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!
