Something has shifted in aesthetic medicine over the last three years. The maximalist decade — bigger lips, sharper cheekbones, more syringes per visit — has given way to something considerably more restrained, and patients are driving the change as much as practitioners.
What went wrong
Hyaluronic acid filler does not always fully disappear. Longevity claims of six to twelve months were based on manufacturer data that has not held up against imaging studies, which have found filler still present years after placement. Layered treatment over a decade adds up in ways that are visible from across the room.
The midface is where this shows first. Repeated volumising of the cheeks can flatten and widen the face, which reads as heavier rather than younger. Because it happens gradually, it is genuinely hard to see in the mirror — patients tend to notice it in photographs, or not at all.
What we do differently now
We treat structurally and conservatively: filler placed deep on bone for support, in small volumes, reviewed a year later rather than topped up on a schedule. For skin quality we reach for Profhilo, polynucleotides and energy devices, which improve the tissue rather than adding to it.
And we say no more often. If a patient comes in with an already over-filled midface asking for more, the right answer is usually dissolving, not adding.
If you think you have been over-treated
Come and have a look with us. Dissolving is straightforward — hyaluronidase breaks filler down within days — but it is disconcerting, because you will look temporarily more deflated than your true baseline before the tissue settles over a few weeks.
Most patients who go through it tell us afterwards that they wish they had done it sooner.