Fix Botched Fillers
why do it?
The use of filler injections to correct volume loss and enhance facial features is increasingly common and mainstream.
Done correctly, filler injections can produce dramatic improvements. One of the most common concerns among patients considering fillers is looking fake, overdone and unlike themselves. While the actual steps of injecting filler seem fairly straightforward to the uninitiated, they actually require a firm foundation in anatomic knowledge, technical expertise in controlling filler placement as well as a great deal of finely calibrated judgment and experience.
Unfortunately, it is common to see people who have had suboptimal results such as overfilling, nodules or a disharmonious appearance especially with inexperienced or unlicensed injectors that may not have a clear understanding of facial aesthetics, or when fillers are used inappropriately. Many of our patients are afraid of looking plastic and misshapen, and we understand their fear.
What happens though, when the filler has already been injected but you don’t like the result? There are quite a number of ways to fix overfilled fillers.
to fix botched fillers safely and effectively
Minor asymmetry or irregularities: Careful and judicious repositioning sometimes suffices. Works better if tried soon after filler placement. Please leave this to your doctor, don't try to do it yourself!
An enzyme that rapidly dissolves hyaluronic acid based fillers (the majority of fillers) and agarose-based fillers. Does not dissolve other non-hyaluronic acid based fillers such as polycaprolactone, calcium hydroxyapatite fillers, but it may allow these to spread out making them less obvious.
Produce heat to break down filler material. Transcutaneous radiofrequency where the probe is placed on the surface of the skin may smooth out the contours for superficial fillers, but may not be able to penetrate deeply enough through the skin to dissolve cheek filler, depending on the placement of the filler. Injected radiofrequency or laser using an insulated probe or laser fibre can directly penetrate nodules of filler to break them down.
Physical removal using excision or extrusion
Used for nodules or well-circumscribed areas of filler, this involves physically draining the filler, more commonly used when the filler is not vulnerable to hyaluronidase injection.
dr wan's perspective
Filler injections seem simple, but in reality, there are many things that could lead to a poor result. Dr Wan is particularly careful with filler injections and pays extra attention to:
- a detailed 3D facial assessment especially any pre-existing facial asymmetry
- choosing fillers with appropriate rheology, viscosity, cohesivity
- accurate placement of products
- knowing when to stop before over-zealous chasing of complete corrections
Even at a buffet, more is not always better. This is especially true when dealing with the delicately balanced proportions of the face. Filler injections can be addictive in a way and patients are sometimes fixated with the brand and amount of filler administered. In Dr Wan’s opinion, it is much more important to place the correct amount of appropriate filler accurately at the correct locations. Precisely restoring the facial proportions in only the areas that are needed with an eye on the overall facial proportions usually yields the best results. A conservative approach is usually better, placing less filler initially then topping up as needed to effect gradual, natural looking improvements.
Dr Wan’s approach to fixing suboptimal filler placement - Analysis is Key
Dr Wan would first perform facial structure analysis with the patient using 3D imaging. This allows the patient to see their own face as others would. Any filler procedure or correction needs to take into account the patient's natural facial asymmetry, which is more obvious on the 3D model. Any areas of suboptimal filler placement will be identified by Dr Wan and he would discuss the patient's opinion on which areas need to be corrected.
Poorly placed fillers sometimes require a bit of finesse to resolve.
The method we choose would depend on various factors in each individual case, such as:
- Degree of overfilling
- Location of filler
- Depth of the filler
- Patient's natural facial shape and pre-existing asymmetry
- Whether complete removal of all the filler is desired or just adjustment