Fillers and hyaluronic acid in Quebec: complete medical guide

Hyaluronic acid fillers have become one of the most sought-after treatments in aesthetic medicine in Quebec - and one of the most poorly supervised in actual practice. Between serious medical clinics, aesthetic centers operating in regulatory gray areas, promotions on social networks, and products of dubious origins, patients seeking reliable medical information often find themselves alone when faced with an opaque market.

This guide is a direct response to this problem. It covers the products legally approved by Health Canada, the areas treated with the techniques and the realistic results to be expected, the duration of the effects and what influences them, the real risks - including serious complications that many establishments prefer not to mention in their marketing - and realistic prices in a Quebec medical context in 2026.

Clinique Omicron performs hyaluronic acid filler injections in Brossard and Saint-Hubert within a complete medical framework, with prior consultation and documented follow-up. The information in this guide reflects our clinical approach.

Products approved by Health Canada in Quebec

Not all fillers are created equal - and not all fillers are legal in Canada. This is the first filter to apply before any other consideration.

The Canadian regulatory framework

Dermal filling agents - fillers - are a range of dermatological class III medical devices in Canada, subject to Health Canada approval prior to marketing. This classification implies a high level of control: manufacturers must demonstrate the safety and efficacy of the product through clinical data before obtaining a license. A filler used in Canada without Health Canada approval is a product outside the regulatory framework - and its safety, actual composition and manufacturing conditions are uncontrollable.

On social networks and in some non-medical establishments, fillers imported without Canadian approval are circulating under little-known brands, at prices far below market. This is not good business - it's a documented medical risk.

Approved ranges

Juvederm - Allergan (AbbVie)

The Juvederm range is the best-known and most widely used in Quebec. It includes several formulations of cross-linked hyaluronic acid, each developed for specific areas and injection depths.

Juvederm Ultra and Ultra Plus target lips and perilabial wrinkles - Ultra offers a softer texture for lips, Ultra Plus a slightly higher density for shallow to moderate nasolabial folds. Juvederm Voluma is formulated for volumetric restoration of the cheeks and malar region - a denser, more cohesive texture designed to be injected deep into the subcutaneous or superperiosteal planes. Juvederm Volbella is a more fluid formulation for fine corrections - lips with a natural result, superficial perioral wrinkles, sub-ocular region in certain cases. Juvederm Volux is the densest formulation in the range, developed for redefining the mandible and chin - an area that has seen a major expansion in demand in recent years.

The Juvederm range uses VYCROSS technology - a mixed cross-linking of hyaluronic acid chains of different molecular weights - which gives products long-lasting hold and a cohesion that limits diffusion into tissues.

Restylane - Galderma

Galderma's Restylane range is the world's other benchmark in hyaluronic acid. Its cross-linking technology - NASHA (Non-Animal Stabilized Hyaluronic Acid) for classic formulations and OBT (Optimal Balance Technology) for more recent formulations - produces products with different rheological properties to Juvederm, resulting in slightly different behavior in tissues and, for certain injectants, a preference depending on the areas and effects sought.

Restylane and Restylane Lyft target areas of moderate volumetric restoration - cheeks, furrows, temples. Restylane Kysse is specifically formulated for lips, with flexibility adapted to labial movements. Restylane Defyne and Refyne address moderate to severe wrinkles, with different flexibility properties depending on the depth targeted. Restylane Eyelight is a formulation developed for the sub-ocular region - a recent-generation product for an area requiring particular technical expertise.

Teosyal - Teoxane

Teosyal is a Swiss range developed by the Teoxane laboratory, whose main feature is the integration of an antioxidant complex - RHA (Resilient Hyaluronic Acid) in the latest formulations - designed to better resist degradation in a dynamic tissue environment. Teosyal's RHA formulations are particularly well-suited to highly mobile areas - lips, nasolabial folds - where other products sometimes show faster degradation.

Teosyal Global Action and Deep Lines target moderate to severe wrinkles. Teosyal Kiss is the lip formulation. Teosyal Ultra Deep and PureSense are used for volumetric areas. The Teosyal RHA range represents the brand's most recent innovation for dynamic areas.

