, or changes in appearance over time. Migration is more likely when fillers are placed incorrectly or too superficially.

What to Do

Do not attempt to massage or manipulate the area unless directed by your provider. If migration becomes noticeable or does not improve, your injector can assess the area and recommend appropriate correction or adjustment.

Types of Dermal Fillers and Their Side Effects

You have several options when it comes to injectable fillers. Each type of filler is made with different ingredients and works best for specific areas of the face, so side effects can vary. While many reactions are common across wrinkle fillers, some side effects are more likely with a particular type.

Understanding the reactions associated with the type of filler you’re receiving enables you to prepare and ask the right questions prior to your appointment.

Hyaluronic Acid (HA) Fillers

Hyaluronic acid fillers are among the most widely used. They contain a substance your body naturally produces to keep skin hydrated and firm. Many people choose HA fillers because the results look smooth and natural, and they can be safely dissolved if needed.

Potential Side Effects of HA Fillers

  • Swelling that lasts a few days
  • Temporary bumps or uneven texture
  • A blue tint under the skin (Tyndall effect) if injected too close to the surface
  • Rare allergic reactions
  • Migration (if not placed properly)

Calcium Hydroxylapatite (CaHA) Fillers

Calcium hydroxylapatite is a mineral-like substance found in bones. It has a thicker texture than HA, making it ideal for deeper facial wrinkles and restoring volume. People often choose CaHA because it lasts longer and encourages collagen production over time.

Possible Side Effects of CaHA Fillers

  • Firmness or stiffness in the treated area
  • Swelling that lasts longer than HA fillers
  • Possible nodules under the skin
  • Cannot be dissolved with an enzyme like HA fillers

Poly-L-lactic Acid (PLLA) Fillers

Poly-L-lactic acid is a synthetic material that helps your skin produce collagen. Unlike most fillers, PLLA doesn’t give instant results. Changes develop slowly over several months, which makes it a good choice for restoring volume with subtle, long-lasting results.

Possible Side Effects of PLLA Fillers

  • Delayed lumps under the skin
  • Redness or inflammation weeks after treatment
  • Longer recovery time because results are gradual
  • Requires multiple sessions

Polymethylmethacrylate (PMMA) Fillers

PMMA fillers contain tiny, smooth beads that remain under the skin to provide long-term support. They are often used to treat deep wrinkles, acne scars, and structural improvements. People choose PMMA for its semi-permanent results, especially if they want a gradual change over time.

Possible Side Effects of PMMA Fillers

  • Higher risk of nodules if injected incorrectly
  • Permanent results that cannot be reversed
  • Possible granulomas (inflammatory reactions)
  • More likely to cause complications if too much is injected

How to Minimize the Risks of Dermal Fillers

Although there is a small chance of experiencing long-term dermal filler side effects, taking the right precautions before and after treatment can significantly reduce risk. Safety depends on several factors, including injector experience, product quality, individual health, and how closely aftercare instructions are followed.

Choose a Qualified and Experienced Injector

When injections are performed by someone without proper training or experience, the likelihood of complications increases. Poor technique can lead to issues such as filler being placed too close to the surface, injected into a blood vessel, or positioned in the wrong layer of the skin. Selecting a licensed, experienced injector is one of the most important steps in minimizing risk.

Ensure the Use of Regulated and Approved Products

Trying to save money with off-brand or black-market injectable fillers is risky. These products often bypass safety testing and may contain harmful or unknown substances. Using FDA-approved fillers sourced through legitimate channels helps protect against unnecessary complications.

Disclose Relevant Health Conditions in Advance

Certain health conditions, including autoimmune disorders, bleeding problems, or active skin infections, can increase the risk of adverse reactions. These factors may affect healing or increase inflammation. Sharing your complete medical history allows your provider to determine whether fillers are appropriate or if another treatment would be safer.

Follow Aftercare Instructions Closely

Post-treatment care plays a major role in recovery and results. Ignoring aftercare guidelines can lead to prolonged swelling, irritation, infection, or filler displacement. Following your injector’s instructions supports proper healing and helps maintain the best possible outcome.

Who Should Avoid Face Fillers

Facial soft tissue fillers are not appropriate for everyone. Certain individuals should delay treatment or avoid fillers altogether to protect their health and safety, including:

  • People who are pregnant or breastfeeding, due to limited safety data during these periods
  • Individuals with active skin infections, inflammation, rashes, or open wounds near the treatment area
  • Those with autoimmune conditions or compromised immune systems, which may increase inflammation or interfere with healing
  • Patients with bleeding disorders or who are on blood-thinning medications, as this can raise the risk of bruising or complications
  • Individuals with known allergies to dermal filler ingredients, even if prior reactions were mild
  • Those with a history of keloid or abnormal scarring, which may affect healing outcomes

Alternatives to Facial Fillers

Dermal fillers are just one of several options available for addressing wrinkles, volume loss, and other signs of aging. Depending on your goals and preferences, one of the following alternatives may be a better fit:

