THE GOOD
The relative
ease of injectables — as opposed to cosmetic surgery — are likely part of why
“having work done” is now treated by many as a piece of lifestyle content, as
shareable as a shopping trip or session in a hairdresser’s chair.
Their
accessibility, short recovery time, and near-instantaneous results have
encouraged people who wouldn’t normally consider having surgery to contemplate
heading to their doctors’ offices for a quick subtle touch-up.
You don't
have to worry about recovery time like you would if you underwent cosmetic
surgery. In fact, you can complete the filler treatment in just 10 minutes
depending on the number of areas needing treatment. Then, you're free to
continue your daily routine or even go back to work.
The majority
of dermal fillers available today feature hyaluronic acid that binds powerfully
to water. Thus, when it is injected, it hydrates, softens and volumizes your
skin for a young, healthy look. Another popular type of filler is a
biostimulatory filler, which is also known to be effective by stimulating
collagen production. As a plastic surgeon, I perform a significant amount of dermal fillers and I love fillers!
So good, so
far! What if you have been injecting fillers for a few years and perhaps extending
to half a decade or perhaps a decade (or two)?
THE BAD?
ENTER FILLER FATIGUE
Enter
'Filler Fatigue', a phenomenon some surgeons are warning their patients about.
It's different to the immediate complications possible from a single injection;
the term is associated with the repeated use of filler injections over a period
of time.
WHAT IS
FILLER FATIGUE?
Imagine
blowing air into a fresh balloon until it's filled to capacity. Now release the
air, then blow back in, release, and so on. The result is something not as
tight and taut as point zero.
Once the
filler is gone (whether absorbed back into the body or dissolved by a doctor),
it leaves behind an enlarged space that requires more filler over time to stay
inflated. And each time you put more filler in, the pocket expands even more and
it becomes a bigger pocket, so it needs more and more filler to keep it
expanded.
LIPS
After the
skin of the lips has been stretched out for example repeatedly over years, it’s
like a tummy tuck when a woman had a baby and her skin hangs loose. There’s all this extra skin that has
to be surgically removed. Pumping in more fillers will result in a somewhat
freaky appearance at this point.
CHEEKS
Fillers in
the cheek is great for someone who has a flat midface or somebody who doesn’t
have very significant cheekbones. But over time, the pocket becomes so expanded
that the volume of filler necessary to hold up and inflate that pocket becomes
so much that you have a very large cheek area (chipmunk cheeks). By comparison,
the chin area and jawline look small.
Madonna –
Before and After “Filler Fatigue”
When that
happens, some doctors will then have filler injected into the bottom half of
the face in an attempt to balance everything out. However, that can leave the
face looking puffed up and deformed.
THE UGLY
Actress Nikki
Cox – a once sultry face now married with chipmunk cheeks and sausage-like lips
due to “filler fatigue”.
Daryl Hannah-
overfilled face, chipmunk cheeks. Her upper lip has lost its beautiful shape
with tapered corners. Too much filler injected in corner or upper eyes in
attempt to “lift” brow causing eyes to look smaller and lose glitz.
Meg Ryan –
Classic Filler Fatigue facial appearance. Her upper lip is so full, it creates
a distorted projection and her once sexy cupid’s bow has vanished. The fillers
for tear trough has migrated down to cheek area giving a puffy appearance.
Parting Thoughts
I routinely
see patients who have been injecting fillers for 10 years or more, often to delay
the inevitable which is a surgical intervention in nature. By this point they
have already done all the injectables and lots of lasers, threads and tightening
devices. They have also spent close to hundred thousand dollars and the effects
of the treatments aren’t working for them anymore.
Filler is
not the answer to everything. There is a time and place for fillers.
It is
important that your doctor assesses your proportions carefully, then uses small
amounts of filler to restore volume to replace bone and fat loss. Every face is different and your
doctor should have an “exit-strategy” for the long term management of the aging
face.
I do not
recommend injecting fillers repeatedly beyond the 5-year mark to avoid “Filler
Fatigue” and the associated draconian effect on the face. The “exit-plan” may
involve fat grafting (including autologous nanofat), a facelift and a browlift.
Perhaps even upper and lower eyelid surgery. Every face is different, so there
is no template formula to get you to your goals.
It is
important to discuss not only the immediate filler treatments you will be
undergoing but also the long-term game-plan and “exit-strategy” for facial
rejuvenation. If your doctor does not perform surgery, he should refer you to
the appropriate professional when the time calls for it.
#fillers #dermalfillers
#dermalfillersmalaysia #aestheticmedicine #cosmeticsurgery #facialfillers
#facialfatigue #facialoverfillsyndrome #plasticsurgery #skincheckmalaysia88 #gemclinic
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Sincerely
Yours,
Dr Lee Seng Khoo
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