Photo-Illustration: Joe Darrow/Muppets/Walt Disney Prods/Kobal/Shutterstock
Since around 2016, millions of people have been going to dermatologists to put stuff in their face with one particular goal: to look like hot babies. The way they achieved this was with filler – usually acid and fat injections. This filler era created a specific aesthetic marked by heart-shaped faces, tiny noses, and full, puffy lips and cheeks.
Quite recently, faces have started to take the opposite path.
“I can’t remember the last time someone asked me for big, juicy, plump lips,” says Dhaval Bhanusali, the doctor behind Martha Stewart’s ageless skin.
If you know any famous faces, the transition can be defined as: “Everyone wanted to look like Kylie Jenner. Now they want to look like Bella Hadid,” says Matthew James, a British makeup artist and beauty influencer who used fillers for ten years to look “a little fluffy.”
A reason for the change? Turns out the fillers weren’t the elixir the youngsters wanted them to be. Over time, many filler enthusiasts have found that the stuff actually migrates around the face.
“It was marketed as this risk-free thing,” says Carly Raye, a Toronto-based content creator who got lip fillers at age 20. She had a common experience: her filler traveled, creating a ring of puffiness around her lips that various surgeons have described as the “Juvéderm mustache”, “duck lips” or “Homer Simpson’s face”.
Filling could accumulate anywhere. “I was smiling and had little bulges on the top of my cheeks,” Rosie Genute, a Jersey-based makeup artist, says of her wandering under-eye filler.
Raye and Genute, like many other patients, were led to believe that minimal risks were involved and that although migration was possible, it was unlikely. Additionally, patients were often told that the filler would wear off quickly. It’s not always the case. “We say the filling only lasts a year, but that’s completely untrue. It most often lasts much longer,” says Sagar Patel, a Beverly Hills facial plastic surgeon.
Why all this new filler information now? It seems everyone – from providers to patients – just didn’t know much about things to begin with. And maybe they still don’t. Hannah, a graduate student in New York, described her first few months with fillers in 2021 as wonderful. “I was looking better than ever,” she wrote via email, “then by month five my whole face swelled up and didn’t sag.”
She says she received “profoundly contradictory” explanations from the 20 doctors she saw in the following months. “The doctor who gave my injections, seeing my face, informed me that such a reaction was ‘impossible’ and that she had ‘never seen anything like it before’.”
Hannah was prescribed dozens of medications to get rid of the swelling. When neither of them worked, she – like Genute and Raye, with their migrated filler – decided to disband.
But dissolving putty, like filler in the first place, is not a magic bullet. This is done by injecting hyaluronidase, an enzyme. Several doctors say that while it’s medically safe, they avoid using it outside of emergencies or — as Simon Ourian, surgeon to Kim Kardashian, Megan Fox, and various Victoria’s Secret angels — puts it — when “things go wrong.” are really grotesque”.
Ourian and several other vendors say this is because hyaluronidase can also dissolve some of your natural tissues, not just your fillers. Additionally, many patients describe dissolution as an uncomfortable and, in some cases, extremely painful process. “Imagine snake venom or pure acid,” says one patient.
But pain may be the best-case scenario, judging by the many internet support groups devoted to the complications of hyaluronidase. I spoke to a dozen dissolvers. All describe their post-hyaluronidase skin in disturbing terms: “spongy”, “melted”, “like jelly”. “I feel like the skin is not attached to my face,” says a woman in her twenties. Another shared a photo of herself pulling handfuls of loose cheek skin from either side of her face.
Patients who have had no filling and dissolving complications spend between $2,000 and $6,000 for the process, but even those who are completely dissolved report scar tissue at the injection site. Patients who have had complications — and tried to sort them out — say that between travel, sick leave, surgical facelifts and various treatments, they’ve spent up to $70,000.
