January 19, 2025

Dermal Fillers & Lymphatic Drainage

We’ve all been told that dermal fillers are safe—and for the vast majority of patients, they are. But as I said in my recent podcast, the idea that fillers are completely risk-free is a myth.

One of the biggest issues we’re seeing now is the rise of Late-Onset Inflammatory Reactions (LOIRs). These are adverse reactions that occur months, or even years, after the filler has been injected.

Late-Onset Inflammatory Reaction LOIRS LOIRS Late-Onset Inflammatory Reaction

In my experience, these reactions often come down to a combination of factors:

  • The Immune System’s Role:
    Our bodies treat fillers as foreign objects. While most patients tolerate them well, certain triggers like illness, stress, or dental work can push the immune system over the edge, leading to inflammation.
  • Repeated Treatments:
    Patients who receive multiple treatments over time may experience a “stacking effect,” where their immune system starts to react differently to the filler.
  • Product Choices:
    Not all fillers are created equal, and poor-quality products are more likely to cause issues.

I’ve seen this play out in my own practice. Patients who’ve had fillers for years suddenly develop lumps or swelling. They came to me panicked, asking, “What’s happening to my face?”

The truth is, this is an industry-wide issue, and we need to be proactive in addressing it.

What Does This Mean for Us as Injectors?

If you’re an injector, you need to take these risks seriously—not just for your patients’ safety, but for your own reputation and peace of mind.

Here are some key takeaways I shared on the podcast:

  1. Be the Educator, Not Just the Injector
    Patients trust you to guide them, not just to perform a procedure. I always explain to my patients that fillers are not a “set-it-and-forget-it” treatment. Adverse events can happen, and being upfront about this builds trust.
  2. Understand the Immune Response
    As I mentioned in the discussion, fillers can spark an immune response, especially in patients with pre-existing conditions or those who are under physical or emotional stress. Ask detailed questions during consultations and don’t shy away from saying “no” if someone isn’t a good candidate.
  3. Adopt a Long-Term Mindset
    One of my biggest theories is that as injectors, we need to think beyond the immediate results. What happens to this filler six months, a year, or five years from now? Are you prepared to manage complications?
  4. Stay Informed About Research
    The article we discussed in the podcast is a wake-up call. As our field grows, we’re going to see more data emerge about the long-term effects of fillers. Keeping up with this information isn’t optional—it’s essential. [Insert link to the Irish Examiner article here.]

The 3 Questions Every Injector Should Ask

Before injecting a single syringe, I believe we should all be asking these three questions:

  1. Is this patient’s immune system in a stable state?
  2. Am I using the best product for this patient’s needs?
  3. Do I have a plan for managing complications if they arise?

If you can’t confidently answer “yes” to all three, you need to pause and re-evaluate.

Aesthetics Consultation Male

Why This Matters for the Future of Aesthetics

This isn’t just about preventing lumps or swelling. It’s about safeguarding the integrity of our industry.

As I shared in the podcast, our role as injectors isn’t just to provide treatments—it’s to educate, protect, and advocate for our patients. This is how we earn their trust and keep our practices thriving.

But it starts with us. We need to take responsibility for understanding the risks, staying ahead of the research, and being prepared for the unexpected.

Final Thoughts: Don’t Let Complacency Put Your Practice at Risk

The world of aesthetics is evolving, and so are the challenges we face as injectors. But challenges also bring opportunities—to learn, to grow, and to set ourselves apart as leaders in the field.

So here’s my advice:

✅ Educate your patients about the risks of fillers.
✅ Stay informed about the latest research.
✅ Be ready to handle complications with confidence and care.

Your patients are trusting you not just with their appearance, but with their health and well-being. Let’s honor that trust by being the best injectors we can be.

P.S. Want to learn more about how to lower your risk of complications? Get my ULTIMATE complications guide here >>

Aesthetics Mastery Show

COSMETIC FILLERS LINKED TO SERIOUS HEALTH RISKS?

Is it true or scare tactics by media!?

Watch the full Aesthetics Mastery Show here.

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Dr Tim Pearce eLearning

Dr Tim Pearce MBChB BSc (Hons) MRCGP founded his eLearning concept in 2016 in order to provide readily accessible BOTOX® and dermal filler online courses for fellow Medical Aesthetics practitioners. His objective was to raise standards within the industry – a principle which remains just as relevant today.

Our exclusive video-led courses are designed to build confidence, knowledge and technique at every stage, working from foundation level to advanced treatments and management of complications.

Thousands of delegates have benefited from the courses and we’re highly rated on Trustpilot. For more information or to discuss which course is right for you, please get in touch with our friendly team.

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