A Beverly Hills reconstructive surgeon is warning people of trusting beauty myths that suggest dermal fillers are a temporary tweak. These days, getting fillers is an incredibly common practice.
“You cannot fill your face to youth,” he says, adding that subtle enhancements can cause irreversible damage, leading to the dreaded pillow face.
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Dermal fillers have become a beauty industry and celebrity favorite, promising a youthful glow without the need for invasive surgery. Believed to be a safe and reversible treatment, these injectable solutions smooth wrinkles, plump lips, and contour the face in ways that makeup alone cannot achieve.
However, Dr. Kami Parsa, an oculoplastic and reconstructive surgeon, is sounding the alarm: dermal fillers are not always the quick, temporary fix people believe them to be.
In July 2024, the Beverly Hills surgeon shared a startling TikTok clip that piqued the interest of 12.4 million online users. The video shows MRI scans of dermal fillers beneath the skin of a patient who received over 12 syringes of hyaluronic acid (HA) filler over six years.
HA is a popular dermal filler used in cosmetic treatments to smooth wrinkles, restore lost volume, and enhance facial contours for a more youthful appearance.
But what’s underneath is startling.
Filler clumps and grows
In the clip, Parsa highlights the green areas on the scan, which represent the clumps of filler material still present years after injection. Upon measuring, the doctor discovered that the filler totaled nearly 28 cubic centimeters – more than double the original amount injected. He explains this increase is due to the hydrophilic nature of hyaluronic acid fillers, meaning they attract and retain water, and their tendency to cause tissue expansion over time.
“We feel that, sometimes, hyaluronic acid fillers have been overused for many years. We felt it’s important to share our findings,” Parsa told Newsweek of the long-term sustainability and safety of frequent filler applications. “We hope that people will learn that less is more when it comes to the HA filler.”
Parsa’s insights highlight an important reality: although HA fillers are promoted as a temporary cosmetic solution that naturally dissolves within six months to two years, small amounts can remain beneath the skin – for up to 10 years, he says – especially when treatments are repeated frequently.
This prolonged presence, combined with their ability to retain water and amplify volume, can result in unexpected and sometimes undesirable outcomes, like overfilled syndrome or pillow face.
Pillow face
Overfilled syndrome refers to the unnatural, over-plumped appearance that occurs when too much filler is injected into the face. While fillers are designed to add volume and smooth out wrinkles, excessive or repeated treatments can stretch the skin and alter facial proportions. This leads to the puffed-out, exaggerated look commonly referred to as pillow face. This goes directly against the beauty standard they are meant to maintain.
“Every day we see beautiful patients from all around the world who are very overfilled. I feel like a broken record but: you cannot fill your face to youth,” the doctor writes on social media. Attached to the post is the image of a woman who needed several procedures to fix the chronic swelling in her face.
How it develops
Dr. Parsa emphasizes that overfilled syndrome is not an overnight issue. Instead, it often results from:
- Layering fillers: Repeated injections without allowing previous fillers to dissolve can lead to filler accumulation.
- Overcorrection: Adding too much volume in one session or focusing too heavily on certain areas of the face.
- Skin stretching: The filler’s weight can gradually stretch the skin, making the face look unnaturally round or puffy.
‘Injecting poison’
The startling TikTok clip generated a flurry of comments from online users who were shocked by the graphic revelation.
@kamiparsamd #kamiparsa #fillers #hylenex #dissolvingfiller #dermalfillers #lips #teartroughfiller ♬ Blade Runner 2049 – Synthwave Goose
“When it first came out, all injectors said it would only last six months,” writes one concerned netizen. Responding, Parsa writes: “That’s what the filler [companies] were telling us.”
A second cyber fan shares, “I got lip filler once and I’m convinced they are above and below my lips and will never go away.” While a third writes, “Finally this is being talked about. The mass production and insane usage without WARNING.”
Another shares that she’ll keep her face as it is: “I will never get filler or Botox or anything like that. It just seems like so scary and weird to be injecting poison into your face,” the user writes.
Were you aware that fillers don’t always dissolve and create clumps beneath the surface?
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