Facial Fillers and a Rare Reaction to Covid & the Vaccine

This won’t affect most ~ if any ~ of you reading this post, but since many of us have had facial fillers, it’s definitely something to know. There is a potential but rare side effect of Covid and/or the Covid vaccine that has caused some people to have facial swelling at the location of their cosmetic fillers. While this reaction is not dangerous, it’s definitely both uncomfortable and not pretty. The good news is that it is also treatable.

One of the foremost national experts in both the study and the treatment of this inflammatory reaction is Charlotte Dermatologist Dr. Gilly Munavalli, who has been leading the way in understanding and treating this rare side effect. Dr. Munavalli has been working on this issue for since he saw his first patient with this 6 months ago, and has developed an arsenal of pharmaceutical-based treatments to alleviate the swelling quickly. 

You Have Questions, We Have Answers

Let’s clear up a few things so you aren’t panicking.

  • We’re not talking about Botox here, or any neurotoxin for that matter. This is only an issue with cosmetic hyaluronic acid fillers, the most common dermal filler injections used to add volume to the face worldwide.
  • This is a rare reaction; Dr. Munavalli and his team have seen or consulted on a limited number of cases in the past 6 months, spread out across the country and world.
  • The reaction has been seen across the types of Covid mRNA vaccines, and in fact, this reaction has been seen in response to other types of viral vaccines in the past, like that for the seasonal influenza virus. “This is not the first vaccine or the first time we’ve seen swelling at the filler site as a reaction,” said Dr. Munavalli.
  • It’s also happened with Covid, not the vaccine but the illness itself. Fillers are known to have an occasional reaction to bacteria or virus in the body. In fact, it’s been known to happen after a dental cleaning. “I always recommend patients separate by several weeks getting cosmetic filler injections from getting their teeth cleaned,” Dr. Munavalli advises.
  • This filler side effect isn’t like a thing you can just wait out though. Patients have experienced this reaction to fillers injected well over a year prior. Various types of cosmetic filler have various longevities in the body, from 8 months to 24 months for most patients. But how long filler lasts also depends on the individual, and it has been published to last 5 years or more in the body. “You can’t see it any longer, but it’s there” said Dr. Munavalli.

Get the Vaccine, Just Be Aware

In no way should this prevent you from getting a Covid vaccine. The risk of reaction is minimal and there are treatments that work within a day to address it. The virus is far more potentially dangerous to your health than this filler side effect. Plus, the same reaction has been seen with cases of Covid, so if you’re one of the very few who reacts that way, you may experience it whether you get the virus or the vaccine.

What Are The Treatments

Dr. Munavalli and DLVSC Nurse Practitioner Rachel Yang are both co-authors on the world’s first publication on this topic, and explained that there are actually several treatments to alleviate the facial swelling, and they tailor the treatment specifically to each patient’s medical history. Dr. Munavalli, who also has a degree in immunology from Johns Hopkins University, has been working on options and results on this issue since it came up with one of his patients during the Moderna trials.

Normally if we have a patient with an issue with their filler(s), we can dissolve the filler by injecting a different product in the area,” said Ms. Yang. That works for this swelling side effect as well, but isn’t as desirable as something that just addresses the reaction and doesn’t eliminate the filler.

Another option is to treat the swelling with steroids, which suppress the immune system and so reduce the inflammatory reaction. “The problem is that we don’t want to suppress the immune system when you’re given a vaccine” explains Ms. Yang. “The vaccine needs to work with your immune system to effectively mount an antibody response to combat the virus.”

Faced with this challenge, and his mission to find a solution, Dr. Munavalli reviewed hundreds of published scientific articles in Immunology, Dermatology, and cosmetic surgery and discovered novel pathway whereby using an ACE inhibitor, a drug commonly used for hypertension and high blood pressure, can suppress the reaction. “So far, it has worked in a majority of the cases in which I’ve been consulted. It’s proven very successful and worth a try in these situations” he said.

What Should You Do

First, don’t hesitate to get the vaccine if you have not already done so. Even if you have fillers. In all likelihood, you will not have this or any reaction. Also, don’t feel like you have to cancel your upcoming appointment for fillers (remember, it’s not botox, it’s just fillers). If you’ve had them in the past, or are ever planning to have them in the future, you could be one of the very few who sees some facial swelling to this or some unknown future Covid virus.

If you do experience swelling, gather your medical facts/records together (very important to have accurate records on your prior dermal filler treatments from whichever provider you use) and call your dermatologist or doctor for treatment right away. The ACE inhibitor should be prescribed by a physician or provider with experience. Fortunately, an option available in Charlotte and the metro area is to call DLVSC (704.375.6766) as they are literally the global experts on this right now. In early March, Dr. Munavalli’s findings were published by the American Academy of Dermatology, and he and Ms. Yang have had professional consults weekly from around the country and internationally.

Before you call though, make sure you have your medical records and facts gathered, as treatment needs to be tailored by patient, depending on any medical conditions. “Fillers are very popular, but your regular doctor may not realize that you’ve had them unless you say so” said Dr. Munavalli. “We’re trying to get the word out about both this side effect and the treatment, so patients don’t have experience the swelling for days and go through a lengthy medical work-up.” Armed with the right knowledge and in the right situation, a treatment option is available and the results have been quick.

Charlotte Office | Midtown Medical Plaza 1918 Randolph Road
Suite 550 Charlotte, NC 28207 704.375.6766

Monroe Office | Metro Medical Campus 1663 Campus Park Drive
Suite A Monroe, NC 28112 704.973.3650

Pineville Office | 10660 Park Road Suite 4150 Charlotte, NC 28210 800.626.6257



scoop team
This article was written by one of the many QC women who contribute to our website. They are out and about and around Charlotte digging up the latest & best scoop 🙂