How Fillers Can Give An Unnatural Look

A mild facelift effect is now possible without having to go under the knife, thanks to the invention of dermal fillers. Usually made up of hyaluronic acid, a natural compound found in our own body, fillers have become quick fixes for restoring volume due to fat or bony loss, and erasing fine lines and wrinkles due to aging. Younger people who are not satisfied with the way they look are also turning to fillers first rather than surgery to improve certain less-than-perfect features, such as adding height to a flat nose bridge, augmenting a weak chin, filling up sunken undereye hollows or thin lips. Some dermal fillers can even be injected superficially into skin, to improve hydration for the smooth, dewy look.

But things can go wrong when correction becomes overzealous, or if the wrong filler was used in the wrong area. In this article, we speak to Dr Michelle Lim from The SW1 Clinic, and give you the inside scoop on major filler no-go’s to help you navigate through the potential minefields of filler disasters so that you can emerge out of the game looking sharp and natural.

The Rise of The Pillow Face

When does too much of a good thing become bad? It may sound a little weird but when the face looks too perfect and completely devoid of lines, with the skin pulled too tight over overly injected fillers, the resulting look is puffy and overstretched – jarring and cosmetically “made”.

Courtney Cox, who admitted that she didn’t like her fillers
and had them dissolved later.

Known as the “Pillow Face”, it started getting noticed amongst aging Hollywood celebrities who were getting too much volume in the midface.

“Where dermal fillers are concerned, less is more, and subtlety is the best.” Says Dr Michelle. “When my patients return after a session of dermal fillers injection and report to me that their close friends noticed a difference, but no one could tell what was done, I know that I have done it well”.

Dr Michelle admits that she has been pressured to inject more than what was desired, and came close to creating a pillow face herself. Luckily hyaluronic acid fillers which she chooses to use are biodegradable and dissolvable, so there is no permanent harm done.

“When I see patients who point out specific insecurities about their appearances now, I look at how I can sculpt the face to lift and indirectly soften lines, rather than simply erase the lines wherever they point. Sometimes, some lines are needed to convey a certain warmth in daily expression, without them one looks insincere and ‘plastic’. So part of the trend now is restoring volume modestly and combining other face lifting treatments whether they are non-invasive devices such as Ultherapy or Thermage, or face threadlifts, and even some tailored Botox treatments, for a complete and natural improvement, rather than chasing specific lines” says Dr Michelle.

When asked about what she does for patients who want more than subtle changes, Dr Michelle says that she readily refers patients who are ready to take the leap to their in-house Plastic Surgeons, Dr Tan Ying Chien and Dr Chia Hui Ling. “That’s the advantage of The SW1 Clinic, we have everything under one roof, and readily refer patients if the need arises”.

Hollywood actress Jane Fonda, 80. Beaming with youth and
widely known for her natural-looking facelift results.

Build It Up

To avoid creating pillow faces, Dr Michelle recommends incremental doses instead of trying to correct everything in a single session. She explains the advantages of doing so: “Firstly, the difference in appearance is more gradual when we build it up over several sessions, so family and friends do not immediately notice that work has been done. Secondly, it is easier to not over-inject when we split the treatment up like that.”

She advises, “One way to do that is to start with a small amount of fillers first and evaluate 2 weeks later and build up from there if needed. Technically, if done correctly, most cheek filler augmentation treatments rarely need more than 1 or 2 mL of hyaluronic acid fillers.”

Don’t Just Have Fillers To Look Younger

Anti-aging treatments should be not over-focus on a single area but instead, incorporate treatments that will give a harmonious, natural look.

Combining treatments seems like the way to go. For example, have the jawline sculpted with Ultherapy or a threadlifting procedure such as the Infinity V- and Necklift from The SW1 Clinic, while restoring volume subtly in the cheeks with fillers.


Before and After Thread lifts (Infinity Instalift)

Skin that is taut from filler plumping may still look aged because of fine lines and pigmentation. Starting a laser regime such as erbium or carbon dioxide resurfacing lasers plumps up the skin gradually over time and gives the skin a healthy hue because of natural collagen stimulation. An example of an erbium laser is Fraxel which can be tailored to just texturizing and pore refinement, or adjusted to stronger settings for deeper lines and looser skin. Similarly, SmartX is a unique carbon dioxide laser combined with radiofrequency that can treat deep wrinkles, flabbiness and scars, and can be used to treat sensitive areas such as the eyelids, neck and décolletage, areas which were considered too sensitive for such lasers.

Obvious wrinkles look like odd creases on ironed bedsheets, so some muscles may need to be relaxed so that everything looks harmonious. “As with fillers, a little Botox goes a long way and definitely avoid the frozen look which looks very passé.”says Dr Michelle.

Opt for Reversible Hyaluronic Acid Fillers

Safety is still the most important, so opt for hyaluronic acid fillers because these can be undone if what your doctor has done becomes too obvious or if there are complications such as lumps and bumps. Hyaluronidase is an enzyme that readily dissolves hyaluronic acid fillers and acts like an antidote to reverse the effects of any filler procedure you do not like.

Here’s an example of how bargain lip fillers can do to you. This patient had permanent silicon lip fillers which unfortunately created lumps. She needed surgery to remove them as these are not reversible. (repost from Allure)

Dr Michelle advises against permanent filler injections which cannot be reversed easily if complications arise. “What people do not realize is that our facial bones resorb with age, so a filler augmentation that was sculpted to suit a person at the age of 25 may look disproportionate to the rest of the face by the time they are 45.” Says Dr Michelle, who has had to refer patients who had permanent silicon injections for surgical intervention.

Look For A Doctor With Respectable Training

You will be surprised at how many doctors who have not received proper training but are able to start injecting without supervision. You should visit a clinic with a track record in the procedures they perform, especially injectable procedures, and only allow a board-certified plastic surgeon to perform surgery on your face and body.

My personal take is that some clinics are pricey but it is a reflection of their quality. I would rather pay more for a procedure in a trusted establishment than take up a cheap bargain in an unknown clinic, because I know in the former, there is respect for the trade, and accountability in treatments I undertake.



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