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In an age where both celebrities and influencers alike are normalising face fillers (hello, Kylie Jenner and sisters), many of us are starting to view these aesthetic treatments as a way to look younger and perkier.

In fact, the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) reported back in 2015 that there was an increased number of patients below 30 years old who seek injectable treatments and cosmetic procedures.

The timing, which was roughly the period that saw the rise of filler-filled celebrity and influencer faces, is hardly a coincidence. It was also roughly the time when reputable aesthetic doctors and experts were in the spotlight more prominently than before, as they made regular appearances in mainstream media – talk shows, reality TV, you name it.

It’s also worth noting that studies have found that the pro-injectable group age better compared to those who are trying to treat already visible ageing concerns, which make sense since, seeing that this group of people are addressing signs of ageing before it actually manifests.

While face or dermal fillers are now a household term, do you really know what they actually do? What about the side effects of getting too much injected into your face? Read on to find out…

What exactly can dermal fillers do?

Amaris B December 2020 Face Tweakment Lip Injections Source Sam Moqadam Unsplash

Source: Sam Moqadam/Unsplash

Before we dive deeper, you’d have to first understand that dermal fillers aren’t the same as botulinum toxin – these work by “freezing” muscles to reduce wrinkles, while fillers smooth out skin by – yes, you got it – filling wrinkles and restoring lost volume due to age.

Considered a minimally invasive procedure that requires no downtime, dermal filler injections are typically crafted from materials that are most commonly found in the body. Collagen used to be a common filler ingredient, but these days most variants use hyaluronic acid as its ability to store moisture and maintain its shape after being injected, allowing it to give skin an augmented, hydrated look that will last for a sustained period of time.

When injected into the tissue, hyaluronic acid will attract and bind water molecules to itself, giving an immediate natural lifting effect. Over the next few weeks or so, it will continue attracting water like a magnet so the injected area looks bouncier, smoother, and more volumised.

Additionally, hyaluronic acid-based fillers can also work to replenish your body’s natural production of hyaluronic acid, which diminishes as you age.

Yet, worryingly, the rise of these minor cosmetic procedures (a.k.a. face tweakment) that came to prominence over the past few years has resulted in an obsession amongst consumers, which contributes to an addiction to fillers as well as the mushrooming of unauthorised, “back-street” filler treatments in unlicensed beauty parlours.

So, what are the consequences of having too many filler injections on the face? And can you reverse a botched filler procedure?

The worrying effects of too many injections

Amaris B December 2020 Face Tweakment Source Vince Fleming Unsplash

Source: Vince Fleming/Unsplash

Newsflash: Those lip, cheek, and nose fillers that you are addicted to are doing you no good.

That’s because over time, these injectables – regardless of the brand or type used – can weigh down the skin tissue and stretch out the flesh. This rising phenomenon, which differs from the immediate mishaps from a single injection, is known as ‘filler fatigue’. Unlike a one-time mistake, it’s related to the repeated use of filler injections over time.

What is filler fatigue? Well, imagine this: you fill up a fresh balloon to capacity with air, and then you release some of the air within. You then block back in, release, and repeat. What you get eventually is a balloon that’s not as tight and taut as point zero.

The theory is that when dermal fillers are repeatedly injected into the flesh, the skin in the injected area will eventually loosen as it gets weighed down by the fillers. This, in turn, means that you’ll need more volume of filler to fill that already stretched-out skin when you make a trip to see your doctor.

Filler fatigue aside, other less-than-desirable consequences that are associated with the overdoing of filler injections include flowerhorn forehead (an unsightly bulge over the forehead), sagging skin, ‘Avatar’ nose (widened nose bridge), trout pout, pillow face (overinflated cheeks), and sunset eyes (peepers get squashed and look smaller due to an overly puffed up face).

