As the saying goes, everything in moderation (is okay). But does the motto hold for fillers, too? Almost like a twisted game of beat the clock, fillers can age the face when used excessively, even though the goal is to turn back the hands of time.
You’re How Old?
For all the good that fillers offer, like smoothing lines and wrinkles and reinstating volume, there are instances where they can make you look older. The primary mechanism of how fillers age one’s face is by creating a distorted or disproportional look, says New York City oculoplastic surgeon Irene Gladstein, MD. Overfilled faces do not exist in nature or younger faces, so society automatically assumes that the face is more mature than it is. “Plus, if we inject too much filler, the face looks fake and done,” says New York City facial plastic surgeon Dilip Madnani, MD.
There’s also migration, which is common in the upper lip and cheeks due to poor injection techniques, using the wrong filler or too thick of a filler, or injecting excessive amounts of product. Fort Lauderdale, FL dermatologist Dr. Matthew J. Elias explains that filler migration is always a potential risk. “Unfortunately, with gravity, the filler tends to migrate downwards, which can give a sagging appearance.” Migrated filler can also cause swelling and a blueish tint under the skin, known as the Tyndall effect. “In addition, it can result in an unnatural ‘shelving’ above the lips, skin stretching (mostly under the eyes), and an unnatural look,” adds Dr. Gladstein.
One reason some patients look natural and refreshed, and others appear aged, comes down to the placement of the filler. “Improperly placed fillers distort your normal anatomy and age you,” says Dr. Elias. “That’s why it is important to see a board-certified dermatologist to assess and treat you properly.” Dr. Gladstein agrees and adds that focusing on one feature creates a lack of facial harmony and reads as more mature.
Here’s what unnecessarily injected and overfilled areas can look like:
Overtly sculpted cheeks that appear stiff or too puffy age the face. If the cheeks appear chipmunk-like, they can obstruct the natural delineation between the eyes and the cheeks, which is a look often associated with poorly done facelifts of yesteryear.
In the case of neurotoxins and not filler (we found this necessary to include), knocking out the frontalis muscle (the muscles above the brows) with too much product can drop the brows and lead to hooded-looking eyes and heavy brows.
Putting unnecessary amounts of filler into the chin distorts facial balance, making the lower-third of the face appear square instead of heart-shaped, which is associated with youthfulness.
Overly plump lips don’t look natural on anyone, especially because, like other features, the lips lose volume and shape with age. Aggressive use of filler can permanently stretch out the skin, which causes sagging.
The under-eyes are tricky, and unless there is true hollowing, it’s one area to avoid. If the area is already puffy or there is excess skin, the additional volume will accentuate the look of aging eyes.
Fillers add volume to deficient areas by attracting water. However, the skin can stretch out over time from excessive use of fillers. “This phenomenon is most commonly seen under the eyes and is usually not associated with the filler itself, but the swelling that comes with poorly placed filler or the use of ones that are too thick for the area,” Dr. Gladstein says. “Long-term swelling of the skin under the eyes tends to damage and stretch the skin, often leading to issues in the area even after removing the filler.” But, when done appropriately, she says fillers should not stretch the skin but rather enhance the area.
As the tissue loses elasticity, no matter how much product your doctor injects into the face, the skin will not bounce back to its original shape. Instead, the stretched-out tissue needs to be corrected, for which Dr. Madnani recommends skin-tightening procedures like Ultherapy.
However, if you follow these rules and seek out the expertise of a board-certified expert injector, chances are you’ll look like a refreshed, more youthful version of yourself—not an older one.