What product choice means for you in concrete terms

For the majority of patients, the choice between Juvederm, Restylane and Teosyal is not a decision you make - it's a medical decision your doctor makes based on the area to be treated, the desired result, your anatomy, and his or her clinical experience with each product. What counts for you is to confirm that the product used is a Health Canada-approved product, of the right brand, stored under appropriate conditions and used before its expiration date. Your doctor should be able to show you or name the product used during the consultation.

Areas treated: lips, cheeks, furrows, hands

Hyaluronic acid fillers do not produce the same result in all areas - because anatomy, injection depth, appropriate volume and optimal techniques differ significantly depending on the area of the face or body being treated.

Lips - the most requested and technical area

The lips are the area for which requests have increased the most over the last ten years in Quebec, driven by social networking trends and increasing accessibility to treatments. It's also the area where technical errors are most visible - and most difficult for the patient to live with.

Labial injection can pursue several distinct objectives, depending on the patient's profile. The restoring lost volume is intended for older patients whose lips have thinned over time - the aim is to restore natural volume, not to increase beyond what existed. L’increase in a young patient aims to create volume that's never been so present - an area where restraint is clinically recommended, as excessive augmentation produces unnatural results that worsen with repeated injections. The redefining the vermilion edge restores the lip line that fades with age. The correction of lip asymmetry treats unevenness between the upper and lower lip, or between the two sides.

The labial injection technique varies according to the objective - retrograde linear tunneling, micro-bolus, fan-shaped injection - and must be adapted to individual anatomy. Labial vascularization is dense, and precise anatomical knowledge of the distribution of the superior and inferior labial arteries is essential to avoid vascular complications.

A natural lip result respects proportions: the lower lip should remain slightly fuller than the upper. A «duck» or «sausage» result is almost always the result of overcorrecting the volume of the upper lip - an avoidable technical error.

Cheeks and malar region - restoring the youth triangle

The young face has a triangular distribution of volume with the base upwards - prominent cheekbones, full cheeks above, defined mandibular line. With age, this triangle inverts: volume shifts downwards, cheekbones flatten, cheeks deepen at the top and become heavier at the bottom, accentuating jowls and furrows.

Volumetric restoration of the cheeks and malar region by deep injection of dense filler - Juvederm Voluma, Restylane Lyft - is one of the procedures that produces the most natural, structuring effects, because it corrects the cause of several signs of aging simultaneously. By restoring volume at the top, we attenuate nasolabial folds, subtly enhance the eyes, and restore a more youthful facial architecture without touching the areas directly concerned.

Cheek injections are performed deep down - at the supraperiosteal level or in the deep fat planes - with volumes generally ranging from 1 to 3 ml per side, depending on the degree of volume loss and the desired result. The deep technique is safer from a vascular point of view than superficial injections in a richly vascularized area.

Nasolabial and nasolabial folds

Nasolabial folds - the folds that run down from the wings of the nose to the corners of the mouth - are among the first signs of aging that patients wish to treat. It's also an area where results can be disappointing if treatment targets the fold directly without addressing its cause.

A pronounced nasolabial fold is rarely just a hollow in this area - more often than not, it's the consequence of a loss of volume in the cheeks and malar region, which allows the skin to sag downwards. Injecting filler directly into the furrow corrects the appearance locally but does not treat the cause - and can produce an artificial result if the added volume is disproportionate to the rest of the face.

Today's medical approach favors volumetric restoration of the cheeks first, followed by residual correction of the sulcus if necessary. This sequence produces more natural results and generally lasts longer.

Hands - an often overlooked but revealing area

Hands age visibly - the loss of subcutaneous volume with age reveals tendons and vessels, and the skin becomes thinner and more wrinkled. Hand rejuvenation with hyaluronic acid filler injection is a well-established technique that restores lost volume on the back of the hands, blurring the appearance of underlying structures and restoring a fuller, more youthful appearance.

The hand injection technique requires precise anatomical knowledge of the location of dorsal veins and arteries to avoid intravascular complications. The volume injected per hand generally varies between 1 and 2 ml, depending on the degree of volume loss. Results are visible immediately and can last 12 to 18 months.

