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Writer's pictureJill Stetson

Filler Fatigue - What Is It and How Do You Avoid?

Updated: Aug 23


woman receives filler treatment
Filler Fatigue Blog Post

Dermal Filler Fatigue Causes and Ways To Avoid

I have worked in the skincare world, or the esthetics industry, for over 12 years and have seen many changes. Most of these changes are improvements in products and natural-looking treatments.


As a 67-year-old, who is a strong believer in aging beautifully on my own terms, I believe the best approach for beautiful skin is to be conservative with injections, implement a hybrid approach, and maintain the quality of your skin.


By that I mean, use fillers & Botox, but also alternate with treatments that will produce collagen & elastin, not just fill, and always use products that will do the same while maintaining skin quality. Using this approach you can have nonsurgical results and help you to avoid filler fatigue.


What are Dermal Facial Fillers?


Dermal Facial fillers started to be used in the 1980s. That gives us roughly 30 years of experience with the FDA-approved fillers. These fillers can be made from silicone (not used today) hyaluronic acid, bovine collagen, or calcium hydroxyapatite.


Dermal fillers are synthetic or naturally derived products that are injected into the skin’s dermis to enhance the correction of wrinkles, depressions, and folds.


However, with the manufacturing of new types, the indications of dermal fillers are increasingly rising to include tissue contouring and replacement of any lost volume in the skin or subcutaneous fat. However, If you have significant fat loss, fillers are not your best option.


Dermal Filler History


In the late 1800s, shortly after the invention of the syringe, chemical agents were used for facial augmentation. These filler injections were in an attempt to maintain a youthful, natural-looking appearance or to reconstruct facial deformities. History has taught us that new technologies must be used with care, because complications can occur, sometimes many months after initial treatment.


The first injectable filling agent was paraffin, whose use was abandoned after significant complications. More recently, silicone use was banned by the U.S. Food and Drug Administration (FDA) because of complications.

In 1981, bovine collagen was the first agent to be approved by the FDA for cosmetic injection. Since its approval, dozens of injectable filling agents have been developed, and many are already FDA-approved for cosmetic use.


Why do you use Dermal Fillers?

Woman receives lip filler treatment
Dermal Filler Natural Looking Effects

The use of dermal fillers to draw a new look is a matter of art that requires artistic eyes and well-trained hands in aesthetic and cosmetic treatments. This is because the procedure requires an understanding of each patients facial anatomy.


When considering a filler your injector will or should always take into account the so-called “triangle of youth”: the face of a young person is shaped like a triangle with the base across the forehead and the apex pointing downwards.


With age, the triangle is inverted and the base moves to the lower part of the face: the face becomes wider and less oval. Consequently, adding volume to the lower third of the face should be done conservatively and cautiously.

Facial fillers are used to add volume - replace volume loss and lift - when you fill your skin lifts up, and your cheeks go higher. There are Hyaluronic Acid Fillers, the most popular, which fill and may slightly stimulate collagen & elastin.


Hyaluronic Acid Fillers


Over the past two decades, the popularity of nonsurgical cosmetic procedures has increased exponentially. According to recent statistics, more than 85% of all dermal filler procedures occurred with a hyaluronic acid derivative.


These numbers are expected to rise in the future as there is currently no other class of filling agent that rivals the popularity of hyaluronic acid. The popularity specifically stems from its effectiveness, ease of administration, and safety profile.


Brands for Filler Treatments


Brands of these include Juvederm, Restylane, Voluma, and Belotero. Within these brands, they have specific fillers for areas such as the lips, nasal folds, and cheeks.


Then there are fillers such as Bellafill or Sculptra that do stimulate collagen & elastin. Botox is not a filler. It works on stabilizing muscles to smooth fine lines and never lasts as long as a filler.


Care After Getting a Filler and How Long Does It Take to Get Back


Depending on the facial area treated with the dermal filler, if lumps are present simply massage them several times a day. After two weeks or so, they will become smooth.


Minimize exercise after getting a filler treatment for 48 hours. This is to keep your metabolism stable to not absorb the filler too quickly which can minimize results. This doesn’t happen to everyone but it can happen.


Sleep on your back the first few nights after the filler injections to minimize movement of the filler.


Fillers will have no impact on your skincare regimen so return to it without concern.


Can You Get Filler Fatigue?

Woman holds up two different filler syringes
SkinTrust Filler Fatigue


Nowadays, the use of filler injections for correcting signs of aging, such as wrinkles, depressions, and folds, has become increasingly popular. However, filler fatigue can be caused in two ways. One is using too much filler at one time or one injection session.

