Full, ultra-plumped lips are one beauty trend that just won’t quit. Influencers like Kylie Jenner and the rest of her famous family have helped to make the use of facial fillers increasingly common. The more we’re bombarded with photos of perfectly plumped pouts on social media, the more we wonder: Is there such a thing as too much? If so, what does that mean?
Enter “filler fatigue,” a buzzy beauty term to describe what happens when someone has had too much filler. Essentially, over time, filler stretches and weighs down the skin, which means you need more filler with each trip to the doctor, which will just stretch the skin and tissue even more.
Overuse of fillers can have serious repercussions.
Over extended periods of time, fillers can actually stretch out the tissues under the skin, essentially accelerating the aging process “because those tissues aren’t going to bounce back the same way as you get older,” Park Avenue facial plastic surgeon Andrew Jacono explained to HuffPost.
New York-based cosmetic facial plastic surgeon Michelle Yagoda told HuffPost that 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.
“Each time you put more filler in, the pocket expands more and it becomes a bigger pocket, so it needs more and more filler to keep it expanded,” Yagoda explained.
When it comes to lips, if you don’t add more filler to inflate the space, you can be left with droopy, wrinkly or even misshapen lips that may require surgery to correct, Yagoda noted.
“After the skin has been stretched out, it’s like a tummy tuck when a woman’s had a baby and her skin hangs,” Jacono said. “When you [get rid] of that big lip, it’s like [after] giving birth. You dissolve away the filler and there’s all this extra skin and I have to cut it away. It’s a pretty big procedure and takes about two weeks to recover.”
Fillers can also migrate once they’ve been injected, and you could end up with a top lip that looks like what Yagoda described as “two saggy boobs,” in which the sides of the lips hang down.
Yagoda said that she doesn’t use injections in the pink part of the lips, as she considers it a dangerous area. She will, however, inject where the pink part of the lip meets the skin.
“I think it’s a big mistake to inject into the pink part of the lip because the lip is a muscle, and the filler gets moved around and can clump and lump and deform the lip and will pretty much require a surgery to get rid of it if you do it more than once or twice,” she said.
It can happen with fillers on the rest of the face, too.
Both Yagoda and Jacono noted that “filler fatigue” also commonly happens when people use too much filler in their cheek areas.
“Filler in the cheek is great for someone who has a flat midface or somebody who doesn’t have very significant cheekbones,” Yagoda said, adding that putting filler in someone whose cheekbones are already defined pretty much just stretches out the underlying tissues.
Eventually, she said, the pocket becomes so expanded that “the volume of filler necessary to hold up and inflate that pocket becomes so much that it tips the balance of the face so that you have a very large cheek area and by comparison, the chin area and jawline look small.”
If that happens, she said, some people will then have filler injected into the bottom half of their face in an attempt to balance everything out. However, that can leave the face looking “almost like a puffed-up bobblehead,” Yagoda said, adding that the normal contours of the face become lost.
Just as fillers can move when they’re injected into the lips, they can also gravitate when injected into the cheeks and weigh the face down.
“What people try to do, because they don’t get the same effect from one or two vials of filler, is that they try to fill the face so that the sagging is lifted, but then the face looks wider,” Jacono said, adding that people may start to look “distorted.”
“When the fillers go in, they don’t really support the face, they weigh the face down,” he said. “[People] start to look a little bit simian or monkey-like, because there’s too much filler that gravitates toward the mouth … it kind of droops down from the upper part of the cheek.”
More filler is not always the best option.
While fillers may be a great option for some people, they may not be the best for others. More importantly, fillers will not stop the body from aging.
“Putting too much filler in the face to try and make up for the aging process, which tends to happen, starts to make people not look like themselves anymore,” Jacono said. “I see patients who have been doing fillers for five to 10 years and they’re coming to me for a solution, because they’ve already done all the injectables and lots of lasers, and now they’ve spent tens of thousands of dollars and the effects of the treatments aren’t working for them anymore.”
As Yagoda said, “Filler is not the answer to everything.”
“As you continue to age and depending on your genetics, you may be predisposed to loose skin and areas where there’s a lot of hanging. And it is not true, even though it’s a perpetuated myth that filler in the cheek can lift skin at the lower part of the face. It’s just not possible.”
If someone is trying to reverse the effects of too much filler, there are treatments available, both surgical and nonsurgical. For example, there is an injectable enzyme called hyaluronidase, which can dissolve hyaluronic fillers like Restylane or Juvederm. There are also minimally invasive treatments like ThermiTight and Ultherapy that work to tighten the skin.
But sometimes, as Yagoda noted, surgery is the right way to go.
How long can someone use filler and still see desirable results?
Both doctors agreed that the length of time someone can use filler and see the results they want is different for each patient.
The younger you are, the firmer and more elastic the skin generally is, Yagoda noted, which means you may be able to use filler a little longer. But for someone in their 40s or 50s, the “sweet spot,” she said, is probably around three to five years.
According to Jacono, some people may even be able to get eight to 10 years out of fillers on a case-by-case basis, but he noted that no matter what, you’ll be stretching the tissues.
“There’s no way to get around it,” he said. “And you have to be careful. Because if you push it too far, you’re stretching them way too much, you’re almost guaranteeing yourself a more invasive treatment at a younger age.”
Here’s what you should know before getting fillers yourself.
If you’re looking to get fillers, especially in the lips or cheeks, Yagoda suggested reading up on the various types of fillers out there to educate yourself and recommended getting different opinions from doctors.
“It’s important,” she said. “I wouldn’t want to make decisions without being as educated as I could be.”