Other areas treated in medical aesthetic medicine

Other areas can be treated with filler injections by an experienced doctor with specific training: the temples - loss of temporal volume is common with age, giving a hollow appearance and accentuating tired eyes - the sub-ocular region or valley of tears - a technically demanding area requiring specific products and a precise technique - the chin and mandible for redefining the oval of the face, and the nose for non-surgical correction of slight irregularities in very selected cases.

These advanced areas - particularly the temples, peri-ocular region and nose - require greater technical and anatomical expertise than that required for standard areas. Patient safety depends directly on the injecting physician's training and experience in these high-risk vascular areas.

Duration of results and maintenance

One of the least understood aspects of hyaluronic acid fillers is the actual duration of results - often optimistically presented in marketing communications and often experienced differently by patients.

The duration of a filler's effects depends on several interacting variables, and no precise prediction is possible for a given patient before the first treatment.

Product type and cross-linking. Denser, more cross-linked products - designed for deep volumetric areas such as the cheeks - tend to last longer than more fluid products designed for lips or superficial areas. Juvederm Voluma injected deep into the cheeks can last 18 to 24 months under optimal conditions. A lip filler typically lasts 6 to 12 months, sometimes less.

Injection area and tissue mobility. Areas subject to repeated, intense movement - lips, active nasolabial folds - degrade hyaluronic acid more rapidly than less mobile areas. This is a physical phenomenon linked to mechanical constraints on the gel matrix.

Individual metabolism. Some patients metabolize hyaluronic acid significantly faster than others - a well-documented clinical reality, but one that is difficult to predict before the first treatment. Physically active patients with a fast metabolism tend to degrade fillers faster.

Injection depth. Deep injections into the supraperiosteal or intramuscular planes tend to last longer than superficial injections into the dermis.

Injected volume. For the same characteristics, a larger volume tends to produce a longer-lasting, visible residual effect, even though hyaluronic acid degrades at the same rate.

Realistic ranges by zone

For cheeks and malar region with a dense volumetric product, 12 to 18 months is a realistic estimate for most patients - some will see results well beyond 18 months, others will notice a marked reduction at 12 months.

For nasolabial folds, A period of 9 to 15 months is realistic, depending on the product used, the injection depth and the patient's metabolism.

For lips, A duration of 6 to 12 months is the most honest estimate - the lips are the area where duration is shortest due to intense mobility and local vascularization.

For hands, In most cases, results tend to last 12 to 18 months.

The maintenance strategy - why regularity produces better results

A counter-intuitive aspect of fillers, but one that has been well documented clinically: patients who maintain regular follow-up - touching up before results disappear completely - generally achieve better results with less product over time than those who wait for results to disappear completely between sessions.

The reason is anatomical: when the filler is still partially present in the tissue, the touch-up works to complement an existing structure. When the filler has completely disappeared, the treatment starts from scratch - and the starting volume required is greater. For patients undergoing regular treatment for several years, doctors often observe collagen neostimulation in the treated areas - a long-term benefit of injections that helps maintain results between sessions.

The recommended frequency of touch-ups varies by area and patient - your Clinique Omicron doctor will propose a personalized maintenance plan based on your actual results after the first treatment.

Risks and serious complications

This is the most important section of the guide - and the one that non-medical establishments are most likely to omit from their communications.

Hyaluronic acid fillers have an excellent safety profile in medically qualified hands with rigorous anatomical knowledge. But serious complications do exist, are documented in worldwide medical literature, and continue to occur - almost exclusively in contexts of non-medical injection or inadequate technique. By understanding these risks, you can make a better choice of provider.

Common, benign side effects

Visit bruises at injection sites occur in a significant proportion of patients - more frequently on the lips and around the eyes, less in deeper areas. They disappear within 5 to 10 days. To minimize them, avoid natural anticoagulants - aspirin, ibuprofen, vitamin E, omega-3, alcohol - in the 48 to 72 hours preceding injections.

Visit post-injection swelling is expected, especially on the lips and under the eyes. It is most pronounced in the 24 to 48 hours following the injections, and gradually diminishes over one to two weeks. For the lips in particular, the «real» result can only be appreciated after two weeks, once the oedema has resolved.

Visit local pain during and immediately after injections is moderate and managed by injection techniques and topical anesthesia (EMLA cream) or local anesthesia (nerve blocks for the lips). Most modern products contain lidocaine integrated into the gel, which significantly improves injection comfort.

