Why some fillers look bad, and how we fix other injectors’ sub-par results
Dermal fillers can be used two ways: to enhance your existing features—such as with lip filler for a plush pout—or to correct volume loss throughout the face. Neuromodulators, like BOTOX®, are used primarily to smooth wrinkles. In the hands of an experienced injector, injectables of both kinds can enhance your natural anatomy while keeping you looking natural and preserving your ability to form natural facial expressions.
Unfortunately, some people end up with asymmetrical results or an over-filled appearance (colloquially called “duck lips” or “trout pout”) that makes it clear they had work done. If you have received a result that looks less natural than you’d hoped, don’t panic: today’s blog covers many of the ways injectables can turn out poorly, how we diagnose the issue at our office, and the methods we have for fixing a sub-par result.
Note that an unsatisfactory result is different from an adverse effect from filler: Seek emergency medical attention if you have an adverse reaction to filler, such as a change in vision, blue skin discoloration, blanching, or severe pain, as these may be signs of a punctured blood vessel. Mild reactions such as swelling, bruising, or redness usually clear up within 2 weeks of receiving filler.
These bad injectable techniques can leave you looking “fake”
To end up with gorgeous results, your injector must use the appropriate products in the right areas, customized to your unique features. Unfortunately, inexperienced injectors can make certain aesthetic mistakes that create a “botched” look or other unsatisfactory results. Here are 4 common reasons why this happens.
1. Over-injection directly in the area of concern
Good results require an eye for aesthetics—the ability to examine your features and understand how injection in one area will change the balance throughout the rest of your face. This is more complex than treating one area at a time. If you visit an injector because of one area that’s bothering you, they should consider the balance of your facial features, and consider all possibilities for achieving your desired look.
For example, if a patient complains of marionette lines (which extend from the sides of the mouth to the chin), injecting filler solely in these lines tends to lead to an unsatisfactory outcome. Instead, dermal filler injected into the related areas of the mouth and jawline may improve the overall contour of the area, creating a more youthful lower face appearance without directly changing the area of concern. Depending on the patient, filler may be injected below the corners of the mouth to subtly lift the mouth’s expression, and/or along the jawline to rebuild lost volume that contributes to a sagging appearance in the lower face.
2. Focusing on one or two features, rather than correcting overall volume loss with filler
Similar to over-injecting in the area of concern, it’s key that your injector consider overall volume loss rather than focusing only on certain areas. Because aging occurs throughout the face, all features should be considered in relation to one another to achieve a natural look with injectables. Rather than focusing on each wrinkle and line, fillers are sometimes best used to reverse aging by building up volume to refresh key facial areas (i.e. thin lips) that contribute to your youthful appearance.
3. Trying to get surgical-level results with injectables
Excess loose skin or certain issues like jowling and deep marionette folds cannot always be satisfactorily treated with dermal filler or Botox-type neuromodulators, and may require a surgical procedure. In these cases, your board certified plastic surgeon should consult with you on the full range of options, and what outcomes you can expect from each.
An experienced injector will not provide unsatisfactory treatment with injectables to a patient who desires more of a change than injectables can provide. A trustworthy injector will help you understand what results you can realistically expect from each treatment.
4. Using the wrong injectable product
It’s the injector, and not the product, that influences your results the most. But you do want your injector to choose the right products for the area they are addressing! There are numerous filler products for a reason: each has been developed to deliver the right amount of flexibility and/or cohesivity for specific areas of the face.
Using the right product involves you as a patient: it’s important to go in with an open mind. Instead of demanding a specific product, focus on your aesthetic goals (“I want to look less tired” or “I want to improve the shape of my upper lip”) and follow your injector’s advice. A qualified injector will have worked with many products and understand where and how they can best be used to achieve your desired results. If you’re unsure of the treatment plan you are given, you can always get a second opinion.
Bad results? How to choose an experienced injector for dermal filler correction
If you’ve received a bad result, the most important next step is to find an injector who can evaluate the cause of the problem and help you correct it. Here are some suggestions:
- Training & Qualifications: Choose either a board certified plastic surgeon who performs the injections themselves, or a physician assistant or registered nurse who offers injectables under the direction of a board certified plastic surgeon. Either way, confirm they have undergone specialty training in correction of dermal filler results.
- Experience: The best injectors have had the chance to learn from experience, through years of regularly treating patients. Ask how many injections they perform each month, and, even more importantly, what their experience is correcting poor results from other injectors.
- Style: Make sure that you like the injector’s sense of aesthetics, or style. Your injector should have numerous before and after photos taken of previous patients either on their website, social media accounts, or in their office. Look for patients that resemble you in the “before” photos and reflect an outcome you like in the “after” photos.
How our experienced injectors fix bad dermal filler results
At Claytor Noone Plastic Surgery, we have helped many patients with injectables correction. If you have a bad dermal filler result, your results may be fixed using these correction techniques:
1. Hyaluronic acid-based fillers can be dissolved
Whether you received too much filler, the filler appears lumpy and does not improve with massage, or your results simply don’t look right, we may be able to use the enzyme hyaluronidase to dissolve the filler if you received dermal filler injections with a hyaluronic acid-based product, such as Juvéderm® and Restylane®.
After the enzyme injection, it takes about 24-48 hours to dissolve the filler. In cases where hyaluronic acid fillers were injected poorly, this allows us a clean slate to reevaluate your anatomy to find a treatment plan that will achieve your desired results.
2. Artful reinjection can give you an excellent result
Expert injectors will be able to handle reinjections artfully, achieving an excellent aesthetic outcome in many cases. Even if we are not able to dissolve your existing filler or change your neuromodulator injections, there are artful ways to use filler and BOTOX® to adjust the overall contour and draw attention to certain areas of your face.
While your particular treatment plan will be unique based on what you want, there are many techniques that our injectors use to enhance your features, rebuild volume, and ultimately help you look like your best self:
- Restore lost volume in the brow fat pad, which lifts your brow arch and frames your eyes
- Build volume in the cheeks to enhance your bone structure
- Use BOTOX® in the masseter muscle to slim the jawline and draw attention to the natural “V-line” of your face
- Build a defined jawline with filler
- Smooth the appearance of acne scars
- Relax the upper lip to define its shape with BOTOX®
Many treatment plans also involve replacing lost volume with filler in areas such as the temples, tear troughs, cheeks, nasolabial folds, upper lip, and jawline. These areas can also contribute to more balanced results.
Visit Claytor Noone Plastic Surgery for injectable filler, BOTOX®, and a range of other non-surgical and surgical options
The best way to avoid a botched injectable result is to choose a trustworthy injector. For those near the Philadelphia Main Line, Dr. Brannon Claytor and physician assistant Julie Holesh at Claytor Noone Plastic Surgery have the skills to give you gorgeous results safely. Whether you are ready for full facial rejuvenation with filler, want to add plumpness to a specific area, or would like to consult with an expert on your facial rejuvenation options, book your consultation today by calling (610) 527-4833.
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