Can hyaluronic acid (HA) fillers cause problems or inflammation years later?

Can hyaluronic fillers cause inflammation years after they are injected? My dermatologist says he has seen patients come in after 6 years with it after receiving a hyaluronic filler. Is there a way to know if you will be one of the people that that rejects fillers like restylane, vollure, ect before being injected?

So glad you asked this! Certain non HA fillers are known to do this in rare instances.  The problem shows up almost always as a “granuloma.”  Which translated into plain english means that, when biopsied, these bumps/lumps show certain white blood cells and cells found in chronic inflammation/irritation (ex. “giant” cells). These look like large, red, tender lumps on the face, or wherever it was injected. They are very hard to treat.

We also know that some patients with certain autoimmune diseases are slightly more likely to develop nodules.  Makes sense.  Some of us are more prone to inflammation.

Please don’t use permanent fillers.  They sound good, but if there’s a problem it’s very hard to treat unless the area is cut out.  And, as your face ages, it can’t be adjusted and often starts to look strange.  Long lasting, but not permanent, fillers are better.

These injectables are:

  • Silicones (permanent filler) – especially non medical grade silicones still used in some parts of the world.  Can cause problems years later.
  • Artefill/Bellafill (permanent filler) – microscopic plastic beads.  Can cause problems years later.
  • Radiesse  (non permanent) – a cartilage like material made with calcium.  Usually not a problem unless injected in areas it’s not meant for.  Tell your provider if you have an autoimmune disease.
  • Sculptra (non permanent) – made from lactic acid.  Usually not a problem unless mixed or injected incorrectly, or used in the wrong area of the face. Tell your provider if you have an autoimmune disease.

Hyaluronic Acid Fillers

I have never seen this reported in the U.S.  And…..if you stick to HA fillers made by Galderma, Allergan, Merck, etc. the quality control is very high and this would be extraordinarily rare. The problem usually comes with cheap HA fillers made in factories in China, Korea, Eastern Europe, etc. where the purification  and quality control process is defective or poor.  As a result, bacterial antigens are still present in these products causing inflammation and granulomas.


Unless an actual biopsy was done to confirm the problem your dermatologist was discussing, it’s very hard to be certain what the problem was.  There are also deep infections (biofilms) that can occur around HA fillers.  These can be long lasting (years) and need special treatment.

Hope this helps,
Dr. Brandith Irwin
Founder, SkinTour
Director, Madison Skin & Laser Center
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Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

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