Can Dermal Fillers "Ruin" Your Face Over Time? We Spoke to Five Aesthetic Medicine Professionals (Exclusive)
"Any sink can overflow if you run large amounts of water faster than the drain can absorb," says Dr. Jimmy Sung, regarding filler overuse.
Feb. 12 2024, Published 1:10 p.m. ET
Actress Courteney Cox has been open about reversing her facial fillers.
Though cosmetic dermal fillers have been around since 1981, they've become uber-popular over the last decade. But people are starting to wonder if this "Instagram face"-chasing plastic surgery trend can "ruin" your face over time.
Social media users can't help but analyze the changing skin and fullness of celebrities' faces, some believing that certain famed personalities have been "touched by an angel" one too many times. Specifically, we're focusing on individuals who perhaps overdo temporary fillers.
Can being poked and prodded in hopes of achieving a plump and sculpted look spawn the opposite result? Can filler overkill lead to (*gulp*) premature aging?
Curious about the filler effect, we spoke exclusively via email with five experts: board-certified aesthetic nurse practitioner Megan Francis, double board-certified aesthetic face and jaw surgeon Dr. Todd Hanna, double board-certified plastic and oral/maxillofacial surgeon Dr. Derek Steinbacher, and board-certified plastic and reconstructive surgeons Dr. Jimmy C. Sung and Dr. Steven Williams.
Do cosmetic dermal fillers ruin your face over time?
Dr. Sung, Dr. Hanna, Dr. Williams, and Dr. Steinbacher all say hyaluronic acid (HA) fillers are the most popular filler option.
According to Dr. Sung, cosmetic hyaluronic acid fillers are perfectly safe and can be broken down by the body with time.
Dr. Steinbacher says HA fillers are quick, easy, and can be adjusted based on personal needs.
"They add volume to areas that are flat or not plump and can help fill in deep creases that form with aging and from facial muscle movement," he tells us.
As for what parts people are targeting, Francis reveals that "lip filler is the No. 1 most requested service by Gen Z, undoubtedly influenced by celebrities like the Kardashians."
In 2023, the AAFPRS reported that 75 percent of facial plastic surgeons noticed an increased demand from patients under 30 years old.
So, when do these "tweakments" lead to undesirable consequences?
"Filler bombing" the face can lead to filler migration and undesirable results.
“The issue of filler migrations is a self-inflicted problem," Dr. Sung says, noting that the face "can only take so much at any particular location."
"The injectors and the patient both decided to 'filler bomb' the face. Like a NYC street after a rain storm, now you have all sorts of lumps and bumps everywhere," Dr. Sung continues.
Unfortunately, Francis says when too much filler is injected poorly, an older appearance is a possible repercussion. Dr. Steinbacher agrees, explaining that "if too much filler is placed on the upper side of a fold, it can actually thicken the skin above the fold and make the shadow of the fold deeper and appear more prominent."
More importantly, too much filler can permanently damage the lymphatic channels. "However, most things can be fixed if you find the right injector," Francis says.
As per a study published in Cureus in 2021, lymphangioma — benign masses of the lymphatic system — is a rare consequence of receiving HA lip filler injections.
Dr. Hanna points to filler misuse, as injections are not meant to change the foundation of the house, so to speak.
"Anytime you are trying to create bone structure (chin, cheeks, jawline), filler is not the right option," he tells us. "Filler is a soft material. It doesn’t lift or build structure, it 'fills.' I find that patients like their facial filler at first, but after five to 10 years of repeated treatments, they find it makes their face look swollen, lumpy, heavy, or fat."
Dr. Williams shares that "contour irregularities or bruising" are common complications of dermal fillers, noting that more serious complications "like vascular or neurologic injury" are possible.
Can dermal fillers be fully dissolved?
Friends star Courtney Cox has very open about her filler journey, even calling them her biggest beauty regret, per Cosmopolitan.
“You don’t realize that you look a little off, so then you keep doing more," Cox said on the Gloss Angeles podcast in 2023.
Cox had her fillers dissolved in 2017. We asked our medical professionals about this process.
Dr. Steinbacher tells us that HA fillers, such as Restylane and Juvéderm, can be reversed with an enzyme called hyaluronidase. He clarifies that it typically takes six to nine months for the body to break these fillers down naturally.
However, Dr. Hanna has found HA fillers can stay in the body for 10 years or more. He warns what HA filler removal can potentially reveal: "Some literature suggests that large amounts injected over years will expand the skin and soft tissue, leaving some degree of laxity or loose skin."
Other fillers don't allow for indecisiveness. While Dr. Steinbacher highlights how polymethylmethacrylate and silicone fillers cannot be dissolved (Lisa Rinna has been outspoken about her experience with permanent silicone lip filler), Dr. Hanna criticizes the misleading "semi-permanent" label put on Radiesse fillers as they "will not go away."
Sculptra brand fillers cannot be reversed.
"Non-HA fillers and biostimulators on the market take much more time to dissolve, which could be upwards of a decade," Francis tells us. "Sculptra, for example, is a biostimulator that acts similar to filler but cannot be dissolved; instead, it stimulates your body to make collagen."
How often should you get HA fillers?
Dr. Steinbacher recommends repeating HA filler injections two to three times annually.
But in the end, we always recommend talking with your doctor before making any rash decisions. As put by Dr. Williams, "patients should balance their desire for youth with the risks and benefits of these treatments."
