HA fillers quickly metabolized , what to do?

Injectables
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Anonymous

July 27th, 2025 11:40

Patient description

25-7-27



Dear all,

few patients report that HA fillers fade very quickly and they often have used a variety of fillers in vain, especiaal on lips.


Amongst the reasons discussed are:

Genetic variability in enzymes ( I was told 1 in 2000)

Age and tissue turnover

Inflammation

Lifestyle factor like physical activity,

Mechanical factors like filler migration, increased movement of lips and muscles.

Biochemical and mechanical characteristics of the HA used

Incorrect perception of size of lips by patient.


Internet searches provide manufacturers information about durability of fillers, however in average patients, 

not in the few patients who metabolize HA quicker than others.


So what to do? And what to recommend?


Regarding lips switching to an HA product which is not meant for be used for lips, but for deeper structures. It may last longer, but the lip may not look as smooth as with a lip filler? And which one?


Does  anyone find one specific brand of lip filler lasting longer?


Switching to a Non - HA filler? and which one?


Referring patients for fat grafts or implants like gortex threads?


Please let me know your experience.


Kind regards


Case description

Dear all,

few patients report that HA fillers fade very quickly and they often have used a variety of fillers in vain, especially on lips.


Amongst the reasons discussed are:

Genetic variability in enzymes ( I was told 1 in 2000)

Age and tissue turnover

Inflammation

Lifestyle factor like physical activity,

Mechanical factors like filler migration, increased movement of lips and muscles.

Biochemical and mechanical characteristics of the HA used

Incorrect perception of size of lips by patient.


Internet searches provide manufacturers information about durability of fillers, however in average patients, 

not in the few patients who metabolize HA quicker than others.


So what to do? And what to recommend?


Regarding lips switching to an HA product which is not meant for be used for lips, but for deeper structures. It may last longer, but the lip may not look as smooth as with a lip filler? And which one?


Does  anyone find one specific brand of lip filler lasting longer?


Switching to a Non - HA filler? and which one?


Referring patients for fat grafts or implants like gortex threads?


Please let me know your experience.


Kind regards


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Prof Daniel CASSUTO

Plastic Surgeon, Italy

July 27th, 2025 15:42

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