Allure investigates the effect filler has on the soft tissues of the face, even after you stop injecting it. In some cases, “I don’t think you ever get 100% back to having no filler in your face,” says one expert.
In our three-part series, The Filler Files, Allure explores our relationship with facial filler. It’s still one of the most popular nonsurgical cosmetic procedures, yet more of us are looking to dissolve our filler than ever before. What does this mean for our lips, our cheeks, and our approach to injectables?
If you clicked on this headline, you likely have some relationship with hyaluronic acid fillers — the injectable gels, like Juvéderm and Restylane, that millions rely on to contour, plump, and smooth their features. Whether you’re a diehard fan or a casual acquaintance, you’ve probably wondered how these sugar-based substances behave inside the body and what actually happens when we decide to quit them after years of routine touch-ups.
In posing these questions to dermatologists and plastic surgeons, we discovered that there’s a frustrating dearth of formal studies investigating hyaluronic acid fillers over the long term — how and when they break down, the ways in which they change over time, and their effects on the quality of our skin and elasticity of our tissues, both during peak injectable use and long after we’ve sworn off the stuff. Given the paucity of hard data, much of what our experts shared is anecdotal — insights informed by their decades of experience injecting and dissecting the human face. Reliable intel, nonetheless.
In the interest of not burying the lede, we’ll start here: If you’ve been getting filler religiously for years, what happens when you stop will hinge on one critical factor: your average dose at each appointment. “People who are getting a syringe or two every 12 months — doing a little bit for specific points of volume replacement — they have a much easier time than those who are receiving 5 to 10 syringes every six months, because they’re not getting to a place of overinflation and tissue distortion,” says Jessica Weiser, MD, a board-certified dermatologist in New York City.
And make no mistake: Countless men and women are walking around with gluts of filler under their skin. While Dr. Weiser’s self-imposed limit for a single session is “two or very rarely three syringes,” she believes she is somewhat of an outlier among injectors. “There are tons of doctors doing 10 syringes at a time,” she tells us. Some of the other physicians we spoke to confirmed that they commonly encounter patients who’ve received 20 or even 50-plus syringes of hyaluronic acid over a one- to two-year span.
When “patients come in with too much filler in their faces, it can be almost disfiguring,” says Lara Devgan, MD, a board-certified plastic surgeon in New York City. The problem can be more than skin-deep, affecting both the look of the face and its functionality. It’s so common that there’s a term for it: “filler fatigue.”
Board-certified ophthalmologist and oculoplastic surgeon Mitesh Kapadia, MD, describes the overfilled face as “an epidemic” for which a growing number are now seeking a cure — namely, hyaluronic acid-melting hyaluronidase, a synthetic version of an enzyme found in the body. You’ve no doubt seen celebrities, like Courteney Cox and Amy Schumer, talking openly about being displeased with the look of their outsize cheeks or lips and having their filler dissolved with this injectable solution. They’re hardly alone. According to The Aesthetic Society’s most recent trend report, their members performed 57% more filler reversals in 2021 than they did the year before. Indeed, a common refrain among cosmetic providers is that they’re spending more time dissolving filler than injecting it.
What’s behind the about-face? “People are realizing that they’re not looking better, but looking odd,” says Elizabeth Houshmand, MD, a board-certified dermatologist in Dallas. It may be an old photo or a well-meaning family member that helps them see the error of their ways. Or a complication will clue them in, as they notice their filler migrating or swelling. Often, though, they can’t pinpoint the exact problem, Dr. Weiser says; they just know “that things feel strange.”
Sometimes, people break up with filler not because they’re overfilled, per se, but because they’re over filler — the look, the upkeep, the headaches — and this too is a form of fatigue. The filler becomes oppressive, a burden. “Especially when they’ve been through bad injectables and dissolving, they just don’t want to deal with it anymore — they’re done,” says Jonathan Cabin, MD, a board-certified facial plastic surgeon in Arlington, Virginia. In other cases, the filler has just exhausted its usefulness, no longer able to obscure insecurities in a natural-looking way and compelling once-loyal users to pursue a more powerful solution, like surgery.
DQH Can I use salicylic acid first and then vitamin C?
