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What are DIY fillers and why should you avoid them?

What are DIY fillers and why should you avoid them

In recent months there has been a rise in botched DIY lip fillers. This DIY “lip filler” trend started a few years ago when people were trying the Kylie Jenner Lip Challenge in which people would insert their lips into a shot glass or other suction cup type tool, suck, and wait for their lips to swell up to an extremely unsettling plump. This challenge resulted in various injuries, heavy bruising and severe swelling.

While there are quite a few methods used for people to achieve a bit of a plump without needing the injections, such as quality lip plumping balms that involve nothing more than a few harmless ingredients such as capsaicin to slightly irritate your lips, in recent years people have been opting for more extreme measures to enhance the size of their lips at home or at clinics that offer a non invasive lip filler approach – the hyaluron pen.

The hyaluron pen can be easily purchased online and is available at certain non-medical day spas that advertise the treatment as a non-invasive and safer alternative to a traditional injectable lip filler. Unfortunately, consumer reports and emergency room visits prove otherwise, as there have been increasingly negative reviews and complaints on the treatment and its results, in addition to an official warning by the FDA to avoid these needle-free devices.

Due to the rise in reports of botched lips secondary to hyaluron pen treatments, there has been a lot of buzz on the treatment, giving the whole idea of the hyaluron pen bad press. The hyaluron pen has been used on other areas including the forehead, nasolabial folds (also called smile lines), marionette lines, and frown lines between the eyebrows, though the most frequently spoken about treatment area, especially when it comes to the buzz about botched results, remain to be the lips.

Below is a detailed description of what the hyaluron pen is, how it works, and why the FDA and countless physicians warn against it.

Let’s start with the real deal

Before we start going over all the details involved in the hyaluron pen, let’s discuss the original treatment: injectable lip fillers. How do lip fillers work? What are the pros and cons, and how much do they cost?

The first equivalent to modern injectable lip fillers was invented at the beginning of the 19th century and consisted of injectable fat, also called fat grafting. While this treatment was originally intended to reshape uneven lips caused by tuberculosis, it triggered a long path of trial and error leading to the injectable lip fillers we have today. You may still find some clinics that offer a fat transfer to the lips, however, due to its unreliable results that often end up migrating, lumping, and settling unevenly, it is typically no longer a common practice.

In the 1960s, liquid silicone began to make its mark in the world of cosmetic enhancements but was disapproved by the FDA fairly quickly (in the 1990s) due to the adverse effects associated with the injection of liquid silicone, including severe pain, scarring, tissue death, permanent disfigurement, silicone embolism, and sometimes even death. Keep in mind that nothing has to be FDA approved in order to still be legal, meaning that liquid silicone injections are still available in select clinics, though the injection of liquid silicone is heavily frowned upon by most medical professionals.

Today, the global gold standard for dermal fillers in the lips are hyaluronic acid based dermal fillers. They have been approved by European regulators in the late 1990s, but only saw the first FDA approval in April, 2004.

What makes hyaluronic acid based lip fillers injected through a needle or a cannula the gold standard? They are the safest type of filler you can get, and here’s why:

  • They are biocompatible. Hyaluronic acid is a naturally lubricating and hydrating substance found in our joints to make movement along various upper and lower body joints a seamless process. This means that the risk of allergy or rejection is essentially nonexistent than if someone was to be injected with an unnatural substance like polymethyl-methacrylate microspheres (the main ingredient in Bellafill filler), which would require allergy testing prior to injection.
  • They are reversible. Hyaluronic acid based dermal fillers are reversible, using hyaluronidase injections, which break up hyaluronic acid and immediately dissolve the dermal filler, reversing your lips back to their original form. This becomes a critical aspect in the event of an inadvertent intravascular injection resulting in vascular occlusion. Non-hyaluronic based dermal fillers currently have no agent for reversal.
  • There are multiple varieties of Hyaluronic Acid based fillers. While Juvederm is the most universally known hyaluronic acid based filler, there are numerous other brands of hyaluronic acid based dermal fillers, each of which is slightly different from the other. This allows physicians to tailor the fillers to each patient’s anatomy and desired results. Currently, FDA approved hyaluronic acid fillers on US market include brands like Juvederm, Restylane, Belotero, Revanesse and Teosyal. These families of fillers are further subdivided into various types, which are specifically designed for different purposes and treatment areas. This allows the injector to choose from a variety of biomolecular properties and formulations that will best suit the individual patient, rather than having to use a “one size fits all” type approach.
  • Their production is standardized. The manufacturing process of all hyaluronic acid based fillers are standardized, making them safe and predictable. All facilities producing fillers must comply with stringent GMP standards and are subject to annual inspections to ensure the quality and safety of hyaluronic acid gels.
  • Easy administration for physicians. Hyaluronic acid based dermal fillers are easier to inject and administer than other fillers due to their predetermined viscoelastic properties and their density, allowing the injections to be more precise during the treatment, which also results in a better, more individualized outcome for each patient. The viscoelastic properties are sometimes expressed as G prime factor, which essentially defines the elasticity of the fillers and their ability to retain shape when a certain force is applied.
    • A filler with a high G prime is a firmer gel allowing to define a specific shape owning to their rigidity. Juvederm Voluma or Restylane Lyft are prime examples and may be used in someone with thinner lips as the rigidity of gel will allow maintaining the newly established structure and shape of the lips.
    • A filler with a low G prime is a softer and more fluid gel making the enhancement more subtle and less noticeable.
  • High reproducibility and longevity. When physicians know the rheological properties of fillers and how they behave in tissues when injected it is easier to predict the expected outcomes. Some fillers are already fully hydrated meaning that they achieved their maximal expansion when loaded in the syringe. Such fillers will produce minimal swelling after injection because their hydrophilic ability is maxed out at the stage of manufacturing. RHA family by Teosyal and Juvederm Volbella are classic examples. Other fillers like Juvederm Ultra or Juvederm Ultra Plus are partially hydrated and may cause substantial initial swelling upon injection as they attract and incorporate extracellular fluid into the gel matrix. Knowing these parameters is crucial to guide patients’ expectations and post-injection recovery. Most of the fillers are also manufactured using advanced crosslinking technology, which makes them resistant to degradation allowing for a predictable duration of the results.

While hyaluronic acid based fillers are the best and safest dermal fillers used to inject the lips, the method used to plump people’s lips with hyaluronic acid using the hyaluron pen, is completely different. The short of the long: traditional lip injections are skillfully injected using a sharp, thin and hollow needle or a blunt cannula utilizing various techniques. This approach permits a precise and thought-out look that matches the patient’s lips and meets their individual needs. Through various clinical studies, it has been established that the only way to safely deliver a filler for aesthetically pleasing results involves the introduction of the needle or cannula under the skin to deposit the filler in a specific way or fashion. While minor bruising is one of the most common side effects it is very transient in nature without any long-term health-related consequences.

The hyaluron pen works by forcefully pressing an unknown type of hyaluronic acid into the lips with an immense amount of pressure, making it a needleless lip filler. To make more sense of how much pressure is being used for this treatment, you can compare it to that of a car tire, where the normal pressure is maintained at 32 – 35 PSI. The pressure used for the hyaluron pen is a shocking minimum of 1000 PSI. Continue reading for an in-depth discussion about the hyaluron pen, how it works, and why so many doctors warn against it.

What is a DIY lip filler?

A DIY or “do it yourself” filler is exactly what it sounds like: a lip filler that doesn’t require a trained medical professional to administer it. This sounds convenient, but how can you get a dermal filler into your lips without the help of a medical professional when you don’t know how to properly inject it? You don’t. The hyaluron pen gets the dermal filler into your lips not through a needle or cannula injection, but through the use of extreme pressure, which can not only be incredibly painful but also completely imprecise. Solely using pressure to press the filler into your lips requires no precision at all, which also leads to messy, but more importantly dangerous results.

When comparing the hyaluron pen to a traditional lip filler injection, the hyaluron pen is advertised to be a method that allows for a more even result, as it spreads the hyaluronic acid evenly throughout the treatment area.

What the hyaluron pen claims to do:

So what are the true dangers of the hyaluron pen?

While the hyaluron pen has been advertised as a safe and effective alternative to traditional injectable lip fillers, it turns out that the majority of patients are disappointed in their results. Some of the main side effects reported with this treatment were inflammatory skin reactions including small white bumps, discoloration and hyperpigmentation of the skin, as well as fungal and bacterial infections.

These recurring side effects were reported to the FDA, which led to a formal warning in October of 2021 against the use of “needle-free devices for injection of dermal fillers”.

According to the FDA, risks included in needle-free dermal fillers include:

  • Bleeding or bruising
  • Infection or allergic reaction
  • Transmission of disease (since one device is used, rather than a fresh sterile needle with each patient)
  • Blockage of a blood vessel (which can lead to tissue death, blindness, or stroke)
  • Scarring
  • Lumps and bumps
  • Discoloration and hyperpigmentation

Aside from the side effects associated with the treatment, the FDA also explains that the filler substances which are sold individually apart from the device used, may not even contain hyaluronic acids, meaning that you could be pressing literally anything, including harmful chemicals into your face. The fillers typically come from overseas where they have different regulations and manufacturing practices, and based on customer descriptions, the ingredients are never listed in English, meaning that most people in the U.S. have no idea what they are actually putting into their faces when using this tool.

