There’s no denying fillers have changed the landscape of aesthetics, but with their rise in popularity has come an equal rise in misinformation. From concerns over filler migration to the fear of looking overfilled or unnatural, it seems filler has gotten a bad rap in recent years. At the AAD Meeting in Orlando, we sat down with four board-certified dermatologists to tackle the biggest filler myths and explain what patients need to know.
Featured Experts
- Dr. David Balle is a board-certified dermatologist in Gross Pointe, MI
- Dr. Bertha Baum is a board-certified dermatologist in Miami
- Dr. Anthony Rossi is a board-certified dermatologist in New York
- Dr. Joel Schlessinger is a board-certified dermatologist in Omaha, NE
Does Filler Make You Look Unnatural?
It’s one of the most common fears among patients. As Miami dermatologist Bertha Baum, MD explains, choosing the right injector is key. “It’s very important to select the right physician, someone who does this daily, understands your background and ethnicity and can set realistic expectations,” she says.
Grosse Pointe, MI dermatologist David Balle, MD adds that technique and placement matter as much as the product. “A lot of it depends on who’s doing the injecting. If filler is placed too superficially or too much is used in one area, it can look unnatural,” he explains. “But when done properly by a skilled injector, it looks great.”
Is Filler Migration Really Happening?
Social media has been flooded with concerns about filler migration, making many believe their filler has moved into unintended areas. But is it as common as people think?
New York dermatologist Anthony Rossi, MD explains that while migration can occur, it’s rare and mostly seen in high-movement areas like the lips. “I’m from New York, so we say location, location, location, right? It’s crucial to understand the plane at which you’re injecting, the product being used, and whether it absorbs water or not,” he says. “Most of what people call migration is actually improper placement. I use a lot of Juvéderm hyaluronic acid fillers, and we see under the microscope that they integrate into the tissue. When placed correctly, filler doesn’t move—it becomes part of the tissue.”
Dr. Baum agrees, adding that incorrect product selection can also play a role. “We see a lot of people using hyaluronic acid fillers that absorb too much water in the tear trough area. If the right product is used and placed correctly, migration shouldn’t happen,” she explains.
Omaha, NE dermatologist Joel Schlessinger, MD adds another layer to the conversation—weight loss. “Think about how many people are on GLP-1 medications,” he says. “When someone loses weight, their filler doesn’t move, but the fat around it disappears, making the filler more noticeable. It’s like a lake drying up and revealing the rocks underneath. What was once perfectly placed filler now stands out because the surrounding volume is gone.”
Does Filler Really Last Longer Than We Think?
There’s been growing speculation that filler lingers in the body much longer than initially thought, but is that a bad thing? “Clinical studies show that hyaluronic acid fillers can last one to two years, but in reality, they integrate into the tissue and may last even longer,” says Dr. Rossi. “You really should find someone that you really trust and who you want to go on this journey with because if you keep hopping around, you will get over-injected and they’re meeting you at different time points. But if you have someone that you really trust and form a really long-lasting relationship with, then you’re aging appropriately together.”
Dr. Schlessinger notes that filler doesn’t just add volume; it also stimulates collagen. “I always tell my patients they’re getting two benefits when I inject filler,” he explains. “First, there’s the immediate volume from the filler itself. Then, about six to eight months later, they experience collagen regrowth and stimulation. This helps improve the skin’s quality and adds a subtle boost in volume over time. It’s not a huge amount, but it’s a nice extra bonus.”
The Bottom Line
The key takeaway? Choosing an experienced, board-certified injector makes all the difference. “The biggest issue isn’t the filler, it’s the injector,” says Dr. Schlessinger. “You want someone who knows anatomy, understands the products, and can manage any complications. That’s why going to a board-certified dermatologist or an experienced provider is so important.”
