Will overfilled, uneven, altogether botched fillers stretch facial skin permanently?

If "expert injector" overfills wrong area, to the degree that the tissues has never been that full before or the skin that "stretched" before, ever -- will injecting hyaluronidase leave skin irreparably stretched or deformed? Does the amount of time it's been in the face impact this? Does the area of the face also impact this? Younger patient w/decent elasticity, upper face, mid face, nasolabial folds Juvederm injections, been in face for 4 mos.

Doctor Answers 8

Do fillers stretch the skin?

I am sorry you did not have a good experience.   Soft tissue fillers are injected in such small quantities that they do not distort the skin.  I would recommend finding an experienced injector who understands your aesthetic goals and keeping open communication about your outcomes as you move forward.  That will ensure that you and your injector are "on the same page".


Nashville Oculoplastic Surgeon
4.8 out of 5 stars 41 reviews

Can Fillers stretch skin

Patients often worry incorrectly that fillers injected into the skin could stretch the skin and create sagging after these filler wear off.  The opposite is actually true.  There are several studies that have shown that fillers tend to create a collagen response from repeated filler injections.

Kyle Coleman, MD
New Orleans Dermatologic Surgeon
5.0 out of 5 stars 7 reviews

Will overfilled, uneven, altogether botched fillers stretch facial skin permanently?

Hello Pretty5555,

The skin is very elastic.  There are procedures where we will have the skin dilate many times its current size to cover defects, such as following a mastectomy.  With filler, even if overdone, the volume is very minimal.  It should have no effect on permanently stretching your skin (it would take multiple syringes injected in the exact same spot causing a noticeable single bubble coming off the skin quite a ways to really be an issue).  Think about a time where you had a big bruise.  The area likely swelled up quite a bit and when it went away, there was no excess skin. 

I would follow up with your injector to show your concern and see what is the best course of action (injecting hyaluronidase or simply waiting). 

I hope this helps and good luck. 

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Fillers and overfill and correction

I am so sorry for your problem.  If the fillers were overfilled I would consult another physician to inject Hyaluronidase to dissolve the treated areas.  If injected properly it should return to how it was before your injections.  Best, Dr. Green

Facial skin will not stretch permanently with too much cosmetic filler, even when filler is dissolved

Thank you for your question. I understand you’re concerned if overfilling with filler could result in permanently stretching the facial skin.

I can certainly help you with this matter as I have been using fillers such as Restylane, Juvederm, Voluma, Radiesse, Sculptra and even the original collagen Zyderm and Zyplast for over 20 years. I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon, practicing in Manhattan and Long Island.

In our practice, we use fillers to address facial aging, which is manifested by loss of bone, muscle, fat, and soft tissue. We do this through a procedure called the Y Lift™. With the Y Lift™, we restore cheek volume and jawline volume, as well as augment and redefine the cheek bones, the jawline, the vertical aspect of the jawbone, and the chin. It is a procedure that can require a significant amount of filler — as much as 2-3 syringes in one given area. But despite this, our patients do not look overfilled but rather more structurally balanced, because we place the filler in the deeper levels of the skin, under the muscle and near the bone.

So, to address your question regarding overfilling, this is dependent on where in the skin you are having the filler placed — are you putting it just under the skin? Are you putting it in the dermal level, within the skin? Or are you putting it in the deeper levels of the face, similar to what we do in the Y Lift™?

Age and tissue quality is also something to take into consideration. But interestingly, when patients come to us to get hyaluronidase, the skin can look quite deflated after the excess filler is removed, but with time, the skin tends to retract and go back to its original position. This is true even for patients who are in their 70s.

Keep in mind that overcorrection or overfilling is not just limited to injectable fillers, but can also occur in fat grafting and even implants, so it certainly is a case-to-case basis.

What also comes to mind is the kind of viscosity of the filler used. Fillers are generally not so viscous or thick that they can stretch the skin beyond a certain limit, as there is a certain amount of resistance the skin will provide against whatever it is being pushed against. And beyond that point, the skin will push back. It’s a different scenario though if you are much older and have more loose skin.

Ultimately, I think you just need to look at the bigger picture. There are many strategies you can employ to improve skin quality, such as platelet-rich plasma, which we use quite often in our practice. Platelet-rich plasma is taken from your own blood and stimulates collagen and boosts blood supply to the skin, thus improving overall skin tone and texture. We’ve used platelet-rich plasma to help patients who’ve had chronic infections and extensive operations that have caused them to lose significant volume, and we’ve been able to restore their skin’s health and resilience quite effectively.

I recommend that you try to meet with several doctors to get more opinions about what your options are. Unfortunately, without specific details of your clinical case, I am unable to give you a more specific answer, but I hope that this was helpful. I wish you the best of luck!

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.3 out of 5 stars 61 reviews

Filler won't leave stretch marks

Thanks for your question, and I'm sorry to hear you are having any concerns following your filler injections, even several months after one’s injections. I always recommend patients have these injections in the offices of board-certified dermatologists or plastic surgeons; if at any point in time you have a question or a concern, you should have the opportunity to consult us because we are the true experts in the use of these products and understand how they work.

The reality for you is you have had perhaps more filler than you have had or expected. Since these products absorb water, they appear to do some skin stretching. If you do not like the look, at any time the HA filler can be dissolved with some hyaluronidase. But if left alone, the fillers, in time, will resolve and you will return to your baseline look. So doing either will work for you, and in no case will there be any permanent skin stretching.

But do make sure the injector is an expert and from a board-certified office.

Michael Gold, MD
Nashville Dermatologic Surgeon
3.9 out of 5 stars 17 reviews

Will overfilled, uneven, fillers stretch facial skin permanently?

Hi, I have used dermal fillers for 30 years and they will not stretch the skin, no matter how much is placed unlike fat transfer.  If you've had the HA filler dissolved with hyaluronidase, the skin should return to its pre filler state quickly.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Overfilled

Hyaluronidase can be injected to dissolve the product that was placed if it was an HA. Best of luck with your decision to move forward.

Steven Wallach, MD
New York Plastic Surgeon
4.1 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.