It replaces what the body stops making. It is a substance of our own whose job is to hold water; as it decreases with age, wrinkles, folds and loss of firmness appear.
The session takes about 15 minutes, with anaesthetic cream, and the effect is immediate — although the final result is seen a few weeks later, once the product has integrated into the tissue.
It is used in very different areas: lips, cheekbones, tear troughs, the nasolabial fold, the smoker’s lines, marionette lines, chin and jawline, non-surgical nose reshaping and deep hydration.
It lasts between 8 and 14 months, less in mobile areas such as the lips; a review is usually planned between 6 and 12 months.
It is reversible: if necessary, hyaluronidase dissolves the product safely. The usual effects — mild swelling, redness or small bruises — are temporary.
At the Instituto de Cirugía Plástica del Mediterráneo (ICPM) in Valencia we are specialists in hyaluronic acid treatments, one of the most sought-after techniques in facial aesthetic medicine today. Their efficacy, safety and immediate results have made this procedure an essential tool for anyone looking to improve their appearance without surgery. In this article we explain clearly and professionally everything you need to know about hyaluronic acid treatments: what it is, how it works, which areas can be treated, what results you can expect, and why choosing a clinic like ICPM makes the difference.
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What is hyaluronic acid and why is it used in aesthetic medicine?
Hyaluronic acid is a substance that occurs naturally in our body, particularly in the skin, the connective tissue and the eyes. Its main function is to hold water, which keeps the tissues hydrated and full. Over time its presence in the skin decreases, which leads to wrinkles, folds and loss of firmness.
Aesthetic medicine makes use of the properties of hyaluronic acid by applying it to specific areas of the face through micro-injections. It is a non-surgical, minimally invasive treatment with results visible from the first moment, which corrects, hydrates or rejuvenates the skin in complete safety.
These are two treatments that are often confused and that work on different things. Botulinum toxin acts on the muscle: it temporarily blocks the nerve signal reaching it and relaxes the repeated contraction that gradually marks the dynamic lines — forehead, frown area and crow’s feet. Hyaluronic acid acts on volume: it is placed beneath the fold and lifts it from within, which is what is wanted in the cheekbones, the tear troughs, the nasolabial fold, the lips, the chin or the jawline. That is why they are not in competition: in many cases they are combined, each on its own ground. Diagram by the Instituto de Cirugía Plástica del Mediterráneo, simplified for explanatory purposes.
Which areas can be treated with hyaluronic acid?
At our clinic in Valencia we take an integrated, individual approach with every patient. These are the areas where we most often apply hyaluronic acid:
Lips: adding volume, defining the border, correcting asymmetry, deep hydration and improving a gummy smile.
Cheekbones: projection and restoration of volume in the middle third of the face.
Tear troughs: filling the tear trough for a more rested look.
Nasolabial fold: softening the folds between the nose and the corners of the mouth.
Perioral lines: treating the vertical lines known as “smoker’s lines”.
Marionette lines: correcting the folds that run down from the corner of the mouth towards the chin.
Chin and jawline: defining the lower profile of the face.
Non-surgical nose reshaping: modifying the bridge of the nose without surgery.
Facial mesotherapy: deep hydration, better skin quality and prevention of ageing.
What is the treatment like and what can I expect?
Hyaluronic acid treatments at ICPM are carried out in the consulting room, with no need for a hospital stay. The procedure takes roughly 15 minutes. In most cases a topical anaesthetic cream is used, which makes it practically painless. Once the product is in place the effect is immediate, although the final result is seen after a few weeks, when the product has fully integrated into the tissues.
Recovery is quick and does not interfere with the patient’s usual routine. There may be mild swelling or redness in the treated area, which settles within a few days.
The main benefits include:
Better hydration and smoothness of the skin.
Restoration of volume lost to ageing.
Softening of wrinkles and expression lines.
A natural result, without altering expressiveness.
