You may be hearing that fillers are losing popularity. But despite news coverage of celebs dissolving their injectables, the data shows that fillers remain hugely popular. So, what’s changed? If you ask the experts, it’s about a higher standard of quality, technique and results. As the “overfilled” look moves firmly out of popularity, it’s the undetectable injectables that reign supreme.
Featured Experts
- Kelly Bomer is a board-certified facial plastic surgeon based in Scottsdale, AZ
- Aviva B. Preminger is a board-certified plastic surgeon based in New York
- Sean Simon is a board-certified plastic surgeon based in Miami
- Jennifer Segal is a board-certified dermatologist based in Houston, TX
The Top Performing Fillers
These days, fillers come in two main categories: hyaluronic acid fillers (HA fillers) and biostimulatory fillers. HA fillers attract and retain moisture, plumping the skin and filling in wrinkles. On the other hand, biostumulatory fillers prompt our bodies to produce more of our collagen.
HA fillers
- Juvéderm: With six different HA fillers created for different areas of the face, Juvéderm offers rejuvenation that lasts between one and two years.
- Restylane: Delivering over 65 million treatments worldwide, Restylane offers eight different formulations to address everything from under eye hollows to aging hands.
- RHA Collection: Designed to work with your face’s dynamic movement, RHA Collection offers lipstick line smoothing, wrinkle smoothing and natural-looking volume restoration.
- Evolysse: The newest HA filler, Evolysse combines hyaluronic acid with Cold-X technology to preserve the look of HA fillers.
Biostimulatory Fillers
- Sculptra: Created to address skin quality, tightness and jawline contour, Sculptra stimulates your natural collagen production and provides a natural glow.
- Radiesse: Designed for the lower face and hands, Radiesse comes promotes collagen and elastin production for an immediately lifted look.
Undetectable Injectables Are the Gold Standard
The truth is, not just anyone can use fillers like Radiesse, Juvéderm or Sculptra to their fullest potential. To get your injectables to be undetectable, you need an expert hand with a deep understanding of anatomy and the filler they’re using.
“Keeping filler undetectable requires the the balance of not only understanding the delicate proportions of beauty and attractiveness for feminine and masculine features, but also the deep understanding of filler properties,” explains Scottsdale, AZ facial plastic surgeon Kelly Bomer, MD. “You need to know how to maximize them to mimic the tissue that is being augmented. An intricate understanding of anatomy is required to know how to access these specific areas safely.”
To achieve an undetectable injectable treatment, practitioners have to adjust their depth to deliver an enhancement that doesn’t show its hand as a filler.
“I keep filler undetectable by injecting into the proper locations, at adequate depth for the desired effect without being able to see or detect the actual filler material,” explains Miami plastic surgeon Sean Simon, MD. “You should also only be using the amount needed to achieve the desired natural-looking effect. Too much filler will always look unnatural and is the most common error.”
To avoid overfilling, New York plastic surgeon Aviva B. Preminger, MD chooses a more gradual enhancement technique. “I find that adding small amounts of filler over time rather than all at once can really help avoid an overfilled look,” she explains. “I also use a micro-droplet technique or cannulas for a smoother distribution of the product.”
Choosing Your Practitioner
Not all practitioners are created equal, and mastering undetectable injectables takes an expert.
“As a facial plastic surgeon, with extensive surgical experience involving all layers from the bone, vascular, muscle, subcutaneous and dermal levels I have found the process of maximizing injecting fillers to augment facial features for enhanced beauty and reducing the signs of aging to be very challenging and satisfying to master,” Dr Bomer says. “For example, in the side of the face, filler can restore volume. It is best to carefully deposit thin layers over time of a flexible filler of appropriate consistency. If too much filler is placed at once, or the filler is too thick and inflexible, it will not mimic natural-looking fat pads. With discreet anatomic areas such as anterior cheeks or lips, less is more.”
According to Dr. Preminger, that anatomic understanding is key to a natural-looking outcome. “My technique focuses on balance and proportion, where we prioritize facial harmony rather than over-volumizing one area,” she says. “That can result in the classic overfilled look.”
Houston, TX dermatologist Jennifer Segal, MD explains that expert practitioners are also thinking about how your fillers will age. “As a dermatologist, we’re really considering how the skin and face will change with age, and you want your fillers to age beautifully with you,” Dr. Segal notes. “It’s really about playing the long game to ensure that your fillers look good not just the second you walk out the door, but years and years down the line.”
Going from Overfilled to Undetectable
The good news is that, in the right hands, even overfilled patients can get to a more natural, undetectable place.
“Fortunately, many fillers are temporary, so one option is simply waiting enough time for the filler material to be metabolized and then start from scratch,” says Dr. Simon. “Also, for hyaluronic acid gels, an enzyme can be used to instantly dissolve the filler material. This injection should also be performed by an experienced plastic surgeon or dermatologist.”
Dr. Preminger notes that depending on the individual, a more balanced approach with fillers may get you to that natural enhancement. “And for those who have been overfilled with synthetic fillers, autologous fat transfer can create a softer, more natural look,” she explains. “And of course, we can combine radiofrequency, ultrasound or laser treatments to improve skin elasticity after excessive filler removal.”
But again, putting your correction in the hands of an expert is critical.
“Reversing and correcting filler takes just as much artistry as putting it in correctly,” Dr. Segal adds. “I think it will come to require a kind of sub-specialty. Ultimately, correction takes time and costs money, and you really want to do the research required to get it done right the first time.”
