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    Filler Fatigue: What It Is, and How to Avoid It

    Woman getting lip filler injections at a medspa

    In the world of cosmetic enhancement, facial fillers have taken center stage as a favored treatment for adding volume to areas of the face like the lips, naso-labial folds, and even tear troughs.

    But with more people turning to fillers on a regular basis, there has been growing concern about a phenomenon dubbed “filler fatigue.” So, how can you avoid developing “pillow face”? Let’s dive in.

    What is filler fatigue?

    Filler fatigue describes the purported weakening or sagging of facial tissues after receiving filler injections. The idea behind filler fatigue is that, over time, the skin could stretch out (and potentially look more aged) from the constant filling and stretching from volumizing dermal fillers. Since dermal fillers eventually dissolve, this could lead you to require even more fillers in order to maintain a youthful appearance.

    “Filler fatigue” doesn’t mean filler stops working—it means it was used the wrong way.

    It’s important to understand that no clinical studies have been conducted to more deeply look into this question by comparing a control group with a large population of study participants. That means it is difficult to say how much an individual’s thinning skin could be due to perceived “filler fatigue” or simply the gradual loss of the collagen & elastin supporting the skin’s structure, which is a natural part of the aging process. In any case, correct filler technique is absolutely critical.

    How to avoid filler fatigue

    If you’re concerned about the potential for filler fatigue, the key is to find a genuinely knowledgeable injector with many years of experience. Talk with your injector about their strategies for using filler properly, and avoiding “filler fatigue” or an unwanted over-filled appearance (sometimes called “pillowface”). Here are some important principles of natural-looking, sustainable facial filler:

    Use small amounts in each appointment

    While dermal fillers can offer transformative results, it’s often best to err on the side of caution, laying a moderate foundation in the first injection appointment. Injectors can always add more filler, but taking it away requires injections of hyaluronidase to dissolve the filler, which is a more difficult process than simply “scaffolding” your filler in the first place.

    A skilled injector will generally take a “less is more” approach, using small amounts of product to create a harmonious and balanced appearance.

    Avoid injectors who give every patient the same cookie-cutter filler treatment or an overfilled appearance that is geared towards showing well in photos versus looking natural in person. What’s trending on Instagram or TikTok is unlikely to complement every person’s features; using gimmicky techniques could lead to the “Instagram face” look and detract from your natural features. Injectors who use so much filler that features lose their definition may also increase a patient’s chances of developing “filler fatigue.”

    Choose an appropriate product

    Each dermal filler works a certain way, in certain areas of the face. There are many different types on the market, each designed for specific uses and areas of the face. Some fillers, like those based on hyaluronic acid, are designed to be reversible and temporary, while others, like poly-L-lactic acid-based fillers, offer semi-permanent results and work by stimulating your body’s own collagen production. Having an understanding of the different types of fillers available, and their specific uses, can help you make informed decisions about your treatment.

    Even among the popular hyaluronic acid fillers, there are numerous options that have different qualities and textures, making them better suited for certain results in different areas. For example, some of our favorite lip filler formulas are Juvéderm Volbella and Restylane Kysse because they feel flexible and light in the lips; we avoid using more cohesive products like Restylane Lyft or Juvéderm Voluma here, as they are better suited for more static facial areas like the cheeks.

    Wait to schedule follow-up injections

    While certain fillers may have a stated number of months they’re expected to last, this number is believed to vary widely from person to person. You may not need a filler touch-up at 6 months or even 24 months just because that is the quoted duration of your product. Unless you have access to an MRI of your face, you are unlikely to be able to tell how much product remains from your last appointment—and it may be more than you think.

    Just because a filler is expected to last a given number of months doesn’t mean all patients will need a touch up at that time.

    It is natural, over time, to become used to how your face looks with the filler. To avoid the natural change in perception of what your baseline appearance is, compare your look with photos of yourself before—not with celebrities or influencers. Wait to get more filler until you desire a change, and don’t simply schedule a touch-up because the product is expected to dissolve after however many months.

    Incorporate alternative & complementary procedures

    While fillers are a fantastic tool for facial rejuvenation, they are just one of many time-tested treatments that reputable cosmetic surgeon-led medical spas offer. Fillers are limited in their scope, and you may benefit from branching out. Consider treatments that promote skin firmness on the surface and other options that achieve reliable, excellent improvements without adding volume:

    These proven medical spa favorites can provide excellent results, either alone or in combination with fillers.

    While filler is the gold standard for adding volume (i.e. lip filler), when it comes to anti-aging, achieving a more youthful look is not always about adding volume. Making efforts to improve your skin’s surface texture as well as enhance collagen production will create a much more natural appearance. It’s also best to adopt a robust skin care regimen using physician-grade products to promote skin health and maintain your results.

    Choose a reputable injector

    Not all injectors are created equal, so you need to be up-front about asking for your injector’s (1) years of experience, (2) medical credentials (i.e. registered nurse or doctor), and (3) training background in cosmetic injectables. Skill, experience, and understanding of facial anatomy varies widely among injectors, so choosing one who is both experienced and has a background in cosmetic surgery or dermatology can help to ensure that the filler is being administered correctly and in the right areas. You should also ask to see before and after photos of previous patients to see what the injector can accomplish and get a sense of their aesthetic.

    Dermal fillers remain a cosmetic staple

    While the concept of filler fatigue can sound alarming, remember that millions of patients have enjoyed the benefits of dermal fillers for many years without experiencing negative effects. The keys are moderation and working with a reputable, experienced injector who understands your aesthetic goals and respects the individual beauty of your face’s structure. The goal should be to enhance your natural features and maintain a refreshed, youthful appearance—not to transform your face into something it’s not.

    Our goal is enhancing the already beautiful you—we don’t do “cookie cutter” filler.

    To us, expertly performed injections are a cosmetic enhancement staple, and we’re here to treat you not with trends, but with customized and time-tested techniques that yield natural-looking results. We have placed facial fillers for years and have many happy patients who return to our practice for other treatments and medspa services. All of our non-surgical treatments are overseen by board-certified cosmetic surgeon Dr. Talon Maningas, and our injector Nurse Beth holds years of cosmetic injectables experience.

    Visit Maningas Wellness & Injectables in Joplin

    To learn about your options for natural-looking rejuvenation, schedule your consultation with Nurse Beth today. Our knowledgeable staff are available by phone at 417-437-0303 or you can send us a message online.

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