A treatment that can be reversed if necessary.
How long it really lasts
«Between six months and a year» is the usual answer, and it falls short. There are trials that have followed patients for considerably longer.
A randomised split-face study — each side with a different formulation, which is the cleanest way to compare — followed 40 patients for 12 months treated in the nasolabial fold. The average severity of the fold started at 2.3 out of 4 and at one year was still 1.5–1.6: it is not that the effect lasted twelve months at full strength, it is that at twelve months there was still a measurable improvement on the starting point. And the three formulations compared behaved equivalently in the long run.
The most interesting part appears on retreatment. In an extension study at 18 months, between 94% and 100% of patients maintained an improvement of at least one point on their initial situation throughout the follow-up. And the practical detail: the top-up needed less than half the volume of the first session.
That is the logic of hyaluronic acid done well. The first session is the one that asks for the most product; from then on it is maintained with small quantities, and that is why the result need not look «filled» or build up over the years.
Which types of hyaluronic acid do we use?
At ICPM we work exclusively with products of the highest quality and proven efficacy. We use the world’s leading brands: Juvederm® and Teoxane®, recognised for their safety record, their technological innovation and their clinical results. Each offers a specific range for each facial indication, which allows the treatment to be tailored precisely.
Choosing the right product depends on a number of factors: the depth of the wrinkle, how hydrated the skin is, the elasticity of the tissue and the patient’s goals. Only an experienced professional can make that assessment, with specific training in filler techniques and a thorough knowledge of the anatomy.
Choosing the right clinic is not merely important: it determines the quality of the result and your safety. At ICPM we bring together every criterion of medical excellence, clinical experience and ethical rigour that a procedure in advanced aesthetic medicine demands.
Some of the reasons our patients choose us:
Proven experience: years of practice and continuous training in advanced techniques of facial aesthetic medicine.
Up-to-date medical technology: we work with the latest generation of products and protocols.
Individual assessment: every treatment is adapted to the patient’s characteristics and goals.
A safe clinical setting: all our procedures take place in an accredited healthcare environment.
Post-treatment follow-up: we look after every stage of the process, from the first consultation to the final check of the results.
Risks and complications: what is worth knowing before being injected
Hyaluronic acid is a resorbable filler with a favourable safety profile, but it is a medical procedure and it has complications. Knowing about them is not a reason not to be treated: it is what allows you to choose carefully who treats you and to react in time if something does not go as it should.
What is to be expected after a session — redness, swelling and the odd mild bruise that settle within days — is not a complication. What follows is.
Vascular occlusion is the emergency
If the product enters a vessel or compresses it, the blood supply to the area is interrupted. It is uncommon, and it is the serious complication of fillers. In its most severe form it can affect vision.
A review of the world literature identified 48 new cases of visual loss between January 2015 and September 2018. Hyaluronic acid was involved in 81.3% of them, and the most frequent injection sites were the nasal region (56.3%), the frown area (27.1%), the forehead (18.8%) and the nasolabial fold (14.6%). Only 20.8% recovered their vision completely. These are figures that explain why certain areas demand anatomical knowledge and are not treated just anywhere.
Signs that mean you must get in touch immediately:
pain out of proportion during or after the injection;
pallor, mottling or a change in the colour of the skin in the area;
eye pain or any change in vision.
Faced with a change in vision, go to A&E, without waiting. Do not treat it at home and do not massage the area on your own initiative.
Nodules and late reactions
These can appear weeks or months later. A consensus published in 2024 places these late reactions usually between three and four months after the injection, although occasionally they appear much sooner, and describes three possible causes: the physicochemical characteristics of the product, an infection or biofilm, and an immune imbalance in the patient — an autoimmune disease or a recent viral infection, for example.
The management is not the same in every case, and that is why it is assessed individually: that same consensus reserves hyaluronidase for non-inflammatory reactions without active infection, proposes observation or a corticosteroid for inflammatory ones, and for infectious ones indicates drainage, culture and antibiotics rather than hyaluronidase. A lump is not dissolved by default.