The second is to use fillers consistently over a longer period of time and over that period of time using too much filler. In extreme cases, the overuse of fillers can lead to disfigurements and unpredictable consequences among users.


Over Filling at One Time Can Create:

  • Puffy face - swollen face with edema that appears sometime after the injection

  • Swollen lips a month or so after the injection

  • Bags and redness under your eyes

People who want more at the time of injections don’t realize that more is usually not appropriate, does not look natural, and can have significant negative side effects. Well-trained injectors understand how much to inject at one time. Being conservative with injections leads to a natural safe appearance.


The other way to get filler fatigue is to get an additional injection too soon. Repeatedly filling your skin over time will create a heaviness to your skin - the opposite result you are trying to achieve.


Remember from above the triangular look of your face as you age and continually filling will accelerate that look.


Filler Warnings


Even when the fillers used are temporary in nature, they should be used with caution because it has been observed that, in the long-term, excessive treatment or “filler fatigue” can give rise to an inharmonious appearance.


Filler fatigue is caused by a decrease in skin elasticity, fibrosis, and the creation of an unnaturally wide face.


All of these changes can occur not only because of excessive use of collagen-inducing fillers such as calcium hydroxyapatite but also owing to the overuse of hyaluronic acid.


Fillers are a useful tool provided they are used in moderation and applied by someone who has a great deal of experience.


How Long Should I Go In Between Dermal Fillers?


Hyaluronic Acid fillers last from 12 to 24 months. A touch-up at 12 months may be recommended to extend the initial results.


Filler Alternatives


Aging and lifestyles can take away our collagen and elastin causing wrinkles and facial volume loss. Fillers are an alternative to help improve your appearance.


But in order to get the fill benefit without the potential side effects, it is best to also invest in procedures that stimulate your collagen and elastin or lift your skin.


These can include threads, micro-needling, chemical peels, retinal treatments, and PRP injections among others. Plus you should always focus on your skin’s quality.


Micro-Needling - Also Known as Collagen Induction Therapy

woman receives Microneedling as a skincare treatment
SkinTrust Microneedling

Medical micro-needling is one of the best treatments to improve your collagen and elastin. And it’s natural. Using a device that makes tiny needles penetrate the epidermis down to the dermis stimulates your system to regenerate collagen & elastin.


Platelet Rich Plasma - PRP


A series of PRP injections can smooth wrinkles, tighten skin and reduce the rate of aging by restoring the declining DNA synthesis that occurs with aging.


Studies have shown that PRP injections improved skin conditions, including increased skin thickness, enhanced collagen content, and reduced pigmentation.


Retinol Treatments


Retinol treatments increase collagen and elastin through fibroblast stimulation.


Chemical peels


Chemical peels do two things: They keep your skin in great shape by slowing down the aging process through the stimulation of hyaluronic acid, collagen, and elastin and they treat specific skincare conditions like acne, rosacea, and pigmentation or dark spots.


Thread Lift

Woman receives thread lift treatment to help relieve filler fatigue
SkinTrust Thread Lift Treatment

Various types of threads tighten and firm skin and are used to reposition loose or sagging tissue. Also, they can increase skin density and have collagen-inducing properties.


Threading is primarily used on the cheeks, jawline, neck, and eyebrows. Some threads nicely improve wrinkles under the eyes. Results from threads can last 9 to 12 months.


Tips For You

Personally, I do a series of micro-needling/PRP treatments or threads each year to stimulate collagen & elastin, Throughout the year I do other skin treatments such as retinol treatments or SWICH to stimulate collagen or stimulate my cells to work better.


And I add micro-current when I can to stimulate my muscles to stay lifted. Plus I use effective products morning and night. For best results, together with treatments, you have to use good products each day.


Why You Should Use A Dermal Filler With Other Treatments

Woman receives lip filler treatment from licensed professional
SkinTrust Lip Filler

If you are over 50 and have not tried to stimulate collagen & elastin, then repeated fillers could be an issue. Your skin is not conditioned to “bounce back”. However, if you do get a filler, then try a treatment such as micro-needling or threads while using skincare products that stimulate collagen & elastin. Or start with a treatment, evaluate the results, and then consider a filler.


The goal is to get as close to natural-looking as possible. Ultimately the result you want from injectables, treatments, and effective skincare products is for someone to say “you look great” and not know why.


Be conservative with your approach and continue to slow down the aging by rebuilding what aging is taking away with effective products & treatments. Then, you will age beautifully, on your terms!

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