Fillers Gone Wrong: Telltale Signs of Too Much Filler Injections

20 Jul Fillers Gone Wrong: Telltale Signs of Too Much Filler Injections

Some of the signs of too much work done with dermal fillers.

How do you tell if someone has had cosmetic enhancement with dermal fillers? The truth is, unless you have before and after pictures to compare; it can be hard for an untrained eye to tell with subtle enhancement done by expert doctors. Dermal fillers are one of the most popular aesthetic treatments in Singapore; and they are a versatile way of sculpting the face to enhance facial proportions and correct signs of aging like laugh lines. However, the more isn’t necessarily the merrier with dermal fillers; in fact too much dermal fillers can make you look dysmorphic.

Related blogpost:

How to Get Rid of Laugh Lines: Nasolabial Fillers

In this blogpost, I’ll be sharing general and specific tips on how you can avoid looking like you had too much work done. But let’s start with the fun part- a look at some of the giveaways that someone’s had too much fillers injected into their faces. If you’d like to see examples of botched Botulinum toxin, this new blogpost Too Much Botulinum toxin: Botulinum toxin Gone Wrong will share more.

Update January 2021:  Facial swelling in a few patients who received the Moderna COVID-19 vaccine has been reported. You can read more about this report and why it happened in this blogpost COVID-19 Vaccine & Facial Swelling After Dermal Fillers.

Update February 2023: Madonna looking unrecognisable at the 2023 Grammy Awards. Spot the signs of an overfilled face on her.

Pillow Face and Sunset Eyes from Cheek Pillows

For a short while (thankfully), pillow face was the de rigeur look to emerge from Hollywood- round, overinflated faces accompanied by sunset eyes.

As we age, changes to the soft tissues and bone resorption cause the cheeks to look flatter and more hollow. Cheek fillers are often used to correct these signs of aging by restoring cheek plumpness and lift the face (the Liquid Facelift). You can read more about cheek fillers and see how it’s done in my clinic in this blogpost Getting Cheeky: A Guide to Cheek Fillers.

A little goes a long way with cheek fillers. The truth is with cheek fillers, you don’t need that much volume of dermal fillers, even if you are looking to create apple cheeks. Overdone cheek fillers can cause a pillow face- an overly puffed up face that looks distorted.

Another victim of the Pillow Face Syndrome, Nicole Kidman.

Not to be confused with chipmunk cheeks (the name is self explanatory), pillow cheeks describe the look when excessive cheek fillers obliterate the natural lid-cheek junction. This causes a continuous swollen face from the lower eyelids to the mid face, like a pillow. The eyes also look smaller and squashed together. The shape of the eyes look like that of a setting sun over the horizon, hence the description, sunset eyes.

How can pillow face and sunset eyes from cheek fillers be avoided?

Look for a doctor with the aesthetic sensibilities to know when to stop-after all, the difference between just right and overdone, is really just one syringe of dermal filler away. It will also help if you speak to your doctor to understand her style and concept of beauty and it differs from doctor to doctor. My preference is to keep to natural looking facial proportions in line with your ethnic group- less is definitely more. Apple cheeks may not be preferred in some cultures and ethnicities.

Secondly, you can consider alternatives or combinations with cheek fillers, so that the total volume of cheek fillers you require are lesser. Using a smaller volume of cheek fillers avoids the overfilled syndrome ala pillow face and sunset eyes. Treatments like Hybrid Cooperative Complex Injectable Moisturiser to rejuvenate and lift the skin and face threadlifts can also restore cheek contours.

Hybrid Cooperative Complex Injectable Moisturiser is an anti-aging treatment for the skin. It contains a high concentration of hyaluronic acid with a unique biochemical structure. This allows Hybrid Cooperative Complex Injectable Moisturiser to hydrate and bioremodel the skin to gently lift the skin and improve skin firmness and texture. Hybrid Cooperative Complex Injectable Moisturiser is not a dermal filler. You can read about the details of Hybrid Cooperative Complex Injectable Moisturiser and see how I do it in this blogpost is Hybrid Cooperative Complex Injectable Moisturiser the Injectable Skincare of the Future?

