Patient and Injector Perspectives on the Use of the Hyaluron Pen: A Population Based Study

BACKGROUND: Emerging do-it-yourself (DIY) trends in hyaluronic acid lip fillers have gained traction on most social media platforms. One popular trend involves using a “needle free” device, called the Hyaluron Pen, distributed mostly by non-medical professionals, which employs compressed air pressure to administer hyaluronic acid into the lips. However, plastic surgeons and medical agencies have raised concerns over this product due to the inability to control the depth of penetration and nonsterile methods of refilling the device. Currently, there is a lack of research investigating its usage and potential enduring complications. In this study, we aimed to explore both patient and injector perspectives and outcomes associated with the Hyaluron Pen. METHODS: Anonymous surveys were administered via Amazon Mturk in February 2024. Eligible participants were 18 years or older who had used the Hyaluron Pen in the United States. Perspectives on use of Hyaluron Pen were assessed through questions regarding Hyaluron Pen administration, distribution, costs, experiences, complications, and training. Data was analyzed using descriptive statistics. RESULTS: A total of 161 participants indicated using the Hyaluron Pen. A majority of the respondents (53.4%) learned about the Hyaluron Pen from social media. About 43% of participants indicated that licensed health professionals administered their Hyaluron Pen treatments, followed by physicians (36%) and self-administration (18.6%). Participants paid on average $536.80 per injection session and had about 47 treatments. Almost all participants (98.8%) rated their experience with the Hyaluron Pen as positive and would overwhelmingly (97.5%) recommend it to others. Most started using the Hyaluron Pen because of its ease of use (70.2%), to have fuller lips (53.4%), and its affordability over conventional injectable filler (47.8%). Common side effects included infection (39.8%), bleeding/bruising/swelling (34.8%), gross asymmetry (31.7%), and scarring (31.7%). Concerningly, 79% developed complications from the Hyaluron Pen that resulted in either hyaluronidase injections (59.1%), corrective surgery (48.8%), emergency room visit (37.8%), or hyperbaric oxygen treatment (24.4%). About 78% of participants with complications reported permanent disfigurement from the Hyaluron Pen and paid an average of $2493.90 out-of-pocket for corrective treatments. Individuals who administer Hyaluron Pen indicated training from Hyaluron Pen courses (81.9%) and videos on social media (17.2%). Alarmingly, 15% of injectors do not counsel on any potential complications. DISCUSSION: While the allure of the Hyaluron Pen may be enticing to consumers seeking a quick fix for achieving plump, youthful lips, self reported complications reported in this study justify growing concerns from the medical community. This study highlights the need for further comprehensive research, strict regulatory oversight, and plastic surgeon-led initiatives against its usage and distribution to safeguard the well-being of patients seeking cosmetic enhancements.