Over the past decade-plus, filler has too often been used to try to achieve unrealistic goals, whether it’s the ubiquitous megalips or a misguided “liquid facelift” with its hallmark overstuffing. Board-certified New York City dermatologist Jessica Weiser, MD, believes this is the main reason she and her peers are now confronting throngs of “overfilled, doughy, distorted faces,” she says.
Board-certified dermatologist Paul Jarrod Frank, MD, sees his fair share of filler fatigue in New York City. “At least two patients a day will come in specifically for reversal,” he says. “I go through bottles of Vitrase [hyaluronidase] a day in my office. It’s not a once-in-a-blue-moon, you’re-looking-for-it-in-the-back-of-the-fridge type of thing.”
He links the uptick in filler reversals and revisions to the growing “commoditization” of filler injections: A certain segment of “med-spa culture is about ‘how many syringes can I sell to patients?’” he says. “[Some of] these [injectors] have very little training and are incentivized by only one thing: money.”
Who’s dissolving their filler — and why?
As we reported earlier in this series, excess filler not only creates an odd aesthetic, it can lead to lymphatic channel obstruction and fluid accumulation, limited muscle function (which can cause strained expressions), and permanently stretch soft tissues over time, according to Ben Talei, MD, a board-certified facial plastic surgeon in Beverly Hills.
But dissolver isn’t the exclusive domain of the overdone. Doctors also use it to correct lesser offenses, like tear troughs left puffy by a misplaced gel and, even more prevalent, the issue of lip filler migration.
Olivia, 29, began getting her lips filled after graduating from college. “I always knew I had thin lips, but it wasn’t until my friends [and I] started getting into lip kits that I realized it was very difficult for me to fill in my lips with the product,” she says. “My friends had fuller lips, so I did feel left out and began questioning what was wrong with my lips.”
When Olivia moved from Florida to New York in 2019, she booked an appointment with Dr. Frank, expecting a routine top-off of lip filler. Instead, he recommended an all-out reversal. “While I was happy to have fuller lips, I never really noticed how they were looking until I spoke to Dr. Frank,” Olivia recalls. He pointed out areas where her filler had strayed out of bounds, distorting her lip line, and he suggested dissolving the filler to restore her natural shape and establish a clean slate. (Olivia had been getting her filler at a doctor’s office, not a med-spa, back in Florida.)
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