A dichotomy exists on TikTok: For every “come with me as I get my filler” video thrown on our algorithm, there’s one vehemently preaching the dangers of the aesthetic treatment shown shortly after. How to age on one’s own terms has been debated for years, but fatigue with dermal filler has been slowly creeping up on the masses.
“Even though filler doesn’t improve the way we look—and it’s also a risk to our lives—we women can’t stop doing it because we bought into the message that we women have an expiration date,” content creator Rochel Leah opines in her viral video on when filler goes wrong (more on the misinformation in the video below). “And God forbid we show any signs of aging, we become completely irrelevant. So we will do anything to stop that from happening, including disfiguring our faces or risking our lives.”
Leah’s video alone has 11.9 million views, more than 900,000 likes, and about 65,000 shares, with thousands of comments in agreement. So are we moving into an anti-filler era? And what does anti-filler even mean? Well, that depends on who you’re asking.
The Public Anti-Filler Movement
Terms like pillow face, which refers to an overly plump or bloated appearance as a result of excessive filler in areas like the cheeks or under the eyes, and scans that allegedly show that filler doesn’t actually dissolve are what started the turn against injectable fillers.
As a result of these fears, anti-filler (and anti-Botox) makeup is on the rise. Videos of creators scrunching their lips, nose, and eyes and filling in the creases with bold, colorful makeup to make their wrinkles more prominent celebrate what it means to age gracefully. “Finally a trend for the natural girlies,” writes makeup artist Gina in her caption trying the makeup trend. “Never thought my wrinkles would be so cute.”
Mainstream media is also questioning its role in pursuing eternal youthful skin. Horror film The Substance, which stars Demi Moore and Margaret Qualley, amassed critical acclaim after its debut at the Cannes Film Festival earlier this year and is going viral for its spot-on—yet graphic—commentary on society’s beauty standards.
“What plays out on screen may seem far-fetched, and certainly it’s wise to leave any regard for logic at the door, especially for the film’s final set piece,” wrote Radhika Seth in her review of the film for Vogue. “But in a world where people are pumping their bodies with Ozempic—one where Linda Evangelista, persuaded by ads asking if she liked what she saw in the mirror, submitted to a CoolSculpting treatment that she says left her ‘unrecognizable’—it also feels oddly prescient.”
Celebs are even being more vocal about stopping treatment altogether. Olivia Culpo revealed on her Instagram Stories that she had her lip filler dissolved before her wedding. Ariana Grande told Vogue in 2023 that she used to get Botox and lip filler but stopped years ago because it felt “too much.”
“For a long time beauty was about hiding for me,” Grande explained. “And now I feel like maybe it’s not.”
A Rise in Alternative Treatments
While public discourse seems to lean toward filler fatigue, experts push back a bit. They say that fillers are still in the conversation; the approach is just different. “I have noticed a significant increase in desire to do less in a session and instead just do subtle ‘tweakments,’” says Dhaval Bhanusali, MD, board-certified dermatologist and founder of Hudson Dermatology and Laser Surgery. “This is more in line with my preference where you can use a few milliliters here and there to help shape areas versus plump them up.”
While last year the American Academy of Facial Plastic and Reconstructive Surgery reported that filler was still one of the top minimally invasive aesthetic treatments of 2023, a report from a few years back also showed a sharp 57% increase in dermal filler reversals in just one year. “With so many editing apps out there, I think they have contributed to the idea of subtle changes making a large impact,” says Dr. Bhanusali. “The days of patients coming in for big lips are long gone, and instead we are more in the ‘just enough where I notice but no one else does’ era.”
“Patients are more educated and cautious, often seeking out consultations to address their worries,” says Hope Mitchell, MD, Skin of Color Society member and founder and CEO of Mitchell Dermatology. “I’ve seen an increase in people wanting more natural, subtle results, with a focus on balance rather than dramatic transformations. Many patients are exploring other noninvasive treatments as complementary options.”
These alternative treatments include microneedling, platelet-rich plasma (PRP), laser therapy, ultrasound skin tightening, and radiofrequency treatments. Dr. Bhanusali’s patients, for example, are put on regimented protocols, where he starts suggesting lasers such as Clear and Brilliant, Halo, or Fraxel depending on the patient’s age and skin goals. “Almost like exercise and meal prep, there is a system in place, and the goal is to just age well,” he says.
“These procedures may stimulate collagen production, helping to reduce fine lines and wrinkles and tighten and lift the skin without the need for injectables,” adds Dr. Mitchell.
Dispelling Filler Fears
The misconceptions about filler are many. The most common ones, says Dr. Mitchell, are that fillers are permanent, fillers can completely replace surgery, or anyone can inject fillers. Social media spreading misinformation only exacerbates the confusion on what filler can and can’t do. (Leah’s viral video, for example, also mentions that filler does not dissolve and may cause cancer, claims which experts say are unsubstantiated if you are going to a licensed professional using an FDA-approved product.)
“I don’t like the idea promoted by some spas that fillers are comparable to a manicure or bikini wax,” says New York City–based board-certified dermatologist Hadley King, MD. “Fillers are a medical procedure and should be treated as such. They offer a great nonsurgical option for volumizing the face, but they are not without serious possible adverse effects.”
Dr. Bhanusali explains that the downsides to fillers are supposed to be minimal if you go to a skilled injector. Though you might experience sensitivity or inflammatory reactions, they are rare. “Most downsides are due to placement error or utilizing too much or too little,” he says.
He goes on to say that how long filler actually lasts is dependent on a couple of different factors. “Like anything, there is always a spectrum,” he says. “The vast majority of people have fillers that last a fixed time. But like metabolism, some people break things down quicker and others slower.” He likens fillers dissolving to scars healing: Some heal quickly while others may take months to years, similar to how some people’s fillers last longer than others.
“Filler longevity can vary widely from person to person,” agrees Dr. Mitchell. “Factors like age, genetics, metabolism, and lifestyle choices, such as exposure to UV light and smoking, can affect how long the body metabolizes fillers. Additionally, the location of the injection matters. Areas with less movement, like the cheeks, may retain fillers longer than highly mobile areas like the lips.”
Filler can migrate, though it is rare. According to Dr. Mitchell, the substance moves from the initial place of injection when too much filler is used or if it is injected too close to areas with high muscle movement. This then causes an unnatural-looking or overfilled appearance, such as pillow face. However, the experts want to reassure everyone that it is an easy fix and that filler can be dissolved. “If pillow face occurs, options to dissolve the filler using an enzyme like hyaluronidase are available,” she says. “[We also] make subtle adjustments to help slim the face with more lateral injections,” adds Dr. Bhanusali.
There is definitely a shift in how we want filler to look. We’re seeing requests move away from “filler face” and toward requests for fine-tuning without having to look completely different. But with the rise of other treatments that produce similar results, only time will tell if (and possibly when) we will abandon filler completely.
And if you’ve been on the fence on the whole thing, you can adopt Grande’s approach of taking a beat and rethinking filler later: “Since I stopped getting fillers and Botox—and maybe I’ll start again one day, I don’t know. To each their own—whatever makes you feel beautiful, I do support. But I know for me I was just like, Oh, I want to see my well-earned cry lines and smile lines. I hope my smile lines get deeper and deeper and I laugh more and more. I think aging can be such a beautiful thing.” To each their own.
