Cross‐sectional study of the microbiological safety profile of reusing hyaluronic acid fillers

Abstract

Hyaluronic acid fillers did not show any fungal or bacterial contamination after being opened and stored at room temperature in nonaseptic conditions. The possibility of reusing the remaining portion of the material in the syringe can be safe and economically viable.

Review of sterility of reused stored dermal filler

“…The two earlier studies that examined refrigerated collagen syringes showed growth of mainly skin flora such as Propionibacterium acnes and Staphylococcus epidermidis. Four out of the six microbiological studies that examined hyaluronic acid products showed no growth, using aerobic, anaerobic, and/or fungal culture media . The remaining two microbiological studies that examined hyaluronic acid products showed growth of skin/oral flora in less than 15% of the samples .…”

“…The details of the included studies are shown in Table . Seven of the nine studies examined hyaluronic acid products while two studies examined collagen fillers . Few samples of calcium hydroxylapatite were included in one study .…”

“…Interestingly, the residual hyaluronic acid syringes in the two studies that showed bacterial growth in this review were stored at room temperature for variable durations (months to years) . However, the only study included that stored hyaluronic acid syringes at different conditions in this review reported no growth in syringes stored at either room temperature or refrigerator . Immediate replacing needles used in injection with a sterile substitute before storage may be helpful in preventing retrograde contamination.…”

“…The finding of the current review showed that the reuse of stored filler syringes is not completely safe and can be associated with bacterial contaminations in small percentage of cases. On the other hand, several studies including the only study that examined the safety of stored hyaluronic acid filler syringes among patients recommend the reuse of stored filler . However, these studies suffer from methodologic limitations.…”

Hyaluronic Acid Fillers, Needle Contamination by Fastidious Microorganisms, and Risk of Complications

“…Most studies and reviews found no evidence of contamination associated with reused HA gel fillers regardless of concentration and original injection site and no correlation between length of storage time and contamination risk. 1,2,[11][12][13] Storage in original syringes at room temperature in nonaseptic conditions for up to 12 months likely increases the risk. 11 Regarding direct evidence of contamination-related adverse effects in injected individuals, a somewhat dated retrospective review reported no infection in the only subject-based study that looked for adverse events among individuals injected with HA from stored filler syringes.…”