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Fatigue syndrome due to fillers.

By Dr. José Villamarín.

Today we are going to talk about fillers’ fatigue syndrome. For many years, fillers have been used to redefine and improve the image of many patients avoiding surgery. Over time, adverse effects related to the continued use of fillers, in particular on the face, have been observed, and one of these adverse effects has been termed fillers’ fatigue syndrome.

But what is filler fatigue syndrome?

Over the years, some patients who receive more or less frequent dermal filler injections become less and less satisfied with the results. They notice that they no longer achieve the definition in their faces as before, so they continue under an injection regimen increased in some way, to try to achieve the goals of years ago. They enter a vicious cycle, a phenomenon known as filler fatigue, and it boils down to the concept that a patient feels that the filler is no longer working for them. If it lengthens over time, the face loses its definition and ends up deforming, in such a way that the patient feels his face swollen and heavy, as well as having an excess of volume that he did not have before. This situation can cause damage to the deep structure of the face, as well as distension and sliding or ptosis of the skin and underlying tissues and of some facial areas. On the other hand, in some compartments subjected to excessive pressure, microcirculation and vascular return, especially the lymphatic, can be compromised and alter the smoothness of the skin or cause hair loss, as well as perpetuate swelling.

Why does fatigue from dermal fillers occur?

When observing patients with fatigue due to fillers, some characteristics have been found that can be associated with their symptoms and that, alone or in combination, can explain their evolution. Among them, we can highlight:

Incorrect preoperative assessment: For example, an incorrect clinical assessment, volume titration, and treatment plan, or an erroneous prescription.

Social networks, trends and social pressure: There is increasing pressure to show off a smoother face and more youthful features, and patients increase their ambition leaving behind conventional fillers, finally resorting to other substances or combining incompatible substances.

Gravity and natural aging processes: These are all factors that play a role, even when fillers are injected.

Excessive use: the continued use of fillers and even their combination with neuromodulators can lead to unsatisfactory results and cause the patient to relapse.

Excessive filler: The use of increasing volumes to achieve the same effect, includes the distension of the skin in excess, which can reach the point of generating stretch marks or folds, and of course, the loss of elasticity.

Poor technique: It can be due to various reasons, such as the use of a product with the wrong density or crosslinking, the injection of the product in the wrong place or at the wrong depth, or the combination of several products that are not compatible.

Being treated by professionals with limited resources: Being injected by an aesthetic doctor who is an expert in fillers is excellent. But you must know when to stop and refer the patient to a surgeon who offers a different treatment than repeated fillers.

What solutions do we have for fatigue due to fillers?

First of all, we must avoid getting into a filler fatigue situation. That includes both the professional and the patient knowing when to stop repeated exposure to fillers. The patient usually realizes her situation in front of the mirror after a few years of repeated treatments, and usually reconsiders treatments with fillers around the 50s. Sometimes, the cumulative expense of money in dermal fillers is another factor that tips the balance, since the amount of money for fillers can be higher than a surgery budget.

But in an incomprehensible way, there are patients who do not remember when they started their fillers, nor are they really aware of their facial deterioration in the form of loss of definition of their features, or even get used to their new face over time.

At the moment that the problem is objectified and the patient internalizes it and decides to act, the first thing is for the doctor to consider trying to eliminate part of the filler, whether distributed homogeneously or heterogeneously, through aesthetic medical procedures such as the injection of the hyaluronidase substance. that undoes hyaluronic acid, or ultrasound-guided manual extraction, accompanied by lymphatic drainage sessions and other procedures.

A more advanced resource is that the doctor, if trained as a facial surgeon (general plastic, oculoplastic, maxillofacial or otorhinolaryngologist) can dissect facial tissues and remove superficial and deep deposits under local anesthesia and sedation.

In some cases, the surgeon may also perform blepharoplasty, facelift, and other procedures simultaneously with the surgical removal of fillers and associated fibrosis. He can also perform it in a second time. This is especially necessary when the skin and deep tissues present severe distension, all due to lack of retention of the deep layers, microstretch marks or loss of elasticity of the dermis.

The conclusions…

The syndrome of dermal fillers’ fatigue, in which the syndrome of excess facial filling or overfilled face is usually included, is a serious condition that we should not reach. For this, I recommend that the doctor who treats the patient with fillers is also a surgeon and can offer alternatives at the right time, or failing that, that every aesthetic doctor who uses fillers knows how to respect the anatomy and has a reference surgeon for work as a team, and thus be able to offer a better and safer treatment plan to each patient.

On the other hand, the patient must understand that each treatment has limits and that they must choose a competent facial aesthetic medical professional. Another great solution, if possible, is to put yourself in the hands of a professional who is a surgeon and with special training in facial aesthetic surgery and also in facial aesthetic medicine, as is the case with Dr. José Villamarín, or many other excellent professionals in Spain. .

If you want more information, do not hesitate to contact Dr. José Villamarín requesting an appointment in person or through his online consultation. Thanks.