When it comes to plastic surgery and non-surgical treatments, my mantra is:  YOU WANT TO LOOK LUCKY… NOT DONE.

Filling (and overfilling) is a really interesting aesthetic, psychological and ethical issue.

It is common today for a patient to start their request for filler with “but I don’t want to look like so and so” (fill in the blank for the most recent over-plumped celebrity). I spend more time today reassuring new patients that they will not look like that.

While fillers* have been a game changer in plastic surgery, a balance must be achieved between tightening, volume enhancement and improvement in texture.  Each has its place and one cannot compensate for the lack of the other.  We’ve all seen ridiculously overfilled cheeks and lips.

Why that happens falls somewhere between the doctor and the patient.  I have certainly found myself in the position of declining further injections because it goes against my aesthetic sense.  Sometimes that decision is clear.  Either I will be able to convince that patient, or they will simply go elsewhere.

However, it can be harder when someone wants “just a little more” to please their own aesthetic sense.  What then?

The spectrum is already swinging from extreme overfilling and is back to hovering to normalcy, I believe.  I remind those who balk that they only notice the overfilled people.  They tend not to notice the patients who have had good, tasteful injections that make them look “lucky” not overfilled!

 *Fillers include Voluma, Juvederm, Restylane, Radiesse, Sculptra