Overfilled cheek filler: dissolve or wait? I've lost fat & collagen previously & don't want face to sag more (Photos)

Question

Hello, I got cheek fillers in March 2024, but they feel overfilled. I’m considering dissolving them, but I’ve heard hyaluronidase can break down natural HA, which worries me. After struggling with an eating disorder and alcohol addiction, I’ve lost a lot of fat and collagen in my face and don’t want it to sag more. Should I wait for the filler to dissolve naturally? I've also heard it can migrate. The filler looks fine when relaxed, but my smile looks off. Any advice?

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. If you're feeling that your cheek fillers are overfilled and are concerned about potential migration or the impact on your smile, it’s understandable to be cautious about your options. While hyaluronidase, the enzyme used to dissolve hyaluronic acid (HA) fillers, is effective at breaking down excess filler, it is also true that it can affect any natural HA present in the skin. Given your history of losing fat and collagen due to past struggles, it’s important to approach this situation carefully to avoid exacerbating any existing volume loss or causing further sagging. Considering your fillers look fine when relaxed but affect your smile, it may be worthwhile to consider dissolving the filler. If dissolving, its essential to use a targeted approach to dissolve only the overfilled areas without significantly impacting the surrounding tissue. Alternatively, waiting for the filler to dissolve naturally is an option, although this may take several months and could potentially prolong any discomfort or asymmetry you’re experiencing. It’s also beneficial to explore other treatments to restore facial volume and collagen, such as Sculptra or other volumizing agents that can help address any underlying loss of fat and elasticity. I hope this helps and best of luck!

Eric M. Joseph, MD · Answer

Based on your photos, you appear to have a pleasing facial appearance both at rest and with smiling. I agree with you about your concerns about the dissolving enzyme. And that regard, let nature take its course and see how things are in the next 6 months. Congratulations on overcoming your demons! I hope this is helpful. Sincerely, Dr Joseph

Leonard Grossman, MD · Answer

Any individual whose cheeks were flatter prior to the filler will see more cheeks when they’re smiling. You have to be happy with the way you look when you face Is relaxed. In the future, you may want to consider photographing. By having a discussion with a Plastic surgeon well in advance and showing how you wish to look, make you happy. I hope this helps and good luck from Leonard Grossman, M. D. organic Plastic Surgery.

Darryl J. Blinski, MD · Answer

Based on your nicely posted photos, a low-dose of HA filler dissolving injections might be the easier answer. Expect fees to range from $500-$2000. Virtual consult with.

Overfilled cheek filler: dissolve or wait? I've lost fat & collagen previously & don't want face to sag more (Photos)

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Answer: Overfilled H A filler to cheek areas options

Answer: Overfilled H A filler to cheek areas options

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Overfilled cheek filler: dissolve or wait? I've lost fat & collagen previously & don't want face to sag more (Photos)

Answers (4)

Answer: Overfilled H A filler to cheek areas options

Answer: Overfilled H A filler to cheek areas options

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Everything you need to know about Hyaluronidase

Our mission is to create a world where every investment in modern beauty is Worth It.