Have We Had Our Fill Of Filler? Why So Many People Are Dissolving Their Injectables

Filler remains one of the most popular cosmetic procedures, but now so many people are wanting its effects reversed. What does this mean for the future of injectables?

When And Just Like That... premiered in December 2021, it created a stir for a multitude of reasons.

Where did Samantha go? Why didn’t Carrie perform CPR on Mr Big? What procedures has Kristin Davis had done to her face?

The latter was by far the most problematic discourse to surface from the Sex and the City reboot, and one that alluded to the much wider, ongoing issue of people thinking it’s okay to comment on someone’s appearance — especially mid-life women.

In an interview with The Telegraph, Kristin shared that the mounting pressure to appear youthful when reprising her role as Charlotte York Goldenblatt saw her turn to dermal fillers and other procedures in a bid to stall the signs of ageing.

Instead, she says she was “ridiculed relentlessly” over her facial fillers. “I’ve had to get them dissolved. And I have shed tears about it. It’s very stressful,” she said in the interview.

But Kristin isn’t the only celebrity to experience public backlash over her decision to use filler, then later have it dissolved.

In March this year, American model Blac Chyna (aka Angela White) shared a now-deleted video to her Instagram of her getting her facial filler dissolved from her cheeks, jaw and lips using an enzyme known as hyaluronidase.

“Enough is enough. It all has to come out,” she said at the time. “Back to baseline. Honestly, I’m just tired of the look, and it’s just not flattering, it’s not what I look like. It totally changed my face.”

It’s not just celebrities, either. There’s a growing number of New Zealand women requesting their filler be dissolved in favour of appearing au naturel or opting for subtle, non-surgical tweakments instead.

Which begs the question: have we had our fill of filler?

To gain a better understanding of the rise of natural-looking injectables and the fall of pillowy faces, we spoke to Dr Ellen Selkon, a cosmetic physician, partner and director at Clinic42 and treasurer of the New Zealand Society of Cosmetic Medicine.

“Cosmetic medicine has come a long way and so have our patients,” Ellen says of the shift in preference towards a more natural look. “While the fashion with Baby Boomers and Gen X was to have a semi-natural look but with cheeks and lips emphasised, Millennials and Gen Z are much more subtle and prefer a ‘nobody knows for sure, but I look amazing!’ look.”

The overfilling of lips, cheeks or nasolabial folds is now known as “filler fatigue”, a 21st-century neologism synonymous with a pillow-faced look.

Filler fatigue has a few hallmarks, the tell-tale signs of over-inflating regions or allowing too much filler to mount up in between appointments.

“Loss of clear definition of the lip border is one of them where lip filler has literally moved or not been placed in the correct area,” Ellen says. “The eyes can sometimes look smaller after too much cheek filler which is also a giveaway look. A round-looking face that has lost its natural contours is also an ‘overdone filler’ look.”

Correcting overdone filler is something Ellen and her team at Auckland’s Clinic42 deal with regularly — and Ellen says a few people a month are coming in wanting to have their filler dissolved. Typical areas to treat include lips, but also lumps and bumps leftover from filler or over-volumisation.

There are myriad factors as to why a pillow-faced appearance can occur, most commonly from being treated by inexperienced injectors. This culminates in one of two ways — with asymmetrical results, or a distorted, over-filled appearance popularised by social media filters.

Something went awry during her appointment, and she was told by her injector she could come back and pay for her treatment the next day. One hour later, she experienced significant bruising to the injection sites (her upper and lower lips).

She’s since had them corrected and says the only clinic she trusts with her injectable treatments now is Clinic 1 Aesthetics in Ponsonby.

The appearance medicine and skin clinic operates under the guidance of Dr Zachary Moaveni, a plastic and reconstructive surgeon and the overseeing doctor at Clinic 1 Aesthetics. His experience spans multiple hospitals across Tāmaki Makaurau, including Middlemore, Kidz First and Starship Children’s Hospital.

Dr Zachary oversees injectable treatments performed by Renjini Nair, Clinic 1 Aesthetics co-founder, medical director and cosmetic registered nurse, who has been registered as a nurse since 2007 and a cosmetic nurse since 2016.

It may seem a little counterintuitive to note how filler reversals are trending just as much as filler treatments themselves, but Ellen says the majority of clients she sees want their filler dissolved in order to achieve a better result next time.

“They are not put off filler, they understand that either they have had too much, or they have had poor placement of the filler, and this can be remedied,” she says. “In rare occasions, we just dissolve a small lump from filler, especially if it has been put into a fine line.”

Lumps and bumps can be caused by something known as filler migration, or the process in which filler moves into the surrounding tissues.

“Unfortunately, filler migration is a real thing! Filler moves above the actual vermillion of the lip into the surrounding tissue, obscuring the crisp border and making the area above the lip look puffy and full,” Ellen says.

Filler migration can be caused by a poor injecting technique, too much filler or the wrong type of filler used. Equally, repeatedly injecting lips with a soft filler can cause this phenomenon.