  • Neuromodulators (Botox or Xeomin): Best for dynamic wrinkles caused by facial movement, such as forehead lines, frown lines, and crow’s feet. These treatments relax targeted muscles instead of adding volume.
  • Microneedling: Helps improve skin texture, fine lines, and overall tone by stimulating collagen production. Often chosen by patients seeking gradual, natural-looking results.
  • PRP Therapy: Uses your own platelet-rich plasma to support collagen production and skin renewal. Commonly used for facial rejuvenation and hair restoration.
  • Laser and Energy-Based Treatments: Target skin laxity, pigmentation, and texture concerns without injectables. These treatments can complement or replace fillers depending on the concern.
  • Combination Treatments: In many cases, combining injectables with skin treatments provides the most balanced and long-lasting results.

A consultation with an experienced provider can help determine which option, or combination of options, best aligns with your goals and comfort level.

Choose a Dermal Filler Clinic That Puts Your Safety First

The best way to lower your risk of serious dermal filler side effects is to choose a clinic that prioritizes your safety above anything else. This means working with a licensed injector or aesthetic nurse who is knowledgeable about facial anatomy and uses FDA-approved products.

Seek providers who offer detailed consultations, show real before-and-after photos, and explain risks and aftercare clearly. This approach enhances your confidence in the process and guarantees that no questions remain unanswered.

Our team of master nurse-injectors and physician assistants at InjectCo fits this standard. We rely on experienced, licensed professionals. We use FDA‑approved fillers and provide transparent pricing and real results. We talk you through risks and follow up until you feel comfortable.

Book a free virtual consultation at InjectCo today. Let us help you achieve the look you desire with care you can trust.

Frequently Asked Questions

What are dermal fillers?

Dermal fillers are injectable treatments used to restore volume, smooth wrinkles, and enhance facial contours. Most fillers are made from substances such as hyaluronic acid, which the body naturally produces to maintain skin hydration and elasticity. Fillers are commonly used in areas like the cheeks, lips, jawline, and around the mouth.

How long do face fillers usually last?

The longevity of dermal fillers depends on the type of filler used, the treatment area, and individual metabolism. Hyaluronic acid fillers typically last between 6 and 18 months. Thicker or collagen-stimulating fillers may last longer, while areas with more facial movement may break down the filler more quickly.

Are fillers safe for the face?

Yes, facial fillers are generally safe when administered by a board-certified dermatologist, plastic surgeon, or master nurse-injector who has received proper training in facial injections. Complications such as infection, lumps, or tissue damage can occur if the filler is injected incorrectly or used in the wrong area. To stay safe, make sure your injector uses FDA-approved products and has a thorough understanding of facial anatomy.

Do dermal fillers have side effects?

Yes, dermal fillers can cause side effects, the most common of which are bruising, swelling, tenderness, or redness around the injection site. To lower your risk, always work with a licensed injector who understands facial anatomy and uses approved products. It also helps to review dermal filler side effects before-and-after photos during your consultation so you know what to expect.

What is the downside to fillers?

Dermal filler treatments can cause temporary adverse effects like swelling, bruising, redness, pain, or itching near the injection site. In rare cases, more serious complications can occur, such as infections, allergic reactions, or uneven results that may need immediate medical attention. Choosing an experienced and qualified injector significantly reduces these risks.

Which is better, Botox or fillers?

Botox and fillers serve different purposes. Botox relaxes muscles to soften wrinkles caused by facial movement, while fillers add volume and structure to areas affected by aging or volume loss. Neither is inherently better; the right choice depends on your concerns and goals. Many patients benefit from using both treatments together.

What are the first signs of vascular occlusion from fillers?

Early signs of vascular occlusion may include sudden or severe pain, blanching or whitening of the skin, a dusky or blue discoloration, or changes in skin temperature near the injection site. These symptoms typically appear shortly after treatment and require immediate medical attention.

What are the long-term complications of fillers?

Long-term complications are uncommon but may include persistent lumps, granulomas, filler migration, or delayed inflammatory reactions. Permanent fillers carry a higher long-term risk than temporary fillers. Most long-term issues are preventable with proper product selection, conservative dosing, and experienced injection technique.

What is the highest risk area for fillers?

Areas with complex blood vessel networks carry a higher risk, including the nose, under-eye region, forehead, and areas around the eyes. These areas require advanced anatomical knowledge and precise technique. This is why choosing an experienced medical injector is especially important when treating high-risk zones.

Written By:
Dr. Adrian Cole, MD


Dr. Adrian Cole, MD, is a Medical Advisor with over a decade of experience in medical aesthetics and wellness. He provides clinical guidance on patient safety, treatment planning, and evidence-based protocols across a broad range of services, including injectables, skin health, and medical weight management. With extensive experience training healthcare providers, Dr. Cole plays a key role in shaping best practices and supporting safe, results-driven care within modern aesthetic and wellness clinics.

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