The sheer number of people in online support groups speaks to the extent of the botched filler. “A few years ago, some doctors were just learning how to make fillers. You tend to get overzealous and fill out the face, chase every line, every sign of aging,” says Ourian. “And people were paying for these procedures by syringe, so there was a tendency to keep putting more and more in pursuit of better results.”
“Now,” he adds, “everyone realizes that looking like a chipmunk is a bad image.”
Some surgeons have pointed to the rise of clinic chains and medical spas as responsible for poorly filled faces. “People will take a course for eight hours and then they will start injecting,” says Akis Ntosos, who runs a boutique clinic on the Upper East Side. A surgeon called overfilled faces a ‘rookie mistake’, while a dermatologist has described medical spas as ‘chop shops’.
For the most part, however, no matter where people have gone for these procedures – the results have been mixed at best. Alice, a Vegas waitress, had her lip filler dissolved by a famous Beverly Hills surgeon she went to for lip enhancement surgery. Alice is a pseudonym – she worries about retaliation from the practice, which sent chills down her spine when she complained about complications from the dissolver, which she says left her with deep gashes around her nose and mouth, rashes all over her body and pink. his lips.
When she called the clinic, the surgeon suggested she had caught a virus, and if she returned she could buy more putty to fix the gouge.
Many patients reported being pressured, fired and gassed by providers. I spoke to a utility retiree in his 60s who went to a medical spa for a consultation about his acne scars, “but they kind of oversold me and started putting on loads everywhere,” he says. Her skin swelled and broke open. It got worse: “The nail polish remover got on my cheek and turned white and discolored. The skin slowly started to peel off and I couldn’t really see through my eyes.
“It’s basically ruined my life,” he said.
With their fillers dissolved, customers looking for a more angular face are now lining up for buccal fat removal.
“Instead of full lips and small noses, we see defined jawlines and cheekbones,” says Patel. “2017 was all about looking young and cute, but now people are like, I don’t want to look like I’m 15. I want to look 28 and sexy.” There is a name for this new face: ripped off.
“You build the mountain with putty and you carve the valley with the elimination of buccal fat,” says Patel.
“People want to look more ripped without drawing attention to themselves, so they’re asking for very sleek lips and sleek jawlines without a lot of bulk,” says Ramtin Kassir, a Manhattan surgeon who does Snooki, New Jersey housewives and my cousin.
“It’s the chic look, if you will,” says Ourian. “It’s a chiseled look. You have nice high cheekbones. You want to look like you haven’t done anything – you naturally look just as good.
A surgeon in Los Angeles with a waiting list until 2025 offered to do my face for free “when you need it”. Technicians would just go into my mouth and slide a slab of fat under each cheek, he explained, and for $5,000 he could inject putty into my cheekbones and I’d look like Bella Hadid — for a few years.
I’m tempted, even after all I’ve just heard, even when I think of patients who claim to be addicted to fillers. “Of course it gets addictive,” British makeup artist Matthew James told me. “You feel like whatever’s wrong with your face can be fixed,” he says. “And then all you see are imperfections, and you’re like, well i’m just gonna do it – is the pursuit of ultra-perfection.
Matthew James documented his filler withdrawal.
“Filler is easy to overdo once you get started. You suddenly look flawless,” echoes grad student Hannah. “Then it seems like it went away after a few months. And you become sad. So you get more. Although she spent more than $60,000 to repair the damage caused by her charge, she says that even if she had known the risks from the start, she’s not sure she would have been swayed.
Would I be? I stood in front of the mirror and sucked my cheeks. Then I took a contour stick, which I had used from 2016 to 2019 to make my heart-shaped face, and followed the instructions of beauty influencers under the hashtag #modelcheekbones on TikTok, painting blue shadows under my cheeks. I thought I was beautiful. My partner, who hadn’t been brainwashed in a month watching dermatologist-altered faces, said I looked like Corpse bride.”
Anyway – with just a quick visit, I could make this my new face. What if the next trend was cherub cheeks? Surely someone could put the grease back in place, somehow.