Dermal fillers: Avoid too much of a good thing

January 15, 2013

Go to your cosmetic surgery consultation armed with photos of yourself throughout the years.
Go to your cosmetic surgery consultation armed with photos of yourself throughout the years.

If you’re thinking about getting dermal fillers, such as Restylane, you probably want to look like yourself, only better, and avoid looking fake and overfilled.

In the 80s and 90s plastic surgery sometimes produced a pulled-tight surgical look. Then along came the ‘liquid facelift,’ which did the opposite. Injections of dermal fillers are now used to enhance cheekbones, jawlines and lips. But instead of subtly-enhancing features, many women receive too much filler and become puffy and swollen-looking.

Injecting dermal fillers takes anatomical understanding, years of experience and an artistic sense. Practitioners with these skills, usually board-certified plastic surgeons or dermatologists, can now also be found reversing too much of a good thing. Women come to them to undo the effects of too much filler - cheeks that are too round and lips that are too full. To reverse these effects, doctors inject enzymes like hyaluronidase, which can break down or deflate dermal fillers such as Restylane, Juvederm and Perlane.

According to the January issue of Marie Claire, the year 2013 will usher in a subtler more conservative use of fillers. The article points to icons such as Diane Keaton, Lauren Hutton and Meryl Streep. In these women, you can’t tell whether or not they’ve had work done. They look great, like themselves, and not like they’re trying to pass for 30. Marie Claire interviewed a prominent NYC plastic surgeon who recommends going to a cosmetic surgery consultation armed with photos of yourself throughout the years, so your doctor can see the original shape of your face and how it has aged.

Before picking up the Restylane syringe, good plastic surgeons look at you long and hard evaluating your 1) skin quality and texture, 2) tissue tone and thickness, 3) cheek and lip volume, 4) bone structure and 5) how your face looks when animated and how it looks when still.

An experienced, knowledgeable injector will avoid pitfalls such as these: adding volume to deep set eyes can recess the eyes further and make them look smaller; overinflating nasolabial folds and marionette lines can take away midface structure; and overfilling cheeks can make the under-eye area appear hollow.

If you’re considering dermal fillers, put yourself in the hands of a board-certified plastic surgeon and proceed slowly instead of doing everything at once.


The mission of the American Society for Aesthetic Plastic Surgery (ASAPS) includes medical education, public education and patient advocacy. Plastic Surgery News Briefs are summaries of current stories found through various news and magazine outlets that relate to or mention plastic surgery and cosmetic procedures. The views expressed in these news articles do not necessarily reflect the opinions of ASAPS, but are merely published as an educational service to our members and the general public. For additional information on these subjects and other plastic surgery related topics, please go to www.surgery.org

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About ASAPS
The American Society for Aesthetic Plastic Surgery (ASAPS), is recognized as the world’s leading organization devoted entirely to aesthetic plastic surgery and cosmetic medicine of the face and body.  ASAPS is comprised of over 2,600 Plastic Surgeons; active members are certified by the American Board of Plastic Surgery (USA) or by the Royal College of Physicians and Surgeons of Canada and have extensive training in the complete spectrum of surgical and non-surgical aesthetic procedures. International active members are certified by equivalent boards of their respective countries. All members worldwide adhere to a strict Code of Ethics and must meet stringent membership requirements.

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