I am worried about my face swelling from facial fillers if I got or get the COVID-19 vaccine!

By Emil Shakov, MD

Like many of my patients, you may have considered getting or have had dermal fillers. You want something that will make you look younger and more refreshed especially with all the hardships that have come from this COVID-19 pandemic.

Have you seen the headlines or maybe saw it in your FaceBook or Instagram feeds about facial swelling after getting the COVID-19 vaccine in people with dermal fillers?

Well fear not! The COVID-19 vaccine is safe to get even if you had dermal fillers or are thinking about getting the procedure done.

What are Dermal Fillers?

Dermal fillers are gel-like substances that are injected beneath the skin to restore lost volume, smooth lines, soften creases, or enhance facial contours. There are a variety of FDA approved filler products that can be used such as hyaluronic acid based fillers like Juvéderm, Restylane, and Revanesse Versa. 2.7 million dermal filler procedures were performed in 2019 alone according to the American Society of Plastic Surgeons.

What kind of reaction can I get?

You could experience a temporary hardening of tissue, redness, and swelling in the area that has been injected with the filler. 

What can cause swelling from fillers?

The process that causes swelling is called delayed inflammatory reactions (DIR). It can happen in dermal filler procedures after a poor injection technique, dental cleaning procedures, bacterial/viral illness, and vaccination. It is caused by cells in your immune system called T lymphocytes. It is estimated that DIR can happen in as little as 1.1% of patients getting the procedure done each year according to Dr. Ali Ghanem’s published work in 2020, “A Systematic Review of the Literature of Delayed Inflammatory Reactions After Hyaluronic Acid Filler Injection to Estimate the Incidence of Delayed Type Hypersensitivity Reaction”. 

How many people with fillers have experienced a reaction after COVID-19 vaccination?

The good news is the number is super low! There have only been 3 reported cases that have occurred during vaccination with the Moderna and Pfizer vaccines. The great thing is all three cases resolved within 3 days of treatment. We do not know how many people have been vaccinated that have had dermal fillers without any incident.

How do you prevent getting swelling from fillers related to the COVID-19 vaccine?

To prevent reactions, you should wait 4- to 8-weeks between filler injections and vaccination and potentially longer for those with risk factors such as autoimmune or immunologic disorders, chemotherapy or immunomodulatory medications, and those with a history of sensitivity to dermal fillers according to the article “The art of prevention: COVID-19 vaccine preparedness for the dermatologist” by Dr. Arianne Kourosh.

Recommendations by the American Society of Plastic Surgeons and American Society for Dermatologic Surgery state that patients should be educated about the potential risks prior to receiving dermal fillers. Patients already treated with dermal fillers should not be discouraged from receiving vaccines of any kind. Dermal fillers should be administered by board-certified physicians who are experts in both the injection of dermal fillers and management of complications arising from them.

What should you do if you have a reaction?

First and foremost, call your doctor. 

If swelling of the face occurs you may be prescribed a short course of oral steroids, a medication that suppresses inflammation but does not appear to lessen the effectiveness of COVID-19 vaccines. Your doctor may also recommend injecting hyaluronidase, an enzyme used to dissolve filler, for swelling that does not improve.

Emil Shakov, MD, FACS is a board-certified general surgeon who is the medical director and one of the leading physicians at The Youth Fountain alongside his wife Doctor Rada Shakov, MD.(www.theyouthfountain.com) located in Freehold, New Jersey. He has been actively performing medical aesthetic procedures since 2013. Follow him on Instagram @theyouthfountain.

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