Visit palpable nodules - small irregularities under the skin - can occur, especially on the lips, when the gel concentrates in one spot rather than distributing itself evenly. In the majority of cases, they disappear spontaneously or resolve with gentle massage. If they persist, they can be treated with hyaluronidase injections.

The Tyndall effect - subocular blueing

The Tyndall effect is a complication specific to injections that are too superficial - in the shallow dermis rather than in the deeper planes. It manifests itself as a bluish tint visible under the skin, resulting from light scattering by hyaluronic acid molecules in the superficial layers. It occurs more frequently in the sub-ocular region and on the lips when the product is injected too superficially. It can be treated by hyaluronidase injection, but may take several weeks to resolve. It can be avoided by correct injection technique.

Vascular necrosis - a serious complication to be aware of

Vascular necrosis due to arterial occlusion is the most serious complication of filler injections, and potentially the most devastating. It results from the accidental injection of filler into an artery - or the compression of an artery by the volume of filler injected nearby - which obstructs blood flow to the tissues irrigated by this vessel.

What happens at the tissue level: tissues deprived of oxygen and nutrients begin to die within a few hours if the occlusion is not lifted. Without immediate treatment, necrosis progresses to irreversible skin lesions - scarring, tissue loss - and even serious visual complications if the artery involved communicates with the retinal circulation.

High-risk zones : the nose and nasolabial fold are statistically the areas associated with the greatest number of vascular necroses reported in the world literature - due to the vascular density and anatomy of arterial anastomoses in these regions. The glabellar region (between the eyebrows), temples and peri-ocular areas also present a significant risk. The lips carry a moderate risk, due to their rich vascularization.

Immediate warning signs : intense, disproportionate pain during or immediately after injection, skin blanching (pallor) in the injected area or at a distance - a sign of ischemia - purplish lividity or network discoloration, and eye pain or partial or total loss of vision are absolute medical emergencies. Every minute counts - treatment with high-dose hyaluronidase must be initiated immediately to lyse the filler and restore circulation.

How risk is minimized in a medical setting: a physician trained in aesthetic medicine with rigorous anatomical knowledge adapts injection zones, depths and techniques - aspiration before injection, slow injection, fractionated volumes - and has hyaluronidase on hand for immediate treatment if required. Hyaluronidase is the first-line treatment for vascular necrosis caused by hyaluronic acid filler - it must be immediately available in any facility performing injections, not ordered after the event.

A facility that does not have hyaluronidase available on site for immediate use should not perform filler injections. This is a non-negotiable safety issue.

Why this risk is higher in non-medical settings: non-medical practitioners generally don't have access to hyaluronidase - a prescription drug. They often lack the training to recognize the early signs of vascular necrosis. And they don't have the skills to manage an acute medical complication. This is the fundamental reason why filler injections outside a medical setting represent a risk that far outweighs the aesthetic benefit sought.

Blindness - the most catastrophic complication

Partial or total loss of vision following filler injection is the rarest and most catastrophic complication documented in medical literature worldwide. It results from occlusion of the ophthalmic artery or one of its branches by filler injected into an artery anastomosing with the retinal circulation - a phenomenon that can occur when injections are made into the glabellar, nasal, temporal or nasolabial folds.

Hundreds of cases of partial or total vision loss associated with filler injections have been reported in the literature worldwide - with an over-representation in non-medical practice settings and in countries with weak regulations. In Canada, cases have been reported, mainly associated with injections outside the medical setting.

This complication is mentioned here not to discourage patients from considering treatment, but to ensure that the decision to entrust such treatment to a qualified medical professional is fully informed.

Quebec prices - realistic range

Hyaluronic acid fillers are typically billed at by syringe in Quebec. A standard syringe contains 1 ml of product - the universal unit of measurement in this field. Some areas require one syringe, others two or three, depending on the volume required and the degree of correction needed.

Depending on the clinic, the preliminary medical consultation may be billed separately or included in the treatment price - check this when you book your appointment.

