"Expression" is a hyaluronic acid product sold by Enhancement Medical, LLC. It had gained popularity as an off-label injectable facial filler, but due to increasing reports of adverse reactions, the FDA has released an official alert to avoid using Expression for this purpose.
“These events have included swelling, tenderness, firmness, lumps, bumps, bruising, pain, redness, discoloration, itching, and the development of hard nodules,” the FDA reported.
The FDA has also sent a warning letter to Enhancement Medical, LLC regarding various violations including Expression injectable being improperly marked as an "injectable filler."
Expression was originally approved in 2012 for use as an intranasal splint, to be used after surgery inside the nasal cavity.
Facial fillers are a popular way to temporarily improve the cosmetic look of one’s face. They can fill wrinkles, improve lip fullness, fill “marionette” lines between the nose and mouth as well as increase volume anywhere age has affected the face.
A number of FDA-approved facial fillers fillers use hyaluronic acid such as Juvederm and Restylane.
What makes hyaluronic acid fillers popular is that they are supposed to be reversible by using hyaluronidase, which allows the body to metabolize the gel in just 48 hours, reported Forbes.
Since it came on the market, Expression had worked its way into being used as facial filler off-label as an alternative to these other approved facial fillers.
One doctor advertised that Expression was superior facial filler because it could be used to treat a number of different areas of the face. Since it came in a larger syringe size than other fillers (1.5 cc’s instead of 1 cc), a single syringe could fill more areas.