When it comes to considering cosmetic enhancements, nothing beats getting the skinny from a friend who has tried them out. So today on the blog we have writer Allie Rowbottom. Allie is the author of the novel Aesthetica, the memoir Jell-O Girls and the beauty column Beauty Mark. She’s also a contributing writer at Elle and The New York Times with a particular interest in the intersection of image culture and technology.
She’s here today to tell us all about FILLER FATIGUE and what you need to consider before you get your filler dissolved. So consider Allie your friend who has been through it all when it comes to filler, filler migration, dissolving filler and RE-filling. She really covers every single angle so if you’re considering filler, or ready to get yours dissolved, this post is for you.
With that, let’s welcome Allie to the blog.
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Filler. Love it, hate it, love and hate it, there’s no avoiding that for the past decade, few products have made such a visible difference in how we perceive beauty. For a time in the mid-aughts it seemed like everyone from your neighbor to your favorite celeb, was hitting the med spa a little too often. Since then, we’ve all witnessed the unfortunate effects of “pillow face,” filler migration and “filler fatigue,” a term developed to describe the appearance of facial tissue when stretched to accommodate too much filler.
Predictably, many of us have developed emotional filler fatigue as well, and dissolving filler has become a trend in 2024. Take it from me, a novelist and beauty columnist with a particular interest in facial aesthetics; my recent novel, Aesthetica, is about a former influencer recovering from a plastic surgery addiction by pursuing a dangerous (fictional) surgery, Aesthetica™, designed to undo all the work she’s had done to her face. Where did I get the idea for this novel? From my own, real-life experience dissolving migrated lip filler, of course!
Today, information is becoming increasingly available regarding the downsides of filler. From lymphatic occlusions, to overstretching facial tissues, the consensus is clear: too much filler is bad news and dissolving filler is a choice more and more people are making. But as with reversing any cosmetic procedure, dissolving doesn’t come without emotional, physical and practical considerations. Let’s get into some tips and tricks and anecdotes from my personal experience to help you decide if dissolving is right for you.
Filler Fatigue: What You Need to Know Before Dissolving
Making the choice.
Choosing to dissolve filler is often emotional. After all, it’s expensive! And, as with any cosmetic procedure, the results often feel personal. We’re talking about your face, after all, your impression-maker, the part of your body people see first, the window of your soul. When contemplating dissolving facial filler, it’s important to remember that nothing–sometimes not even surgery–can fundamentally alter the anatomy of the human face. If you came to filler hoping for a full facial transformation, you were doomed for disappointment. Ask yourself, what was your goal when starting on your filler journey? Have you achieved that goal? Was it realistic in the first place? If not, very rarely is adding more filler the solution. And contrary to popular lore, filler rarely fully dissolves on its own.
Prep your psyche.
An unfortunate side effect of the injection boom of the last decade has been the downplaying of the psychological effects of nonsurgical interventions. In most American cities you can’t walk a block without passing a med spa. Filler and Botox are marketed as “lunchtime” procedures. It’s easy to pursue “tweakments” we’re led to believe, and often, logistically, it is: most Botox appointments take under ten minutes, many med spas accept walk ins. But altering your physical appearance, particularly in a short time frame, can be emotionally jarring.
This is true when it comes to adding filler to your face and it is true when it comes to taking filler away. Before your dissolving appointment, prepare yourself for the change in your appearance. You may even be surprised; personally, when my filler dissolved, I was pleasantly shocked to see a younger-looking, fresher reflection when I looked in the mirror. It also helps to be honest with friends and family about what you’re doing; shame and secrecy only serve to isolate us and make recovery worse. Remind yourself that filler doesn’t define anyone’s beauty or perceived lack thereof. If you need additional support, don’t be shy, seek it out!
Prep your skin.
Filler is dissolved using hyaluronidase, an enzyme that quickly breaks down hyaluronic acid, the main ingredient in most dermal fillers. In order to get the most out of your dissolving journey, you may need two appointments. This is more likely if you’ve had a lot of filler over the years as the product tends to build up and form stubborn “nodules.” Like any injection, hyaluronidase is not not painless, so making sure you and your skin are prepped correctly is key.
Come to your appointment with clean, makeup free skin. Some injectors ice before the procedure, others don’t. For my money, I would ask for ice no matter what. Then, your injector will apply a topical anesthetic like lidocaine and leave you to wait for about fifteen minutes while the cream soaks in. Pro tip: if you’re worried about pain, ask to sit with the numbing cream for an extra five minutes. Extra pro tip: bring your Skinny Confidential Ice Roller to the appointment for use on the car ride home.
Aftercare is key.
Results of hyaluronidase injections are, for the most part, instantaneous but can continue to present themselves for up to two days after your dissolving session. In my experience, about seventy-five percent of the dissolving was immediate. The remaining fifteen percent happened gradually over the next twenty-four hours so it’s important to take it easy. After your appointment, go home, plop on the couch and ice the area. You may continue to feel numb and tingly for the next twenty-four hours (I did!). Some people report excessive swelling, others less so; if you’re worried about this, sleep propped at a forty-five-degree angle. Personally, I had minimal swelling. But my lips did bruise to a greater degree than they ever had when receiving filler. Use a topical arnica gel to speed the recovery process. Bonus if you take arnica orally as well. And again, ice ice ice.
The long term: to refill or not to refill.
The soonest you can refill an area after dissolving old filler is one week. If you’re panicked about waiting that long, take a beat to really sit with why; what might your panic have to teach you about your relationship with filler? If you’re on the fence about refilling, I recommend having a deep think about your filler goals. Filler should work as a cherry on top, not a band aid. If you’re trying to lift your face using filler, you’re wasting your money and may have even done damage to your skin and soft tissues by overfilling. If this is you, consider saving up for a surgical intervention instead; in the long run, you’ll save money, achieve more natural results and cut down on trips to the med spa with a one and done procedure. If your filler has migrated, bear in mind that prior migration can increase chances of more migration in the future, even if you dissolve and start over. This is because filler that migrates forms subcutaneous pathways that don’t necessarily disappear alongside the filler as it dissolves.
IF, however, you want to add a small bit of sparkle back to your face, maybe refilling is for you after all. My top tip for anyone considering refilling is to be extra choosey about who you trust to inject your face. Seek out board certified PAs, nurse practitioners or, better yet, plastic surgeons (in my opinion, the best injectors are often plastic surgeons as they have the most intimate understanding of the anatomy of the face). Carefully study the before and afters of anyone you trust with your face; read their reviews, ask to speak to satisfied clientele. It’s also imperative to research the products themselves and to discuss at length with your injector what brand of filler they plan to use. The number one mistake I made early in my filler journey, was agreeing to the use of products ill-suited to the area of my face I wanted to fill. This led to migration, which led to me to dissolve. So above all, do your research!
The main thing to remember about any cosmetic procedure is that you don’t need it. And wanting it is always tough to unravel from the very real pressures to conform in an image driven society. Does that mean you should opt out of all cultural messaging and move to a cabin in the woods? Maybe! But for many of us “opting out” is simply not an option. The goal is balance and critical thought, even (especially) when it comes to something as superficial as filler.
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Have you ever gotten your filler dissolved? Is there anything you wish you knew before you got filler? Let us know below in the comments so we can all use this post as a resource.
Be sure to follow Allie on Instagram where you can find out about her latest articles and where to find them.
x, The Skinny Confidential team.
+ Learn the benefits of lymphatic drainage after surgery.
++ Read about the proper way to recover from plastic surgery.
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