The Puffy Face Phenomenon: Tallulah Willis and Facial Filler Regret

On March 22, Tallulah Willis, the youngest of the three daughters of Bruce Willis and Demi Moore, published a carousel of photos with her naked face on her profile to talk about her experience with cosmetic fillers. "Hello! I was afraid to mention it, but I recently had my fillers dissolved—after being emotionally and psychologically wrapped up in what I thought I was being given—I hadn't seen my true bone structure in 6 years. I'm still learning to let go of the tweaking and prodding and accept myself for who I am, which is hard when your brain is telling you yes! “More is better!” she finished. Among her comments, she showered him with compliments like “Don't hide your true face again” or “You're much better now!”

Tallulah Willis has always stepped up to talk about mental health issues. Last year, in a report for

Vogue magazine,

Willis confessed that her physical disagreements began at the age of 11, when a fashion website published a photo of her with her mother, Demi Moore, and she stopped to read all the comments. Among the phrases that stuck with the model, the following stands out: “Wow, she looks deformed. Look at her masculine jaw: he's like an ugly version of her father. Her mother must be very disappointed.” From there, her perception of herself changed, and after going through periods of eating disorders, she turned to aesthetic medicine to look beautiful. Now, at only 30 years old, she ditches the fillers and steps forward to show off her unretouched face.

Willis is not the only one who has reversed the effects of aesthetic treatments. Amy Schumer, Courteney Cox, Kristin Davis and Khloé Kardashian long ago dissolved the fillers in her face after confessing that they did not recognize her face in front of the mirror. A growing trend if we take into account that the TikTok videos tagged as #dissolvingfiller accumulate 28.8 million views compared to the 73.3 million views of those tagged as #lipdissolving.

The phenomenon of overly swollen faces

The search for respectful beauty reevaluates unnatural features such as excessive cheekbones or lips. More and more aesthetic doctors are aware of the damage that those alien-looking faces do to their profession. The phenomenon has a name:

facial overfilled syndrome

(FOS) and it occurs when the volumes of the face, especially those in the middle third, are disproportionate due to excessive infiltrations that do not respect the timing or have not been placed in the correct place. Often part of a patient's addiction to fillers; But we cannot ignore that many experts in aesthetic medicine also have overly full faces.

The disproportion of volume in the cheekbones, cheeks and jaw is the product of several factors. “On the one hand, we are faced with a patient who wants to avoid sagging at all costs, and is increasingly asking for more. Hence the importance of finding a professional who knows how to apply the product well and dares to say no when you have to stop. It's not about poking and poking. Correcting sagging only with injections puts naturalness at risk. That is why it is important to incorporate treatments with technologies capable of tightening the skin; Although the result is not so fast, excess

fillers

are avoided . Above all, in risk areas such as the mandibular angle where so many syringes are often placed that in the long term they cause more sagging and sagging due to the weight they exert. Furthermore, we now know that the duration of hyaluronic acid is longer than what the laboratories say and that after a few years small amounts still persist in the tissues," explains Dr. Beatriz Beltrán, founder of the clinic that bears her name and the only Spanish member. of the ISAC (International Society of Aesthetic Complications).

The latest report from the SEME (Spanish Society of Aesthetic Medicine) presented last February indicates that 45% of Spaniards claim to have undergone aesthetic treatment. Among the most in demand are neuromodulators (39%) and injectables (38%) such as fillers with hyaluronic acid, mesotherapy or PRP (platelet-rich plasma). Dr. Beltrán warns “hyaluronic acid is one of the most used fillers, and there are many types. Some provide more volume than others and there are those that only hydrate and do not fill; It depends on the cross-linking of the acid, its cohesiveness and the technology on which it is based. It is important to clarify that hyaluronic acid is the only substance that can dissolve. Neither collagen stimulators (such as calcium hydroxyapatite, polycaprolactone or polylactic acid), nor injections with autologous fat can dissolve. There is no antidote for them, so it is necessary to put yourself in the hands of highly experienced doctors to avoid problems. Vitamins, PRP and botulinum toxin do not plump. Neuromodulators only stretch, but they can give the sensation of filling because they modify the mobility and strength of some muscles. The correct use of the toxin depends on the hand of the expert, and can be done in a very natural way while maintaining mobility without changing the expression. Although all doctors put toxin, not all know how to do it naturally.”