But it isn’t just lips that are prone to filler migration, a common area Ellen treats is tear troughs or under-eyes. “The most common reason for this is the incorrect filler with the incorrect depth of placement. This is a highly specialised area and should only be performed by very qualified injectors,” she says.

This was the case for Charlotte*, who experienced filler migration on her upper lip two years ago.

Her desire for fuller lips stemmed from teendom, when Charlotte says she felt insecure about her smile following years of having braces. “When I went to smile it looked and felt weird. And that was a big reason why I got filler; it helped to even out my smile and I felt really confident,” she says.

For her first lip filler appointment, Charlotte booked in at a franchised appearance medicine clinic back in 2018. But her results weren’t as drastic as she hoped, so she moved her sessions closer and closer together.

“When you first get it done, 1ml doesn’t go that far — it’s not a drastic change like you think it would be unless you have really small lips. After three months you start thinking you have to get it done again. I got caught in that trap of going in and getting a couple of mls in close succession,” she says.

While Charlotte says she didn’t have anything drastic go wrong (she would get bruising each time but never badly), towards the end of 2018 Charlotte noticed a slight migration above her lip, which was particularly lumpy on one side. “It looked horrendous, but I convinced myself it was great because I didn’t want to get it dissolved,” she says.

With this in mind, Charlotte says she wasn’t keen to see the same injector, so changed to a new one at the same clinic. But while her new injector was placing the filler a lot better and using less product each time (about 0.25ml), Charlotte says the new filler was piling on top of the migrated filler.

It wasn’t until her injector left the clinic that Charlotte started seeing an appearance medicine doctor, who convinced her to have her lip filler dissolved.

“Two years ago, I started seeing a doctor and she is so knowledgeable. She wouldn’t let me go over and above what I needed and she’s the one that convinced me that I really needed my lips dissolved because it was not looking good,” Charlotte says. “I ended up having two sessions of dissolving my top lip and I’ve never had filler since.”

It’s been five years since her first appointment, and Charlotte says her lips are still rock hard — a sure sign that her lips are filled with scar tissue as a result of years of injecting filler. “They’re still looking pretty full, to be honest, but not as big as they were,” she says.

Charlotte doesn’t regret getting fillers, nor has her experience put her off getting fillers in the future. “I’m not against getting lip filler. It has a place for people and if it’s done well, it can look really good. There are way too many people who aren’t doing it well or placing it correctly. Too many people have way too much filler,” she says. “I’m lucky enough that I have a really good doctor I trust. I wouldn’t put much in and I would be careful with placement. But for now, I’m giving my lips a break.”

Her decision to forgo fillers for the meantime has a lot to do with wanting to reclaim some of the freshness she sees when she looks back at photos of her younger self. “I think sometimes filler can be ageing. You get to a certain point where all of a sudden it can just make you look much older — including people like Kylie Jenner,” Charlotte says. “I’m definitely leaning towards a ‘less is more’ approach now.”

Experiences like Charlotte’s point back to the lack of regulation in the injectables industry, and Ellen says it’s vital to do your research before allowing anyone to come near you with a needle.

“Interview your injector! Ask them about their experience, how long have they been injecting, what areas are they competent to inject, if they have before and after photos to show you,” she says.

It also pays to ask your injector if they have hyaluronidase (filler dissolver) on-site and who you should call if there is a complication post-treatment — someone who should be available 24/7.

If it’s your first time meeting with an injector, Ellen recommends being very open and specific about your goals and the look you’d like to achieve. Ask about the type of filler they’re using, especially considering the sheer number of products available — many of which aren’t registered in New Zealand and Australia for safe use.

Ellen says the qualifications to look out for include NZSCM (New Zealand Society of Cosmetic Medicine), a training course over two years for doctors practicing cosmetic medicine who spend over 500 hours training. Check out an injector’s website to see if they have the NZSCM logo on display. Nurses who are injecting can be affiliated with an NZSCM doctor too.

But it’s not all bad news when it comes to filler. When administered correctly, Ellen loves the positive dimension filler can add to a face.

“It can give beautiful curvature to a flat cheek, create more of a chin for a person who is born with a small one, fill temples, or hollowing to stop people looking tired and gaunt and in some cases glamorise or accentuate a beautiful facial feature,” she says.

“When performing one of the above procedures, people are ecstatic. They are so happy that they don’t have to resort to surgery and that there is a simple solution to improve their self-esteem and make them feel like a million dollars.”

*Names have been changed

More About Cosmetic Treatments

Treatments and their alternatives.

These Are The Appearance Medicine Treatments To Try In 2023. From non-invasive lasers to injectable alternatives.

Bite-Sized Beauty: Express Treatments To Overhaul Your Look In Your Lunch Break. In and out in less time than it takes to eat your sushi.

Can These Manual Skin Treatments Really Change The Shape Of Your Face? They’re gadget-free, relying instead on practices like massage and acupuncture.