Price ranges per syringe in 2026

In medical clinics in Quebec, the price per 1 ml syringe of approved-brand hyaluronic acid filler is generally between 550 $ and 900 $ depending on the facility, region, product used and level of expertise of the injecting physician. Large urban areas - Montreal, Quebec City - tend towards the upper end of this range.

To estimate the cost of a complete treatment, multiply by the number of syringes required. A standard labial treatment typically requires 1 ml. Bilateral cheek treatment often requires 2 to 4 ml, depending on the degree of volume loss. Treatment of the nasolabial folds typically requires 1 to 2 ml. Hand treatment requires 2 to 4 ml for both hands.

Clinique Omicron's specific fees are available on cliniqueomicron.ca - they are clearly communicated to you during the medical consultation before any treatment is undertaken.

What justifies price variations

As with Botox, variations in filler prices between clinics reflect real variables. The cost to the clinic of purchasing the product varies according to the brand and the volumes ordered - an approved brand-name product costs more than one of dubious origin. The qualifications and experience of the injecting physician directly influence the price - and this difference is clinically justified, not artificially inflated. Whether or not post-treatment follow-up - a two-week review consultation - is included in the initial fee. And the operating costs of a complete medical clinic - medical records, safety protocols, complication management equipment, professional medical insurance - are significantly higher than those of a salon or spa.

Why mistrust of low prices is medically justified

A filler price well below the market range - under 400 $ per syringe in a context that presents itself as medical - merits direct questioning. Possible explanations are not very reassuring: product not approved by Health Canada, expired or poorly preserved product, dilution of the product to reduce the cost per syringe, or service performed outside the legal framework by an unauthorized practitioner.

The risk associated with filler of dubious quality is not limited to a disappointing aesthetic result - it includes late inflammatory reactions, chronic granulomas, bacterial biofilms and complications that may require complex medical interventions to resolve.

Rule of thumb: if the price of a syringe of filler seems unusually low, ask for the exact name of the product used, and check that it is licensed by Health Canada. A reputable establishment will not be reluctant to give you this information.

Frequently asked questions

The difference between Botox and fillers is often confusing - how can I tell what I need?

Botox works by relaxing the muscles that produce expression lines - it treats the muscular causes of dynamic aging. Fillers restore lost volume and fill in hollowed areas - they treat the loss of structure and subcutaneous adipose tissue. In practice, the majority of patients seeking overall rejuvenation benefit from both in combination, in different areas. Botox for the forehead, frown lines and crow's feet - fillers for the cheeks, furrows and lips if desired. Your medical consultation will help you define what is most appropriate for your anatomy and goals.

Can the filler be dissolved if I'm not satisfied with the result?

Yes - this is one of the significant advantages of hyaluronic acid over other fillers. The hyaluronidase is an enzyme that rapidly degrades injected hyaluronic acid - in most cases, the dissolution effect is visible within 24 to 48 hours. Total dissolution may require one or two injections, depending on the volume to be dissolved. It is also the first-line treatment in the event of vascular complications - which is why the immediate availability of hyaluronidase in the facility performing the injections is non-negotiable.

Are fillers covered by RAMQ or private insurance?

Aesthetic fillers are not covered by RAMQ. Some private insurers may partially cover therapeutic treatments in very specific cases, but most aesthetic indications are excluded from standard plans. The cost of filler injections may be eligible as a medical expense for tax credits under certain conditions - check with your tax advisor. A detailed medical receipt is provided with each treatment at Clinique Omicron.

At what age should I start using fillers?

There is no universal age - it's a question of clinical indication and objective. Young patients - under 30 - consulting for lip augmentation have a different indication to 45-year-old patients consulting for cheek volume loss. What is constant is that the preliminary medical consultation must assess whether the treatment is anatomically justified and whether expectations are realistic. Clinique Omicron does not perform injections on minor patients, and applies a rigorous evaluation standard for young adult patients - because unjustified aesthetic treatment rarely produces a satisfactory long-term result.

Can I have my fillers injected if I'm breastfeeding?

Breastfeeding is a precautionary contraindication to filler injections - data on the passage of products into breast milk are insufficient to establish safety, and the precautionary principle applies. If you are planning a treatment, discuss the appropriate delay after the end of breastfeeding with your doctor during the consultation.

 

Aesthetic medicine - Medical aesthetic care | Clinique Omicron