Avatar Nose from Nose Fillers

The pursuit of a higher and slimmer nose bridge are among the common reasons patients request for nose fillers. Nose fillers in the bridge can elevate the nose bridge for a slimmer and more elegant look. For patients with a broad and low nose bridge, nose fillers are a convenient in-clinic treatment for nose enhancement.

Related blogpost:

5 Things You Need to Know About Nose Fillers

One of the lesser known side effects of nose fillers is the appearance of the Avatar nose. The broadening of the nose bridge occurs due to the nose fillers spreading sideways. The appearance is akin to the blue Na’vi in the movie, Avatar, hence the name Avatar nose has been coined to describe this side effect of nose fillers.

The evolution of Kylie Jenner’s lips through the years. A lot more than bee stung perhaps?

Duck Lips/ Sausage Lips/ Trout Pout from Lip Fillers

The lips are one area where it’s easy for fillers to go horribly wrong.

Fuller lips are sought after as plumper lips are thought to be more attractive. As we age, our lips thin and lose their natural, full shape due to collagen loss. Lip fillers can be used to plump up and refine the shape of the lips.

Related blogpost:

Lip Fillers Explained

Overdone lip fillers can be unforgiving. There are many terms to describe overfilled lips- duck lips, sausage lips, trout pout. Although celebrities like Kylie Jenner have made overfilled lips mainstream, unnaturally swollen lips due to excessive lip fillers can look disproportionate.

How can duck lips/ sausage lips/ trout pout from lip fillers be avoided?

Besides avoiding overdoing lip fillers, consider non-surgical alternatives like the Botulinum toxin Lip Flip or use lip plumpers.

In the Botulinum toxin lip flip, a small dose of botulinum toxin is injected into the muscles around the mouth to flip out the edges of the lip. This gives the illusion of a fuller lip without actually adding volume to the lips. The results of Botulinum toxin Lip Flips are more subtle than lip fillers.

Related blogposts:

Is Botulinum toxin Deadly?

More Than Wrinkles: 5 Surprising Uses for Botulinum toxin

Another non-invasive alternative to lip fillers is lip plumpers. Lip plumpers are lip serums that are applied to the lips. They contain ingredients like menthol that increase blood flow to the lips, causing them to plump up temporarily. Lip plumpers are non-invasive; however the disadvantage is that lip plumpers may cause contact dermatitis in some people. You can read more about lip plumpers in this blogpost NoTox: Non-Invasive Botulinum toxin Alternatives- Which Ones Work and Which Ones Don’t?

Hong Kong actress Fanny Sieh before and after cosmetic enhancement. The proportion and shape of her chin has changed drastically.

 Witch’s chin from Chin Fillers

In ideal facial proportions, the face is divided into equal thirds. For patients with a short or square shaped chin, chin fillers are one way to lengthen and shape the chin. Improving facial proportions of the lower face can give the face a slimmer look. Chin fillers are often combined with masseter Botulinum toxin injections (to slim down the sides of the face) for a more defined jawline and a slimmer silhouette.

Chin fillers can also be used to correct chin asymmetries and ‘butt chin’ in both males and females. When done by an experienced doctor, the results of chin fillers can be very natural and harmonious with the rest of the patient’s facial features. However, there is a risk of developing a witch’s chin if the chin filler is overdone. A pointy and protruding chin can make one look villainous instead of enhancing one’s appearance. Learn about the benefits of chin filler and how it is done in Chin Fillers: A Guide to Non-Surgical Chin Augmentation.

How can witch’s chin from chin fillers be avoided?

Besides choosing an experienced doctor for your injectables (injecting chin fillers with the wrong technique can also cause a witch’s chin), you can consider alternative treatments to shape the face.

Jaw Botulinum toxin slims down the masseter muscles at the sides of the face.

