What does hyaluronic acid wrinkle filling involve ?
Wrinkle filling involves injecting hyaluronic acid, a naturally occurring skin component whose concentration declines with age. It is used as a gel of varying density according to the indication, to fill a fold, smooth a static wrinkle, deeply rehydrate or restore lost volume (cheekbones, chin, temples).
The procedure is quick (15 to 30 minutes) but never trivial. It requires precise assessment of the treated area, detailed facial anatomy knowledge and strict respect for contraindications.
Before any injection, certain precautions are essential to minimise risks, avoid side effects and optimise result longevity.
Why is consultation essential before hyaluronic acid injection ?
Before every wrinkle filler session, a thorough medical discussion is essential. Rather than an administrative formality, it is vital assessment time to review medical history (conditions, treatments, allergies), identify absolute or relative contraindications, analyse the aesthetic request realistically and establish a personalised treatment plan.
This consultation also transparently explains the protocol, possible after-effects and alternatives. Informed information is an ethical requirement, strengthening trust and safeguarding the process.
What should be avoided before hyaluronic acid injection ?
Some seemingly harmless substances may increase bruising, bleeding or local inflammation risks after injection. Unless otherwise indicated, discontinuing the following is therefore recommended :
- Non-steroidal anti-inflammatory medicines (ibuprofen, ketoprofen) : 4 to 7 days beforehand. Only after advice and according to the prescribing doctor's instructions.
- Anticoagulants (aspirin, Kardégic®). Only after advice and according to the prescribing doctor's instructions.
- Supplements containing ginkgo biloba, turmeric, vitamin E, garlic or omega 3, 5 to 7 days beforehand.
- Alcohol, at least 24 to 48 hours before the procedure, as it encourages vasodilation and therefore bruising.
Although not an absolute contraindication, smoking impairs healing and encourages inflammation. Reducing consumption in the days before the procedure is therefore preferable.
Finally, adequate hydration, a balanced diet and good-quality sleep help prepare the skin and optimise recovery after injection.
When should hyaluronic acid injection be scheduled ?
Some women's skin becomes more reactive according to hormonal or emotional state. Where possible, avoiding injections during menstruation is therefore advised (greater sensitivity, swelling or bruising risk), as is postponing sessions during significant tiredness or acute stress and planning ahead for important social or professional events. Ideally, injection should be performed 5 to 7 days before any occasion where bruising, swelling or redness would be inconvenient (a meeting, wedding, departure for a trip…).
The aim is not to add burdens but to let the skin recover under the best conditions and allow patients to experience the procedure calmly.
Which treatments should be avoided before hyaluronic acid injection ?
Before injection, preparing the skin and avoiding certain treatments or procedures is important. In the preceding days, abrasive or heat-based treatments such as scrubs, saunas or microdermabrasion are discouraged because they weaken the skin. Vigorous massage of the areas to be treated should also be avoided. Invasive dental procedures such as scaling, cavity treatment or implant placement may also increase cross-inflammation risk and should not be performed within two days before injections around the mouth.
Telling the doctor about any current antibiotic or antiviral treatment is also essential. In some cases, the session must be postponed, particularly for people prone to herpes outbreaks, to ensure safe, effective treatment.
Which skincare practices should be avoided before hyaluronic acid injection ?
In the days before hyaluronic acid injection, skin quality and stability significantly affect procedural safety and tolerance. A weakened skin barrier may increase side effects — particularly inflammation, irritation, post-injection discomfort or rarer complications such as delayed nodules.
In the 4 to 5 days before treatment, avoiding the following is therefore recommended :
- Exfoliating cosmetics, particularly those containing fruit acids (AHAs), retinol, benzoyl peroxide or salicylic acid.
- Abrasive or “detoxifying” salon treatments (mechanical scrubs, microdermabrasion, rotating brushes).
- Warming or purifying masks that may cause local microinflammation.
- Essential oil applications, which may sometimes be irritating or photosensitising.
Although perceived as “cleansing” or “revitalising”, these practices often disrupt the skin's protective hydrolipidic film and alter its microbiota, the bacterial ecosystem essential to local health. Temporary disturbance may sometimes encourage an inflammatory reaction after injection or complications such as delayed infectious biofilms — rare but well described.
A gentle, non-irritating cosmetic routine is therefore advised, centred on cleansing without harsh surfactants (such as syndets) ; physiological moisturising with non-occlusive, non-comedogenic products ; and daily sun protection.
What precautions should be taken before another hyaluronic acid injection ?
Before another injection, the patient's aesthetic history must be known, particularly : previously injected product types (hyaluronic acid, collagen stimulators, non-absorbable products) ; the last procedure date ; result evolution and any abnormal reaction (nodules, inflammation, asymmetry).
If a non-absorbable product (such as silicone or polyacrylamide) was previously injected — even abroad — this must be reported, as injection in those areas is contraindicated.
What preparation takes place before hyaluronic acid injection ?
Photographic documentation is systematically obtained before the procedure. It provides an objective medical record, evaluates pre-existing asymmetry, guides injection volume and depth and tracks result evolution over time.
A personalised treatment plan specifies areas to treat, hyaluronic acid types (density, cross-linking), planned quantities and the possibility of a touch-up at 15 days if needed.
What are the contraindications and precautions before hyaluronic acid injection ?
Some patients have particular medical backgrounds requiring increased vigilance before any hyaluronic acid injection. These situations are not always formal contraindications but may require protocol adjustment or temporary postponement.
Risk profiles include :
Patients with autoimmune diseases : conditions such as lupus, rheumatoid arthritis, Hashimoto's thyroiditis or scleroderma are not absolute contraindications. However, they require rigorous assessment of disease stability, current immunosuppressive treatment and recent symptom changes. No injection should be performed during an inflammatory flare, after a recent treatment change or when the disease is unstable. In well-controlled cases with effective, stable treatment, the procedure may be cautiously considered, prioritising the safest products, limiting treated areas and ensuring attentive follow-up. Dr Romano, however, does not perform injections in patients with an autoimmune background.
Patients taking anticoagulants or antiplatelet medicines : treatments such as long-term aspirin, Plavix®, Xarelto® or Eliquis® increase bruising or haematoma risk after injection, particularly in vessel-rich areas such as the tear trough or upper lip. These patients require individual risk assessment and must never stop treatment without advice from their GP or cardiologist. A temporary treatment interruption may be discussed in some cases. Technical adjustments such as microcannulas or more superficial injection may also reduce bleeding risk.
Patients with previous aesthetic complications : after a delayed allergic reaction to an injected product, inflammatory nodule, post-injection infection or difficult-to-correct asymmetry, detailed analysis of the product traceability record is essential. Benefits and risks require informed discussion, and in some cases a skin test or very low-dose trial injection may be offered.