Keys to avoid a swollen face Hyaluronic acid injections to smooth wrinkles, provide volume and achieve smoother skin are one of the star treatments in medical consultations and the result, with good practice, is natural and flattering. However, the increase in demand and the desire to stop the clock has increased the resulting complications. As Dr. Conchita Pinilla, specialist in plastic surgery, explains, “the filler provides the necessary structure so that it ages more slowly (with age it is reabsorbed), and therefore it has to be natural. If there is overfilling with hyaluronic acid, it is because the patient develops addiction to the technique or the protocol is not appropriate. It must be clarified that autologous fat requires overfilling, because only 70% is absorbed, but the swelling is temporary.”

We must also take into account the difference between the fillings before and now. “In the past, too many vials were used, between 8 and 15 per session, and they ended up weighing in the middle third area. The current trend advocates naturalness and less is more. In addition, there is certain genetics that predisposes the increase in volume when performing an infiltration. And there are also patients whose infiltrations are not completely reabsorbed, hence the importance of personalized diagnosis,” comments Dr. Mar Lázaro, specialist in aesthetic medicine.

The excessive use of filters on social networks creates the false image of plastic skin without a trace of pores or distorts features to appear thinner. This causes many people to turn to aesthetic medicine with unattainable demands. “We professionals have the great responsibility of educating the patient, advising them and saying no to requests for disproportionate treatments. If a patient shows us a photo with a filter, we know that there is a risk of dysmorphia: not only does he seek to eliminate a defect that does not exist, but he also wants to bring to reality an unreal image, impossible to achieve outside the digital world, although in his head. is achievable,” explains Dr. Mar Mira from the Mira+Cueto Clinic. Hence the importance of choosing a good doctor with experience in aesthetics. “There is a lot of intrusion and that increases complications. I see a lot of accounts based on before and after photos with the goal of gaining more followers. And immediacy is not good, we must always think about the long-term effects. To choose a good professional you have to

Look at your experience, because the hours worked are what make you an expert. I also advise looking at the resume, the evaluations and the importance of having a similar concept of beauty. For example, if you are looking for natural results and in the clinic you see thick lips or very exaggerated features, everything indicates that you are not in the right place,” concludes Dr. Beatriz Beltrán.

Techniques to Get Rid of Excessive Fillers

The launch of temporary and reversible hyaluronic acid fillers was a success more than 25 years ago. At first, they were used to fill areas such as the lips or nasolabial folds. But over time its use has extended to cheeks, temples, forehead, chin or jaw. Can we reverse the effect when the result is not the desired one? “Yes, when there are excess fillers we apply hyaluronidase, a natural enzyme that degrades hyaluronic acid. Hyaluronidase is applied through facial mapping in which not all areas are treated equally, since it depends on their anatomical characteristics. Different dilution variables and quantities are applied to the conflict areas to recover the naturalness of the face. After the treatment, the hyaluronic usually dissolves between 1 and 3 days, which is when it stabilizes with a definitive effect,” explains Dr. Mar Mira, from the Mira + Cueto Clinic. After injecting it “it can bother a little and cause bruising. The doctor's expertise is important because he must calculate the exact dose and know how to inject it so that it affects only the filler and not the hyaluronic acid itself. We review after a week and, if necessary, we inject again. We must evaluate each case because sometimes there is flaccidity that can be worked on with ultrasound or radiofrequency,” advises Beatriz Beltrán.

Hyaluronic acid can also be removed with a laser. “We use a 200/400 nanometer fiber, as fine as a thread, which we introduce with an ultrasound guide to liquefy the filling material. The results are good. Without a doubt, the most resistant fillers are the old silicone or polymer ones because it is necessary to resort to surgery to remove them. If they are dispersed, it is very difficult to remove them,” explains

Dr. Daniel Zarza from the Benito Institute to

S Moda

. Dr. Mar Mira agrees “although there are few cases left, since silicone is a filler that has not been used in consultations in Spain since the nineties, we have cases from certain countries where it is still used. The body does not integrate silicone or substances that are not biocompatible and behave like a foreign body; The body's reaction is to generate its own tissue around it until its volume increases. They are difficult fillers to treat because they are fibrotic tissue. Sometimes, we can provide greater symmetry in certain cases, seeking compensation, but it is not always possible.”