Because the product is simply pressed into the treatment area, there is no control of how and where the filler is placed, leaving many patients with bumps and lumps around their lips and other areas in which they have used the hyaluron pen.

Another thing that is terrifying about this is that anyone can purchase it online and do it themselves at home without any medical background whatsoever. Instead, people are taking phony classes in apartments led by untrained and uncertified scammers to learn how to administer the treatment, which based on reviews and results (even if administered by medical professionals) have proven to be nearly impossible.

The American Med Spa Association warns that even though this treatment is legal and does not involve needles, the skin is still being pierced by the product, which means that at the very least it should be administered by a trained medical professional.

How much it costs:

The cost of the hyaluron pen ranges $100 to $500 depending on where you get it and what package you get. If you get a DIY kit that comes with lidocaine, filler, and the pen, the cost may be on the higher end of that scale. The pen itself can be purchased for as little as $99, with tiny filler cartridges that can be purchased for only $16. If you go to a clinic, the average cost is about $300 per session, and is said to last 6 – 12 months once two sessions are completed.

Hyaluron pen

Are there any benefits to the hyaluron pen?

Hypothetically speaking, the benefits involved in the hyaluron pen include:

  • Needle-free
  • Noninvasive
  • Cost-efficient
  • Easy administration (DIY)

However, if these were benefits that everyone went by without considering the dangers involved, we could also all be rubbing bleach on our faces to help eliminate hyperpigmentation. Fortunately, the word has spread about all the dangers involved in this DIY needle-free filler, and while it is not illegal, it seems that it is slowly decreasing in popularity as more and more people are starting to worry that such drastic side effects will happen to them.

Hyaluron pen injections

I still don’t want a traditional filler, what can I do instead?

While traditional injectable lip fillers are completely safe as long as they are performed by a trained and skilled medical professional, a lot of people still don’t want to get them due to fear of needles, or other reasons. Here are a few minimally invasive and non-invasive alternatives to an injectable hyaluronic acid lip filler that are both safe and effective.

  • Lip flip: A lip flip is a minimally invasive mini lip enhancement that involves the injection of a neurotoxin like Botox right above the lip. This causes the lip to flip upward, creating a plumper-looking pout. While this method is still an injectable, it does not physically add more volume to your lips. Instead, it creates the illusion of a slightly larger top lip. The cost of a lip flip can range anywhere from $120 – 300, making it an affordable and subtle alternative to a traditional lip filler.
  • Lip plumping balms: Lip plumpers are completely non-invasive and can be found in almost any pharmacy or beauty store. Lip plumpers have been around for a long time and work to plump your lips temporarily (about 20 minutes) by slightly irritating your lips due to ingredients such as capacisin and peppermint.
  • Lip scrubs: Lip scrubs can give you a temporary plump by exfoliating your lips and causing mild swelling in the process. While you should be careful as this can dry out your lips (so be sure to apply plenty of moisturizers after), it is generally safe as long as you don’t scrub too hard and will give you a temporary plump.
  • Stay hydrated: You may have noticed a difference between the size of your lips before and after you apply some lip balm to your dry lips. When our lips are dry, they tend to look smaller and lose their brightness. Try to stay hydrated and moisturize your lips to keep them fresh and naturally plump.

DIY lip fillers summed up:

The hyaluron pen has been advertised as a safe and effective alternative method to fill your lips with hyaluronic acid without using the traditional technique of injections. After multiple botched outcomes and bad reviews, the FDA released a warning to avoid this dangerous needle-free filler due to its array of possible risks and side effects, including bruising, swelling, lumps, bumps, clogged blood vessels, and more serious side effects including tissue necrosis. The hyaluron pen is not approved by the FDA, but is legally sold online and by certain providers at some day spas. People can administer the treatment on themselves at home, and are even offered courses online and in people’s personal homes by untrained individuals with no medical experience.

In order to avoid such serious side effects and all the risks involved in this treatment, if you want to enhance the size of your lips without getting a traditional dermal filler injected, there are other options safer than the hyaluron pen, such as a lip flip, lip plumpers, lip scrubs, and simple natural methods such as keeping your lips hydrated.


Needle-free lip fillers Needle-free lip fillers

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