In my practice, chin fillers are often accompanied with jaw reduction Botulinum toxin injections. In patients who have large jaw muscles (i.e. masseter hypertrophy) or grind their teeth (i.e. bruxism), relaxing the jaw muscles with masseter Botulinum toxin is a useful treatment. Botulinum toxin jaw injections relax and slim down the sides of the lower face to improve facial proportions. A smaller amount of chin filler is needed after masseter Botulinum toxin injections so the risk of distorting the face or witch’s chin is much lower.

Related blogposts:

Jaw Reduction Botulinum toxin and Chin Filler Review

Bruxism: Symptoms, Causes and Treatments

Flowerhorn Cichlid fish

Flowerhorn Forehead from Forehead Filler Injections

Forehead fillers can fill up the forehead to reduce the bony contours or increase the convexity of the forehead. Excessive forehead fillers can cause an overinflated forehead, like that of a Flowerhorn Cichlid fish (Luohan fish), hence the moniker, Flowerhorn Forehead.

Related blogpost:

Temple Fillers for Hollow Temples

Filler moustache- when lip fillers migrate or injected into the upper lip region to create a roll, looking like a moustache. This is another giveaway for lip filler injections. 

Filler Moustache from Lip Fillers

Trending right now on TikTok is the subject of botched fillers. Filler moustache, as you can probably guess, is when dermal fillers intended for augmentation of the lips settles above the lips to create a bulge or roll, akin to a moustache.

Again, filler moustaches are an unwanted outcome from lip filler injections. This could happen after lip filler injections due to migration of the dermal filler to the upper lip region- excessive oral movements, excessive lip fillers or poor lip filler placement can cause the upward displacement to create the bulge.

When filler moustache occurs from lip fillers- the only way to treat this complication is to dissolve the bulge with an enzyme called hyaluronidase.

You can read more about dissolving fillers in How to Dissolve & Remove Filler with Hyaluronidase. You can also learn about Tiktok beauty trends in Slugging Your Face: The Viral TikTok Trend Explained and 5 Worst TikTok Skincare & Beauty Trends to Avoid.

Conclusion

Dermal fillers are a useful way to restore natural contours and sculpt the face. Having a balanced approach is the key to having good results without overdoing dermal fillers. Overfilling with dermal fillers distorts the natural appearance of the face and looks very unnatural.

Besides the specific alternatives to avoided these looks, here’s a couple of general tips to consider before getting dermal fillers:

• Choose an experienced doctor who is very familiar with facial anatomy and has an understanding of cultural preferences across different ethnic groups. For example, cheek fullness may be a sign of youth but apple cheeks are not preferred in some cultures. A slim and high nose bridge may look very unnatural if the natural ethnic anatomy is not respected.

• Choose a gentle approach to dermal fillers, especially if it is your first time getting fillers. You can always get your results topped up, so I would suggest doing less if you are uncertain. I personally prefer a less is more approach; using small amounts of dermal fillers (or combination treatments) to enhance your appearance and facial proportions, without overdoing or looking like someone different. An analogy would be doing Baby Botulinum toxin to erase wrinkles without freezing the facial muscles. I share my personal results of Botulinum toxin for my wrinkles in this blogpost Baby Botulinum toxin and Preventive Botulinum toxin in Your 20’s.

• Consider using reversible dermal fillers. There are several types of dermal fillers available in Singapore and the only types of dermal fillers that can be dissolved away with are hyaluronic acid fillers. Learn more about non-surgical removal of dermal fillers in How to Remove & Dissolve Fillers with Hyaluronidase.

• If you dislike the results of your dermal filler injections, the effects can be reversible. If you had non-reversible fillers like Ellanse, Radiesse and Sculptra injected, the effects cannot be reversible. You can read more about the different types of dermal fillers available in Singapore in this blogpost Botulinum toxin vs Fillers: Differences, Uses, Effects and Myomodulation.

I hope that you found this blogpost on dermal fillers useful! Have a good week ahead.