Facial Aesthetics 101 – the growing trend of dissolving filler

Facial Aesthetics 101Mel Bastani explores the growing popularity of dissolving fillers and explores what drives many to reverse this treatment.

I have discussed the trends in facial aesthetics alongside the increased popularity in having facial aesthetics.

But one things facial aesthetic practitioners are not so keen to advertise is that dissolving filler is taking a bit of the spotlight.

One of the biggest starts to this trend was influencer Molly Mae. She talks about her journey getting poorly applied filler, as well as too much of it. She explains how she went about getting it all dissolved and stripped back to her natural features.

When filler is in a place it’s not meant to be, it’s usually because it has either been injected into the wrong part of the face, or that area of the face is over filled. It therefore causes distortion in the surrounding areas.

In cases like this there is no fixing it. Clinicians must dissolve it and start again.


Figure 1

Figure 1 is a prime example of poorly filled lips on the left of the image. You can see that the filler has been injected past the vermillion border and has now created a disproportionate and distorted lip shape – not very attractive!

To the right of the picture, you can see that the filler was then later dissolved and then re-done professionally; look at the difference it makes to the face to have the correct proportions.

As mentioned before, men and women have different face proportions and therefore their face shapes need to match.

There are different types of classes we can categorise filler into – particularly lip filler.

Class one – normal

This is where the proportions of the lip are normal and there is a defined vermillion border. This is either when there is no filler present or a minimal/less invasive amount of filler has been injected.

Class two – ledge

This is where lip filler has been injected, but the filler is sitting slightly above the borders of the lip and therefore creates a ‘ledge’.

This is mainly visible on the top lip as the bottom lip naturally curves downwards. A minor defect is not as visible and is usually approximately up to 1mm above the vermillion border.

Class three – shelf

In this case the filler is visible between 1-3mm outside of the vermillion border. It gives the lips a more pronounced pout as there is more filler injected into this site.

Usually when this is the case, it distorts the side profile of the lip. The top lip gives the appearance of ‘flip’, where the pronunciation of the philtrum has started to disappear.

A common example is the ‘Simpson look’.

Class four – plateau

And finally, we have plateau.

Plateau in the lip shape happens when the lips have been overfilled and carried out incorrectly. The filler appears to be 3-6mm outside of the vermillion border and spreads to the philtrum subunit and the lateral subunit for the top lip and the lower subunit on the lower lip. This gives the appearance of this part of the face looking ‘puffy’ or ‘swollen’.

In addition to this, the vermillion border lateral to the philtrum starts to droop, creating a ‘draped’ effect. You will also notice the labial commissures appear to tuck inward towards the opening of the mouth.

In this case, the lip fillers need dissolving before using any more filler. At this stage, we cannot correct the lips and they will need professional intervention.

It is brilliant that so many people are identifying when they need professional intervention to reassess previous facial aesthetics.

Just like with anything else, filler needs maintenance. Occasionally that maintenance is to dissolve all the filler and start again to redesign and enhance your natural shapes and features.

However, sometimes a natural look is more preferential after having years of aesthetic treatment.

Whether your patients want aesthetics or want to dissolve fillers to bring back original features, both can bring fantastic results.

Ensure you educate the patient. And with all your patients, make sure you keep up with reassessments and maintenance with your patients. They will appreciate the extra time and care and that’s what will keep them coming back to you.

Catch previous Facial Aesthetics 101 columns

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