Safety of Storing and Reusing Hyaluronic Acid Fillers: A Retrospective Chart Review

Injectable dermal fillers are an integral component of cosmetic dermatology for soft tissue augmentation. Many patients request intermittent, subtle augmentation that does not require use of the complete syringe of filler material. The ability to safely store and reuse dermal fillers is of paramount importance to the cosmetic dermatologist. We investigated potential infectious complications associated with the reuse of hyaluronic acid (HA) dermal fillers stored in a medical-grade refrigerator. We performed a retrospective review of patient records for infectious complications associated with the use of stored HA fillers (Restylane and Juvéderm Ultra Plus) from January 1, 2007, to May 31, 2009. No infections were associated with the reuse of stored HA fillers. The number of syringes reused during this time period was 83 of Restylane and 199 of Juvéderm Ultra Plus. Patients were retreated at mean days of 190 (72456 days) and 195 (52490 days) with stored Restylane and Juvéderm Ultra Plus respectively. Even with subsequent reuse, 12.9% of the stored Restylane and 13.6% of the stored Juvéderm Ultra Plus syringes were incompletely used and discarded after 1 year of storage or upon their expiration date. This large-size, retrospective study shows that there is minimal risk of bacterial infection associated with the use of stored HA fillers.