5 Facts About Facial Fillers and the Covid-19 Vaccine

Aging is a beautiful part of life, but for many people it’s a process that they’re trying to slow down, especially when it comes to what we see in the mirror. Dermal fillers are a great way to renew that full, fresh look to your face without having to undergo surgery. These fillers are substances that are injected beneath the skin’s surface to add a dose of volume and plumpness, highlighting your unique, best features. They come in a variety of different brands and styles, like Juvederm, Belotero, Restylane, Bellafill, Radiesse, and Sculptra. All are great for helping to smooth out  unwanted lines and add volume in a way that looks and feels natural.

However, recent reports show that certain people that have had the COVID-19 vaccine (in all forms — Pfizer, Moderna, and Johnson & Johnson), had adverse reactions to dermal fillers, raising the question of whether or not it’s safe to get the COVID-19 vaccine if you’ve had dermal fillers. Dr. Hooman Khorasani breaks down the science behind what is going on between the vaccine and dermal fillers.

What are dermal (facial) fillers?

Dermal, commonly known as "facial fillers", come in a variety of different formulas and compositions, each of which is designed to correct a certain concern or treat a specific area of the face. Fillers essentially act as "synthetic collagen" that fills out areas affected by volume loss or enhance areas that have always been naturally deficient.

Injectable fillers are safe, FDA-approved, minimally invasive treatments. They are gel-like in texture and usually made with a naturally-occurring substance called hyaluronic acid. Our bodies naturally produce this, but with time, the natural production of hyaluronic acid begins to slow down. As we age, our face also loses a certain amount of fat, and collagen and elastin production slows down as well.

Injectable fillers temporarily reverse these natural signs of aging, and in the right physician's hands, provide natural-looking results.

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The concern behind dermal fillers and the COVID-19 vaccine

Back in December, the Food and Drug Administration (FDA) reported two cases of people who experienced facial swelling and one person with lip swelling after receiving the Moderna vaccine's phase three trial. There were a total of 7,255 females vaccinated; 3 patients developed reactions to previous filler treatments. One of these volunteers  had dermal fillers injected six months prior to the vaccine. The second person had dermal fillers injected two weeks before they were vaccinated. Both patients experienced swelling within two days of being vaccinated. A third person had swelling in the lips after being vaccinated. This person also had dermal fillers previously injected and reported similar swelling when receiving an influenza vaccine in the past or when having an influenza-like illness in the past.

These reactions caused confusion among people who had dermal fillers, creating a situation where many patients were unsure about whether or not it was safe to get the vaccine, dermal fillers, or both. Fortunately, this is something that doctors have seen before.

"What we saw is actually nothing new," said Dr. Khorasani. "This is something that can be observed anytime anyone has a dermal filler and comes down with something like the common cold, which is virally induced."

A study published in 2019 in the Clinical, Cosmetic and Investigational Dermatology journal confirmed that patients with facial fillers saw delayed reactions after being triggered by influenza-like illnesses.

"What happens is that whenever we get exposed to a virus, our body goes into high alert, so it tends to occasionally react to anything that is perceived as foreign," said Dr. Khorasani.

By the same token, occasionally certain vaccinations can also stimulate the body. It can stimulate the immune system and react with the filler, which is exactly what is happening with the COVID-19 vaccine and these few cases.

For patients who experience a reaction — which is a rare occurrence — they may notice swelling in areas that have been injected with filler, particularly the lips. It may be uncomfortable, and the area may likely be tender while it is swollen.

Is the reaction between the COVID-19 vaccine and dermal fillers dangerous?

The good news is that this is not a serious reaction and it resolves itself typically within two weeks. Patients may be able to resolve the swelling and tenderness more quickly with a dose of oral Prednisone. However, this medication should only be used in cases where the swelling is debilitating as use of anti-inflammatories post vaccination may reduce your body's ability to mount a good immunity against the virus.  

"The important message to give out is that this can happen, but it's not unique to the COVID-19 vaccine. It can occur with other vaccines and other naturally occurring viral infections. You may feel uncomfortable, but it's typically short lived. The take home is that it is not something super serious," said Dr. Khorasani.

Should I still get the COVID-19 vaccine even if I've recently had dermal fillers?

"I 100% encourage you to get the vaccine," assured Dr. Khorasani. If a patient has the rare swelling reaction after receiving the vaccine, Dr. Khorasani notes that you do not want to take an anti-inflammatory medication if you recently had the vaccine or plan to have it, as it may decrease the vaccine’s efficacy. The most important thing is to build up a good antibody response to the vaccine before taking any anti-inflammatory medications.

How should I take care of COVID-19 vaccine filler swelling?

"The best approach is to start by icing as soon as possible. I recommend using ice packs for 10 minutes on the hour, around the clock. Keeping the treated areas cool help both with the discomfort and swelling. "The majority of the time icing is all that is needed," Dr Khorasani notes.

What are some medical treatments for COVID-19 vaccine filler swelling?

If the pain is severe it's important to see a dermatologist for proper medical management. Medical treatments include systemic steroids, oral antihistamines, and local steroid injections. Local steroid injections have slower systemic absorption and therefore, may be more favorable in a setting of vaccine immune stimulation. In rare cases, the filler may have to be dissolved with an enzyme called Hyaluronidase.

Which filler is the safest if I am planning on getting a COVID-19 vaccine?

HA-type fillers are the fillers most often associated with viral induced or vaccine induced facial swelling. Biostimulatory fillers such as Sculptra and Radiesse are structurally different from HA-type fillers and have a theoretical reduced risk. Longer safety data and reporting of specific filler brands will be needed in order to determine which fillers are least vaccine reactive. The "filler" which will have the least chance of reacting to the vaccine is your own fat. Fat transfer is a safe alternative to filler injections and may be a good option in patients who are looking for a longer lasting filler, and planning on getting the Covid-19 vaccine.

For more information on fat transfer visit our procedure page.

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Questions? Follow-ups?

If you have any questions regarding your dermal fillers and the COVID-19 vaccine, or any other type of reaction with dermal fillers, do not hesitate to call our office. A consultation with Dr. Hooman Khorasani is the best way to find out if Facial Fillers are right for you. To expedite a consultation, message us, or call our Manhattan office at: 212-230-3378. Dr Khorasani and his highly-specialized team look forward to working with you to transform your medical and aesthetic goals into reality.