Chin, Temple and Nose Filler: Which Areas Have a Label, Which Are Off-Label, and the Risks

Chin, temple and nose filler: which areas have a label?

In the US FDA database, chin and temple filler have hyaluronic acid products with a recorded use, and nose filler has no record at all [2][3][5]. For the chin, the database records Juvederm Voluma XC (2020), Restylane Defyne (2021) and Restylane Lyft (2025), in adults over 21 [2][3][4].

For the temples, it records Juvederm Voluma XC (2023) for moderate to severe temple hollowing and Restylane Contour (2026) [2][3]. The FDA also recorded that Restylane Contour for the temples is distributed only to providers who completed a device-specific training programme [3], and approved a device-specific training programme for Voluma XC for the temples in 2024 [2].

For the nose, none of the 1,060 approval order statements for product code LMH contains the words nose, nasal or rhinoplasty [5]. The FDA page marked content current as of 07/06/2023 says the FDA recommends against filler in the glabella (between the eyebrows), nose, around the eyes, forehead or neck, and that the risks of unapproved uses are not known [1]. A 2023 review says any filler used in the nose is off-label and the patient should be told [9].

The Thai FDA (อย.) press release of 2023 gives the nose and chin among examples of where filler is used, but says each filler suits different areas and the details are on the label and leaflet [6]. US FDA records speak for US status, not Thai registration, so ask for the registration number and read the label of the product to be used. For brands, read [[filler-brands-compared]]. For the general picture, read [[what-is-filler]].

What is chin filler?

Chin filler is filler injected into the chin to change its profile, and in two randomised trials the common effects were tenderness, firmness and swelling at the site, mostly not severe [10][11]. Both trials enrolled people aged 22 or older with chin retrusion [10][11].

The first trial gave VYC-20L from Allergan to 192 participants. After the initial treatment, participants reported in diaries tenderness on touch (81.8%), firmness (75.1%) and swelling (68.5%), mostly mild to moderate and resolved within 1 week [10]. One participant had cellulitis and an abscess that needed hospital treatment with intravenous antibiotics and drainage, and recovered without lasting effects [10].

The second trial gave Restylane Defyne. It found treatment-related adverse events in 14% of people after the initial treatment, with a median duration of 4 days, all mild except one moderate injection-site pain [11]. There were two nodule events, one starting late, 53 days after treatment [11].

The two trials used different products, measured things differently, and were funded by the company that owns each product, so their numbers should not be compared [10][11]. The 2020 consensus puts chin injection in the lowest-risk group for blindness, but says even that group should be treated by trained people in a clinical setting [7]. For lumps and how long filler lasts, read [[filler-aftercare-lumps-duration]].

What is temple filler?

Temple filler is filler injected to correct temple hollowing, and an expert consensus puts the temples in a higher risk group than the chin [7]. Temple hollowing is a common change with age [8].

A 2019 review lists the temple as one of six facial danger zones with higher risk of vascular compromise, together with the glabella, the area under the eyes, the lips, the nasolabial folds and the nose [8]. Its author says the artery and vein that run through the temple must be avoided [8].

The 2020 consensus says high-risk areas, which include the temples, should be treated only by people with adequate training, up-to-date anatomy knowledge, and in a clinical setting with rapid access to medical staff [7]. That fits the training requirement the FDA recorded for products with a temple use [3][2].

The FDA says the most concerning risk of any filler is unintended injection into a blood vessel: the chance is low, but the result can be serious and permanent, such as tissue death, blindness and stroke [1].

What is nose filler?

Nose filler is filler injected to reshape the nose, which the US FDA recommends against, and an expert consensus rates the nose as very high risk for blindness [1][7]. A 2023 review calls it nonsurgical or liquid rhinoplasty and says using filler in the nose is off-label [9].

That review explains that filler entering a vessel can flow backwards along the arteries that supply the nose to the eye's blood supply and cause permanent blindness, and that nasal vessels vary widely between people [9]. Its authors conclude that injecting the nose is a high-risk procedure, not for a novice injector [9].

The same review reports a meta-analysis of 37 studies and 8,604 patients who had nonsurgical rhinoplasty: an overall complication rate of 2.52%, mostly bruising (1.58%), with vision loss in 0.09% and skin necrosis in 0.08% [9]. These are pooled figures from published reports, not any one person's risk.

In the cases of blindness from filler gathered in two earlier reviews by the consensus authors, the most common regions were the nose (56.3%), glabella (27.1%) and forehead (18.8%) [7]. The consensus puts the nose in its highest-risk group, to be treated only by people with extensive experience and full training, in a medical clinic [7].

What to ask the doctor before filler

Ask whether the product's label supports that area and what the clinic's plan is if filler enters a blood vessel [1][6]. The FDA advises discussing the injection sites and risks and reading the product's patient labelling [1]. The Thai FDA advises choosing a facility with a dermatologist on staff and checking the product's registration number [6].

The FDA says to seek immediate medical attention for unusual pain, vision changes, skin near the injection that looks white, gray or blue, or any sign of a stroke, during or shortly after the procedure [1]. Questions to prepare are below. For under-eye filler, read [[under-eye-filler-questions]].

• Which exact product will be used, what is its Thai FDA registration number, and does its label support the area? [6][1]
• If the area is not in the label's indications (for example the nose), how does the doctor justify it and explain the risks? [1][9]
• Has the doctor trained specifically for injecting this area, and will it be done in a facility that can handle an emergency? [7]
• If filler enters a blood vessel, what is the clinic's plan? [1]
• Which of my allergies to lidocaine, collagen, eggs or animal products, pregnancy, or bleeding disorders must I tell the doctor? [1]