| Name | Bellafill (not for lips), Belotero, Hyaluronidase, Juvederm, Juvederm Voluma (approved for temples if necessary), Radiesse, Restylane, Revanesse Versa, RHA Fillers, Sculptra |
| Uses | Facial volume restoration, correction of wrinkles and folds, enhancement of facial contours, scar revision (e.g., acne scars), and hand volume restoration. Approved areas depend on product. Temple filler is limited to Juvederm Voluma. |
| Route Of Administration | Intradermal or Subdermal Injection (dependent on depth and area being treated) |
| Frequency Of Use | Maximum: Every 3 months for same area. No more than 6 treatments per year in the same anatomical region. |
| Concentration(s) | Varies by product: Hyaluronic acid fillers typically 20-24 mg/mL; Sculptra (poly-L-lactic acid); Radiesse (calcium hydroxylapatite); Bellafill (polymethyl methacrylate with bovine collagen). |
| Maximum Dosage (Day, Wk) (g/mL)/mL | Typical maximum per treatment session: 1-3 mL per anatomical region, not exceeding 6 mL per full-face treatment. Product-specific limits apply (see product labeling). |
| Contraindications | Pregnancy or breastfeeding. History of severe allergic reaction to any filler component (hyaluronic acid, lidocaine, bovine collagen, calcium hydroxylapatite, poly-L-lactic acid, mannitol). Active skin infection or inflammation at treatment site. History of hypertrophic or keloid scarring. Autoimmune diseases affecting connective tissue. Bleeding/clotting disorders. Untreated mental illness including severe body dysmorphic disorder. History of embolism or necrosis from prior aesthetic procedures. Recent aesthetic treatments (chemical peel, laser resurfacing) within 2 weeks or facelift within 4 weeks. |
| Possible Side Effects | Swelling, bruising, tenderness, redness at injection site. Asymmetry, lumpiness, Tyndall effect (bluish discoloration with superficial filler). Infection. Vascular occlusion (emergency). Nodules or granulomas. Delayed onset inflammatory reactions (especially with Vycross fillers). |
| Compatibility With Other Treatments/Drugs | Avoid combining with laser treatments, chemical peels, or microneedling within 2 weeks. Caution if patient is taking anticoagulants, steroids, or immunosuppressants. If previous filler from a different brand exists in the same area, consultation with the Medical Director is required. |
| Allergies | Hyaluronic Acid (Juvederm, Restylane, Revanesse, RHA Fillers, Belotero) Bovine Collagen (Bellafill) Calcium Hydroxylapatite (Radiesse) Poly-L-lactic Acid (Sculptra) Lidocaine (present in most fillers) Mannitol (Sculptra) Gram-positive bacterial proteins (some fillers derived from bacterial fermentation). |
| Administration Time | Typically 30-60 minutes including consultation, photography, consent review, and injection. |
| Dosing/Settings | Cheeks: 1-3 mL Lips: 0.5-1.5 mL (except Bellafill - not approved for lips) Nasolabial Folds: 1-2 mL Jawline/Chin: 1-3 mL Temples: 1-2 mL (only Juvederm Voluma allowed) |
| IM/Push | Not applicable - injectable fillers must only be placed intradermally or subdermally. Never injected intravenously. |
| What To Do If Adverse Reaction Occurs | 1. Stop the procedure immediately. 2. Assess patient’s airway, breathing, and circulation (ABCs). 3. For mild reactions (swelling, bruising), apply ice and elevate. 4. For vascular occlusion (whitening of skin, pain), immediately inject hyaluronidase if using hyaluronic acid fillers — follow emergency vascular occlusion protocol. 5. For allergic reactions, administer antihistamines and consider epinephrine if severe. 6. Document reaction thoroughly, including time, symptoms, treatment provided, and patient outcome. 7. Notify Medical Director immediately and arrange for emergency transfer if needed. |
| Additional Documentation Requirements | Pre-treatment photographs (front, side, oblique) are mandatory. Written informed consent must be signed and scanned into chart. Complete medical history, including history of aesthetic procedures. Document injection sites, volumes, and lot numbers for each product. Document patient counseling regarding risks (vascular occlusion, granuloma formation, delayed inflammatory response). Document post-care instructions provided to patient (avoid massage, sun exposure, extreme heat, strenuous exercise for 24 hours). |