Dermal fillers are a popular aesthetic treatment in Singapore. When done well, fillers are an excellent way to sculpt the face and enhance facial proportions. They are also used to reduce signs of ageing, such as fine lines and wrinkles. However, patients can sometimes obsess over the way they look and think the more the merrier — but this is not necessarily true. In fact, I always tell patients less is more; you don’t want to risk looking fake, overdone and overfilled. 

It takes a good doctor to be able to tell how much filler is too much, and an even better one to understand facial anatomy and possess technical expertise. How much is too much, and how can you fix botched fillers?

How to tell if you are getting too much fillers

You look too puffy
If your face looks extremely bloated and round after a visit to your aesthetic clinic, you may have had too much filler injected into your nasolabial folds, cheeks or in your nasojugal grooves, which are the lines under your eyes. This puffy look is also known as the Pillow Face Syndrome, where the area from the lower eyelids to the mid face plumps up like a pillow. Madonna and Nicole Kidman were once victims of the Pillow Face Syndrome.

You look too “full”
A youthful face is slightly chubby with no loose skin and a healthy glow. Dermal fillers can replicate the fullness you once had in your face, but it cannot tighten skin. Too much fillers will then result in a full face but tired and lumpy skin. You may have seen some celebrities with this unnatural look, like Suzanne Somers.

Your lips look bee stung
Although celebrities like Kylie Jenner may have made swollen bee stung lips look attractive, overfilled lips from excessive lip fillers can look disproportionate to the rest of your face. In fact, overdone lip fillers are one of the most obvious ways to tell if someone has had work done. Your lips play a huge role in the overall look of your face. If your lower lip can’t touch your upper lip, I suggest laying off the filler work.

Your cheeks change the way your eyes look
Injecting dermal fillers into the cheeks is a common way to replace lost volume under the eyes. However, if your eyes start to look cat-like and squinty because of how your filled cheeks push up on your eyes, it may be a sign that you’ve had too much work done. A good baseline or rule of thumb is to be able to see a bit of your cheeks when you look down. If you see a whole lot of cheeks when you look down, it means you have too much dermal fillers.

Your nose looks wide or resembles an Avatar nose
When getting nose fillers, a side effect we want to avoid is the Avatar nose, or the broadening of the nose bridge due to the nose fillers spreading sideways. This effect is called the Avatar nose because the appearance resembles the blue Na’vi in the movie Avatar. Overfilled nose fillers also include devastating consequences like blindness and tissue necrosis. If you want a sharper and slimmer nose bridge, I recommend opting for nose thread lifts instead as they are a safer alternative.

Your chin looks too long
Chin fillers are a great way to lengthen the chin and give the face a slimmer look. They can also be used to correct chin asymmetries and cleft chins in males and females. When done well in appropriate amounts, chin fillers can look very natural and flattering; if overdone, there is a risk of developing a pointy chin or a witch’s chin. Hong Kong actress Fanny Sieh is an example of someone with overdone lip fillers.

How to fix botched/overdone fillers safely and effectively

Manual adjustment 

This only applies to minor irregularities and works the best if done as soon as possible after filler placement. But please only leave this to your doctor and don’t attempt it by yourself!

Hyalase injection 

Hyalase injections contain an enzyme that rapidly dissolves dermal fillers. However, it only works on hyaluronic acid-based fillers and agarose-based fillers. Polycaprolactone and calcium hydroxyapatite fillers are not reversible.

Radiofrequency

Transcutaneous radio frequency is used to break down the filler; but this method only works for superficial fillers and may not be able to dissolve cheek fillers depending on the placement of the filler.

Avoiding getting too much filler 

I recommend taking a less is more approach when injecting dermal fillers, especially if it’s your first time. Remember, fillers are supposed to enhance and maintain your appearance. If you start to change your appearance, you lose the benefits of fillers and start to look like a caricature of your former self. 

References 

  1. Rao, V., Chi, S., & Woodward, J. (2014). Reversing facial fillers: interactions between hyaluronidase and commercially available hyaluronic-acid based fillers. Journal of drugs in dermatology : JDD, 13(9), 1053–1056.
  2. Juhász, M., Levin, M. K., & Marmur, E. S. (2017). The Kinetics of Reversible Hyaluronic Acid Filler Injection Treated With Hyaluronidase. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 43(6), 841–847. https://doi.org/10.1097/DSS.0000000000001084