When the needle goes awry

Dr Vikas Sharma

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Decades ago, in order to recapture the youth, one had to undergo excessive facial surgeries but that used to leave behind end results in form of stretched ‘wind tunnel’ and unnatural faces. The advent of botox and fillers saw a dramatic decline in facelifts and consequently, that pinched-face look became a thing of the past.

Botulinum toxin ensured one could literally freeze the ageing process, but it does nothing to counter the effects of volume loss, which occurs at around age of 38-40.

The process of filling out the cheeks to make them look prominent is an effort to recreate the plumpness of youth.

However, a new cosmetic side-effect is now appearing and that ‘gone-too-far face’ is back in the form of the ‘pillow face’.

Pillow face is a condition that occurs as a result of a person getting over-injected with dermal fillers in their face. This leads to an overstuffed look, which causes the cheeks and other areas of the face to puff out disproportionately.

Too much of a good thing?

As we age, our skin becomes depleted in the substances that give it elasticity and volume. Older people, especially if they are slim, will notice a hollowing of the cheeks and around the eyes. These things visibly age the face. Fillers are chemicals that occur naturally in the body, such as hyaluronic acid or collagen, that are injected into areas in the face to plump out the skin, restoring a youthful look.

Unfortunately, too much of a good thing can be bad. The end result of too much fillers is a condition typically referred to as ‘overfilled syndrome’ also known as “pillow face” or “chipmunk cheeks”. Overfilled syndrome or pillow face is a real concern for people who are thinking about facial injections. The ‘too-far face’ is a term used to describe somebody who has gone past the tipping point of cosmetic work – when smooth becomes frozen and when nicely plump becomes pillow-like.

Strike a balance

Every face is different and needs to be studied and researched before treatment. The skin around the eye is just 2mm thick, which is half the depth of skin elsewhere on the face. It’s also an emotion-filled area – one used to smile, laugh and cry – so it ages faster.

While a little filler, injected can help a tired eye, however, too much has the opposite effect: In some cases, you can actually see a bumpy “lake” under the eye because the skin in this area is so thin. And remember – whatever your treatment – less is more; it’s better to have a little, getting it right little by little each time. Don’t chase instant results. Don’t let your quest to stay young turn you into a pillow face.

Despite the many benefits of facial injectables, overfilling can completely undermine the original purpose of using facial fillers — to create a more attractive look. The dreaded pillow face can bring unwanted attention and make you even more self-conscious than you were before seeking treatment. It is important that you maintain realistic expectations about what facial fillers can and cannot do and understand the effects of overfilling.

(Dr Sharma is a Chandigarh-based dermatologist)