It’s no secret that there’s a lot of negative coverage of cosmetic filler treatments in the media. Dr. Alexandra Bowles, shares her perspective in Cincinnati Magazine, on the growing concerns around dermal fillers and what to consider if you’re thinking about getting treated.

 

If you’ve been scrolling through social media lately, you’ve probably noticed a shift in how people talk about fillers. What was once celebrated as the go-to anti-aging treatment now comes with a side of skepticism. That being said, it’s still one of the most popular cosmetic treatments. One that I perform and recommend to my patients daily! These are some of the most common concerns my patients bring up, and the advice I share so that they can make an informed decision.

Overfilled Features:

Looking overly plump or overfilled is a natural and common fear, and, to be fair, it’s probably the number one reason my patients are second-guessing getting filler altogether. However, it is important to note that when this happens, an inexperienced injector has usually placed the product in the wrong area or used the wrong technique. The goal of filler should never be to change your face. Rather, it’s a helpful tool to enhance your natural features and restore volume that you’ve lost over time.

Looking Unnatural:

Some of my patients come in concerned that they won’t look like themselves. I understand this, especially if they’ve had a friend or family member with this experience. But not all injectors are created equal. Filler requires an in-depth understanding of facial anatomy, an artistic eye, and years of experience to get it right. It is important to listen to your patient and consider their individual characteristics and not use a “one size fits all” approach.

Migration:

One of the hottest topics right now is filler migration. The idea that filler can move from where it was originally placed and end up somewhere else. While migration can happen, skilled injectors rarely see it when they perform the procedure correctly. Migration typically occurs when an injector uses too much product, places it in the wrong plane, or selects the wrong type of filler for a specific area. The right technique and appropriate product selection keep your filler exactly where it’s supposed to stay.

Your Guide to Filler Success

Find a Qualified, Experienced Injector:

This is a non-negotiable. Your injector should be a board-certified dermatologist, plastic surgeon, or highly trained medical professional with extensive experience in facial aesthetics. Don’t be swayed by cheap deals or convenience. Your face deserves an expert. Ask about their training, how long they’ve been injecting, and request before-and-after photos of their work. Look for results that appear natural and balanced, not overfilled or dramatic.

Ask For a Full-Face Assessment:

Cookie-cutter approaches don’t work when it comes to your face. A great injector will take time to understand your concerns, assess your facial structure, and create a personalized plan that enhances your unique features.

It’s OK To Start Small:

If you’re concerned, ask to start with less. I always start conservatively, because it’s much easier to add more filler later than to correct an overfilled result. I’d rather see you back in a few weeks for a touch-up than have you leave with too much product. That being said, a treatment may require multiple syringes of product. This may depend on the area we are treating.

Communicate Your Goals:

Be honest with your injector about what you want—and what you don’t want. I love when my patients share photos with me and are honest about their goals as well as concerns.

Trust the Process (and the Timeline):

Great results don’t always happen in one session. Building volume gradually over time often leads to the most natural-looking outcomes. Be patient with the process. Trust your provider’s expertise on how to best use filler to give you the most natural results.

Other Options:

If you are still wary of filler treatments, consider PRF Ez Gel, which uses your own platelet-rich plasma as an alternative to traditional filler. Although results may be more subtle and won’t last as long, it’s a nice option as well.

The Bottom Line

Concerns around filler are real, but that doesn’t mean filler is the problem. It’s how it’s being used and who is injecting it. When placed thoughtfully by a skilled injector who understands facial anatomy and prioritizes natural results, dermal fillers can be an incredible tool for looking like the best version of yourself. My goal is always for my patients to feel confident and beautiful in their own skin! Filler should enhance who you are, not change you into someone else.

To learn more about filler or book a cosmetic consultation.