It’s easy to create a skincare routine, but knowing how to use it is another thing entirely. In most cases, if you’re not getting the desired skin results, it could be due to the layering of conflicting ingredients. So, is it possible that salicylic acid and vitamin C are such ingredients? Or are these active ingredients the duo that’s been missing from your skincare routine? If you want answers, stick around because today we are going to explain the benefits of salicylic acid and vitamin C and how they can be used in your daily life.
What are the benefits of salicylic acid for skin?
Salicylic acid is one of the most commonly used beta hydroxy acids and is favored by many people with oily, acne-prone skin. This acid is derived from willow bark, and unlike its water-soluble relatives (called alpha-hydroxy acids), salicylic acid is oil-soluble, which means it can penetrate deeper into the lower layers of the skin. Once it reaches the lower layers, it can help unclog pores of excess sebum, dirt, bacteria, debris, and impurities. This results in clearer skin tones and greater definition.
Not only does salicylic acid benefit the underlying layers, but the outer surface of the skin benefits as well. When applied to the skin, salicylic acid removes the buildup of dead skin cells. This is accomplished by breaking the bonds that hold dead cells to the surface. Over time, this can cause the complexion to look dull and prone to acne, blackheads, and other blemishes.
If you’d like to learn more about salicylic acid and how it can improve your skin, check out this dedicated blog post from a beauty insider.
What are the benefits of vitamin C for skin?
Vitamin C is considered one of the most powerful antioxidants, which means it is very effective at fighting free radicals and preventing them from causing further skin damage. Examples of free radicals include pollution, central heating, UV rays and harsh climate. They attack proteins, fats and cell membranes as soon as they come into contact with the skin, causing signs of premature aging such as fine lines and wrinkles as well as hyperpigmentation, flaky patches of skin and loss of elasticity.
Many people usually prefer to use vitamin C in their morning routine as this ingredient gives the complexion a radiant glow. You’ll also find that vitamin C can target areas of hyperpigmentation, plumping the skin and reducing the appearance of fine lines and wrinkles.
The thing about vitamin C is that there are a lot of outdated studies going back to the 1950s that describe vitamin C as an unstable skin component. Thanks to improvements in modern technology, this is no longer the case as all products now contain a stable form of vitamin C.
Visit The Beauty Insider to learn more about vitamin C. So please check out our blog post.
Can I use salicylic acid first and then vitamin C?
Yes, you absolutely can. In fact, it’s thought that using salicylic acid before using vitamin C ensures it penetrates faster and works faster.
This is an efficient way to utilize two power sources, and the reason has to do with pH. For example, the skin’s natural pH is about 4.7, making it slightly acidic. Salicylic acid and vitamin C are also both acidic, and you’ll find that vitamin C is absorbed quickly into the skin. Therefore, using salicylic acid beforehand can increase the acidity of the skin and allow vitamin C to penetrate into the skin faster.
While this is considered an effective way to combine two powerful ingredients, you need to be aware of your skin type and how it reacts to certain active ingredients. Even people with perfect, normal skin can experience skin sensitivity and irritation. Therefore, always consult a doctor or dermatologist before using any new products on your skin.
It’s also important to follow skin application rules. In this case, you need to use the product correctly to ensure you get the best results for your skin. If you’re not sure what I mean, the basic rule for skin is to start with the thinnest consistency and work your way up to the thickest consistency. This prevents a barrier from forming on the surface, preventing other active ingredients from penetrating the skin.
Can I use salicylic acid at night and vitamin C in the morning?
Yes, absolutely, this is considered the most effective way to get returns without any adverse side effects. This is because there is enough time between applications to ensure that the skin’s pH levels return to balance.
You’ll also find that Vitamin C is rich in antioxidants and is perfect for use in the morning to ensure your skin is protected and looking its healthiest. Due to the small size of salicylic acid molecules, it is an acid that is able to reach the deepest parts of the skin. While this is effective at keeping skin clear, it also increases the risk of irritation and photosensitivity. Therefore, many people prefer to use powerful BHAs in their evening routine without exposure to UV rays, pollution, or harsh weather.
Warning: If you avoid using sunscreen every day, none of these ingredients will do what your skin needs. The combination of chemical peels and powerful ingredients increases the risk of further damage to the skin’s surface. Use SPF 50 every day to keep your skin protected and your lipid barrier healthy, even on cloudy days, keeping your skin in top condition.