Reversible: that is what sets it apart
Hyaluronic acid can be undone with hyaluronidase, an injectable medicine administered by a doctor. That is the fundamental difference from permanent materials and the main reason it is preferred: if the result does not convince, or if a complication appears, there is a way back. With a permanent filler there is not, and removal is surgical.
Book an appointment
You can book your own appointment. Pick the day and time from the free slots in the diary, in a panel that opens right here, without leaving this page.
Is the treatment painful?
No. In many cases we apply an anaesthetic cream that keeps the discomfort to a minimum. Modern products also contain lidocaine for extra comfort.
How long do the results last?
It depends on the area treated and the type of acid used. Usually between 8 and 14 months. In mobile areas such as the lips it tends to be somewhat shorter.
Can the treatment be reversed?
Yes. If necessary, hyaluronidase can be applied, an enzyme that dissolves hyaluronic acid safely.
When is a top-up recommended?
We usually recommend a review between 6 and 12 months, depending on how the product behaves in the tissue in each individual.
Are there side effects?
The most common are mild swelling, redness or small bruises. In general they are temporary and disappear within a few days.
Hyaluronic acid and responsible aesthetic medicine
One of the pillars of the way we work at ICPM is responsible aesthetic medicine. We believe that any facial treatment should seek harmony of the face, respect for the anatomy and an improvement in appearance without losing naturalness. That calls not only for correct technique but for a professional ethical judgement about when a treatment is genuinely needed and when it is not.
That is why at ICPM we take an integrated approach to facial rejuvenation. On occasion, hyaluronic acid can be combined with other techniques such as neuromodulators, thread lifts or biostimulators to achieve a more complete result, always safely and under control.
How to start your treatment at ICPM
The first step is to request an individual medical assessment. In that first consultation we will look at the areas to be treated, your aesthetic goals and your medical history, and we will offer you a specific treatment plan. The assessment is carried out by a specialist doctor with the appropriate training and proven experience.
You can book directly through our website or by telephone. We are in the centre of Valencia, in modern, accessible premises that meet every health regulation.
Hyaluronic acid treatments are an effective, safe and minimally invasive tool for correcting, hydrating and rejuvenating the face. At ICPM we have the people, the technique and the scientific grounding needed to deliver high-quality results with the greatest possible safety.
If you are looking to improve your appearance with a natural, discreet treatment carried out by experienced professionals in Valencia, we are here for you.
Prager W, Wissmueller E, Havermann I, Bee EK, Howell DJ, Zschocke I, Simon J.A prospective, split-face, randomized, comparative study of safety and 12-month longevity of three formulations of hyaluronic acid dermal filler for treatment of nasolabial folds. Dermatol Surg. 2012;38(7 Pt 2):1143-1150. PMID 22759250 — 40 patients, split-face: from 2.3 initial severity to 1.5–1.6 at twelve months, with the three formulations equivalent.
Narins RS, Brandt FS, Dayan SH, Hornfeldt CS.Persistence of nasolabial fold correction with a hyaluronic acid dermal filler with retreatment: results of an 18-month extension study. Dermatol Surg. 2011;37(5):644-650. PMID 21281385 — 94% to 100% maintained at least one point of improvement over 18 months; retreatment required less than half the initial volume.
Beleznay K, Carruthers JDA, Humphrey S, Carruthers A, Jones D. Update on Avoiding and Treating Blindness From Fillers: A Recent Review of the World Literature. Aesthet Surg J. 2019. PubMed
Baranska-Rybak W, Lajo-Plaza JV, Walker L, Alizadeh N. Late-Onset Reactions after Hyaluronic Acid Dermal Fillers: A Consensus Recommendation on Etiology, Prevention and Management. Dermatol Ther. 2024;14(7). PubMed
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