A complete guide to making an informed decision
Introduction
Hyaluronic acid injection is today one of the most performed aesthetic medicine procedures in the world. Lips, cheekbones, under-eye hollows, nasolabial folds, temples — the indications are numerous and the results can be remarkable. Yet between the promises of social media and medical reality, there is a considerable gap. Before taking the plunge, understanding what hyaluronic acid really is, how it works and what risks are involved is essential to making a fully informed decision.
🩺 Dermotips
Nasolabial folds are the lines that run from the sides of the nose down to the corners of the mouth. They are also called « smile lines » or « laugh lines. » They naturally deepen with age as the face loses volume and elasticity.
What is hyaluronic acid?
Hyaluronic acid is a molecule naturally found in our body — in the skin, joints and eyes. Its main role is to retain water: a single hyaluronic acid molecule can hold up to 1,000 times its weight in water. This is what gives skin its volume, elasticity and radiance.
With age, the body’s natural production of hyaluronic acid gradually decreases. The skin loses volume and firmness, hollows appear, and wrinkles deepen. Hyaluronic acid fillers — synthesised in a laboratory with a structure identical to that produced by our body — make it possible to restore this lost volume in a natural and reversible way.
A recent clinical study evaluating an injectable high molecular weight hyaluronic acid formulation in 86 participants demonstrated significant improvements in skin elasticity and recovery four months after a single injection (Efficacy and Safety of a Stabilized Composition of High Molecular Weight Hyaluronic Acid, PMC, 2024).
Treatment indications
Hyaluronic acid injections cover a wide range of aesthetic indications:
Wrinkle and fold correction — nasolabial folds and lip lines are among the most commonly treated areas. A randomised double-blind clinical trial published in the Journal of Dermatological Treatment in 2023 confirmed the efficacy and safety of hyaluronic acid fillers in the treatment of nasolabial folds (Li X.Z. et al., 2023).
Facial volume restoration — cheekbones, temples, chin and jawline can be redefined with volumising injections. A systematic review and meta-analysis on augmentation of the mid-facial region confirmed the efficacy of hyaluronic acid fillers with a satisfactory safety profile (PMC, 2025).
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The mid-facial region refers to the central third of the face: the cheekbones, cheeks and under-eye area. This is the zone that gives the face its contour and youthfulness — and one of the first areas to hollow with age.
Under-eye hollow correction — injections in the sub-orbital region correct hollows and a tired appearance. A meta-analysis of 2,556 participants reported an overall satisfaction rate of 91% after hyaluronic acid injection in this area (Liu X. et al., Aesthetic Plastic Surgery, 2024).
🩺 Dermotips
The sub-orbital region is simply the area directly beneath the eyes — where hollow dark circles form. It is a particularly delicate zone to treat, as the skin there is very thin.
Skin quality improvement — superficial micro-injections (known as the skinbooster technique) improve hydration, radiance and skin texture. A prospective study published in the Journal of Cosmetic Dermatology in 2024 demonstrated that hyaluronic acid gel micro-injections are safe and effective for improving the quality of ageing skin (Lee J.H. et al., 2024).
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A skinbooster is a very superficial injection technique using a highly fluid form of hyaluronic acid. Unlike classic fillers that restore volume, a skinbooster hydrates the skin from within to restore radiance and suppleness.
What happens during a session?
A prior consultation is an essential and non-negotiable step. It allows the practitioner to assess your anatomy, understand your expectations, inform you about realistic results and ensure the absence of contraindications.
On the day of the session, a numbing cream is generally applied 30 to 45 minutes before the procedure. Injections are performed using a fine needle or a cannula, depending on the area treated and the practitioner’s preference. The session typically lasts between 20 and 45 minutes.
Immediate after-effects are usually mild: redness, slight swelling and sometimes small bruises at the injection site. These effects generally disappear within a few days.
Expected results
Results are visible immediately after the session, although the final outcome is best assessed after a few days, once the swelling has subsided. The duration of effects varies depending on the areas treated, the type of product used and the patient’s metabolism — generally between 9 and 18 months.
Hyaluronic acid has a considerable advantage over other fillers: it is reversible. In the event of an unsatisfactory result or complication, an enzyme called hyaluronidase can be injected to dissolve the product quickly.
Risks and how to minimise them
A systematic review published in Aesthetic Plastic Surgery in 2024 concluded that hyaluronic acid fillers are generally safe and effective, with the vast majority of adverse effects being transient and mild to moderate in intensity. Severe complications, although rare, do exist (Kyriazidis I. et al., 2024).
The most common risks are minor: bruising, swelling, temporary asymmetry. Serious complications — vascular occlusion, skin necrosis, vision loss — are rare but real, and occur almost exclusively when procedures are performed by untrained or non-medical operators.
🩺 Dermotips
Skin necrosis is the destruction of skin cells due to a lack of oxygen. In the context of injections, it can occur if the product is accidentally injected into a blood vessel and blocks circulation. This is why only a physician trained in managing such complications should perform this type of procedure.
The golden rule: never get injected by someone who is not a doctor. In most countries, dermal filler injections are regulated by law and constitute medical acts reserved for doctors or authorised healthcare professionals. Check the regulations in your country before taking any steps.
Questions to ask before you start
Before any injection, ask your practitioner these questions:
— What is your training in aesthetic medicine?
— Which product are you using and why is it the right choice for my situation?
— Do you have hyaluronidase available in case of a complication?
— What will the after-effects look like and how long do they last?
— When can I resume normal activities?
— What happens if I am not happy with the result?
A serious practitioner will take the time to answer all of these questions without rushing you.
Conclusion
Hyaluronic acid injection is a safe and effective aesthetic medical procedure when performed by a qualified physician, following a thorough consultation and using certified products. It is neither a trivial act nor one reserved for the privileged few — it is a personal medical decision that deserves careful thought and informed research. If you are considering this procedure, consult a trained dermatologist or aesthetic physician who will guide you towards the most natural and appropriate result for your face.
Scientific references
1. Lee J.H. et al. — The efficacy of intradermal hyaluronic acid filler as a skin quality booster — Journal of Cosmetic Dermatology, 2024. https://pubmed.ncbi.nlm.nih.gov/37705328/
2. Kyriazidis I. et al. — Systematic review on HA filler safety — Aesthetic Plastic Surgery, 2024.
3. Li X.Z. et al. — Randomized double-blind clinical trial on nasolabial folds treatment — Journal of Dermatological Treatment, 2023.
4. Liu X. et al. — Meta-analysis on HA filler for tear trough (2,556 patients) — Aesthetic Plastic Surgery, 2024.
5. Efficacy and Safety of a Stabilized Composition of High Molecular Weight Hyaluronic Acid — PMC, 2024.
6. Systematic review on mid-facial augmentation with HA fillers — MDPI Medicine, 2025.