Do liquid facelifts and temporary fillers cause future sagginess once they disappear?

I have heard this before, have gotten temporary fillers for YEARS, and recently read an article referring to the sagging temporary fillers can cause. It kind of makes sense, since losing and gaining weight is supposed to cause sagging, and what can one do about this?

Doctor Answers 16

Do fillers cause sagging when they wear off?

When used properly by an expert injector fillers will not cause stretching of the tissues and therefore, will not cause later sagging.  Fillers are used to replace lost volume, a common effect of the aging process, and while temporary, can rejuvenate the face significantly.

Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 22 reviews

If you do not touch up or maintain your filler, then your skin will return to how it looked before.

No, properly injected filler will not stretch out your skin to the point that it will become saggy after the filler dissipates. If you do not touch up or maintain your filler, then your skin will return to how it looked before, and of course the natural aging process will continue with or without fillers. Always be sure to visit a board-certified dermatologist for any filler injections to ensure the best results.

Karen Beasley, MD
Baltimore Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

Late Effects of Fillers and Liquid Facelifts

Unless you have the area significantly overfilled and stretched (which an expert injector should not do), you will never have post filler absorption sagging. In fact, almost no one returns to their pre filler state as the body uses some of the filler to create its own collagen. Even after the filler has long been absorbed (in those people who do not return regularly for touchups), I never have to inject the same amount of filler to achieve the same result as I did the last time. Of course, if you wait long enough after one episode of filler, you can sag further from normal aging. This, however, is not the result of placing a filler. When done properly by someone who knows what they are doing, fillers can actually slow the aging process by supporting the tissues. (See as there are very many people doing injections without significant training or experience.)

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews


When filler is injected it increases and stretches surrounding tissue.  The skin maintains a baseline tension. Acute increases in pressure cause increase tension and the skin will stretch to accommodate this.  The pregnant abdomen is an example.  As the fetus enlarges, it increases the pressure on the abdominal wall and skin.  Tension increases and the tissues stretch to restore baseline tension.  That is why the abdomen enlarges without exploding.  After delivery, the tissues somehow sense tension below baseline, and the abdomen and skin shrink until baseline tension is resumed. Not everyone shrinks the same, but everyone shrinks.

Fillers exert the same phenomena on a smaller scale. When injected, they increase pressure and tension. 

The tissues respond by stretching to normalize the tension. As the filler metabolizes the tissues shrink to normalize.  With good elastic tissue, the skin is usually not permanently stretched or damaged.

However, the aging process proceeds un-retarded. Facial sagging and aging proceeds according to your genetic programming.  The fillers may be masking these changes and they seem more pronounced as the fillers wear off.

This is why attempts to "lift" the nasolabial fold with fillers in the cheeks, is not sound science.  The skin rapidly relaxes, often leading to more filler in the cheeks to chase it. The cheeks then start to look over full and sometimes bizarre.  Fillers should be used to fill, not to lift.

Luis Villar, MD, FACS
West Palm Beach Plastic Surgeon
4.8 out of 5 stars 10 reviews

Liquid Facelift - What happens when it wears off?

Thank you for your question. Facial fillers do not cause the tissues to stretch when properly injected. They simply restore the skin to its more youthful state, prior to the age associated loss of volume. Please see a board certified plastic surgeon with expertise in facial rejuvenation for an in-person examination. Hope this helps.

Steven J. Rottman, MD, FACS
Baltimore Plastic Surgeon
4.9 out of 5 stars 81 reviews

Do liquid facelifts and temporary fillers cause future sagginess once they disappear?

No, when used properly the use of dermal fillers should cause future sagginess. Best to see a board certified plastic surgeon for the proper use of dermal fillers. 

Richard Zienowicz, MD
Providence Plastic Surgeon
4.9 out of 5 stars 63 reviews

Tissue sagging from facial fillers

Thank you for asking about your facial fillers.
  • I have also heard this but there is no way to tell for sure -
  • It would take a long-term study done by injecting people with fillers only on one side -
  • No one would agree to that.
  • My impression from what I see is that fillers that plump up areas that have lost volume do not sag.
  • But over-filling an area can stretch the tissues.
  • Many liquid face lifts use 5 - 10 syringes of filler - with this amount of filler, stretching might occur.
  • With the usual 1 - 2 syringes, I don't this it does.
  • I think the real problem is that over years, our tissues naturally sag - it's from time, not from fillers.
Always see a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Do liquid facelifts and temporary fillers cause future sagginess once they disappear?

Generally speaking, no.  Since small amounts of filler are added (less than 10 mL), the volume change is minimal and slow so the skin tightens accordingly.  This is as opposed to weight gain and loss in the breast or abdomen which can be multiple pounds.  Your question is insightful, however.

Samer W. Cabbabe, MD, FACS
Saint Louis Plastic Surgeon
4.9 out of 5 stars 59 reviews

Do liquid facelifts and temporary fillers cause future sagginess

One would not expect fillers while performing volume enhancement to cause future sagginess in the skin. Usually the amount of fillers would be insufficient to cause the skin to stretch out and fall. If anything, fillers may serve to prevent future following by stimulating collagen growth under the skin which may help maintain tissue in its position. I can honestly say after thousands of facial injections that I have never seen facial sagging that I have attributed to fillers.

George Volpe, MD
Newton Plastic Surgeon
4.8 out of 5 stars 26 reviews

Fillers and Sagginess

Temporary fillers should not contribute to sagginess of tissues, and this is even more true for fillers that stimulate collagen production. In those cases, there may even be improvement over time of naturally-sagging tissue.

Jeffrey Ridha, MD
Saratoga Springs Plastic Surgeon
5.0 out of 5 stars 24 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.