The body’s immune system is wonderfully complex.  It protects us from all sorts of foreign invaders.  The system recognizes when things we aren’t born with get into our bodies, then tries to isolate, repel, and destroy them.  Fantastic!  We need that to survive.

Vaccines are used to boost our natural immune responses.  In the FDA vaccine trials, a small number of people who received the Moderna COVID-19 vaccine developed swelling in areas of their faces where they had facial fillers.  Here’s what you should know.

Anything that triggers an immune response creates some degree of inflammation.  This includes viral and bacterial illnesses, vaccinations, and even dental procedures.  An immune system on high alert recognizes and combats foreign substances in the body, including cosmetic facial fillers.

In the Moderna vaccine study trial, three people out of 15,184 who received at least one dose of the vaccine developed lip or facial swelling in areas where dermal fillers had been placed.  No one in the placebo group of the trial experienced this type of reaction.

In all three patients the swelling developed within two days of receiving the vaccine.  One of the patients had received a facial filler treatment two weeks before receiving the vaccination.  One patient had received a facial filler 6 months before the vaccine.   It is unknown in the third patient how long before receiving the vaccine she had undergone facial filler treatment.  Interestingly, other vaccines, including seasonal flu vaccines, have also been associated with inflammatory reactions in people with dermal fillers.  So, this type of reaction is not unique to the Moderna COVID-19 vaccine.

We know that dermal filler inflammatory events are rare and occur with both hyaluronic acid (HA) and non-hyaluronic acid fillers.  The most commonly used fillers are made of HA.  Well-known brand names include Juvederm and Restylane.  The inflammatory events described in relation to the Moderna vaccine appear to be very similar to those that occur from other vaccinations and viral and bacterial illnesses.   The inflammation is temporary and responds to treatments like oral steroids and antihistamines.  If needed, hyaluronidase may be used to dissolve the HA product.  It also appears that the inflammation may respond spontaneously, without requiring treatment.

Recommendations regarding COVID-19 vaccinations and facial filler treatments

Given the low numbers of patients affected, and the relative ease of resolution of symptoms, the American Society for Dermatologic Surgery suggests:

• if you have been treated with dermal fillers, you should not be discouraged from receiving vaccines of any kind.  This includes COVID-19 vaccines as well as other routine vaccinations.
• if you have received any type of vaccination, you should not be discouraged from receiving dermal fillers.

As of today, we have not seen any reactions in our patients in our Fort Worth office.  For patients who receive facial fillers, it might be best to consider separation of at least 2 weeks between receiving filler and vaccination:

• if you received a facial filler, wait at least two weeks before receiving a COVID-19 vaccine.
• if you received a COVID-19 vaccine, wait at least two weeks before having a facial filler treatment.

Neuromodulators like BOTOX are not an issue

Neurotoxins like BOTOX and Dysport have not been reported to be involved with this type of inflammation.  BOTOX is a chemical, a drug.  Once injected, it does not stick around and occupy space.  Dermal fillers, on the other hand, are like small injectable implants.  They fill a particular space in the tissues and stay there for several months, if not years.  BOTOX doesn’t linger.  It does its thing, then dissipates away.