What you need to look out for when seeking dermal filler injections

Amaris B December 2020 Dermal Fillers Source Wind Ira Unsplash

Source: Wind Ira/Unsplash

If you want to avoid being a victim of yet another filler injection failure, the best thing you can do for yourself is to prepare before you plump. Below, we break down the key things you should be aware of before the syringe touches your skin.

Different filler brands and types can give different results

This might seem trivial but yes, the type of filler brand and variant that you use matters. Using inferior quality products or unstable filler type can give you unpleasant results, no matter which facial area you choose to target.

For example, certain fillers are better suited to smooth the skin under the eyes, while other variants may work  for plumping lips or cheeks instead. Some fillers also tend to be heavier than others, so if you use those on your cheeks, you’ll just end up with droopy, unnatural cheeks à la a bulldog.

Avoid beauty salons at all costs

This is pretty self-explanatory, to be honest. While the ‘Jennerfication’ of our beauty standards have done for cosmetics what Cara Delevingne did for eyebrows, it is important to remember that face fillers are medical procedures that can cause serious complications when administered incorrectly.

While fillers and botulinum toxin injectables, are regulated in Singapore and can only be performed by trained and accredited doctors, this has not stopped beauticians and laypeople with no certification whatsoever to procure fillers that are not registered with Health Sciences Authority (HSA) and use them on their unknowing clients.

When procedures go awry (usually due to poor technique as well as unsafe fillers), these unlicensed practitioners tend to deliver an unnatural result, causing lumps to form over the injected area.

More severely, it can also lead to necrosis (permanent tissue damage) if they are injected into a blood vessel instead of skin tissue. These beauticians, who often do not have adequate medical and anatomical knowledge, don’t recognise the signs and symptoms of it, and would also not have the right equipment to resolve it.

Do thorough research and identify a skilled, licensed doctor

Perhaps the most crucial step of all is to ensure that your doctor is experienced and licensed to perform dermal filler injections before you make your appointment.

When searching for a doctor, prioritise skills, experience, and credentials over cost and convenience. When the treatment costs a lot cheaper than what other clinics are offering, always find out why instead of jumping on the opportunity thinking you’ve scored a good deal.

Remember: your doctor’s skill is primary and he or she should ideally have a good understanding of facial anatomy, facial harmony as well as proper injection sites. The doctor should also ideally not be the type to blindly follow the trends – that’s because what works for the celebrities and your friends may not work for you.

With that said, it should be clear that you should look for a doctor that advises you on what works and what doesn’t. A good doctor would also always communicate about the realistic cosmetic outcome that best suits your entire facial harmony.

Less is more

When it comes to dermal filler injections, you’d want to get less  in order to achieve natural results. So when a clinic is hard-selling and convincing you to get a higher volume injected into your face, your inner alarm should be sounding off for potential danger.

Don’t give in to their pushiness, take all the time you need to make a smart decision or just step away. Your safety always comes first, and no good doctor will compromise that. A skilled medical professional will also tell you to stop injecting fillers into your already-stretched skin instead of selling you more.

A good filler treatment is invisible

Those pillowy full lips, extremely straight nose bridges, and perfectly rounded cheeks you see on Instagram are notorious telltale signs of a bad filler job.

But a good filler procedure that’s done right is basically naked to the eye – that means your voluminous lips will still look natural if you get a doctor with a keen aesthetic eye to administer the filler injection in the treated area.

Bottom line: you should look like the better and improved version of yourself, and not like someone else.

Fillers botched my face, what can I do now?

Well, the (sort of) good news is that you can still seek redress if you seek medical attention immediately following the mishap.

An ideal solution to botched filler jobs comes in the form of a hyaluronidase injection, often referred to as a reversal agent for hyaluronic acid-based fillers.

For the uninitiated, hyaluronidase is an enzyme that can accelerate the breakdown of synthetic hyaluronic acid filler while leaving your own natural hyaluronic acid intact. This treatment is performed to correct fillers that are injected incorrectly, excessively or unevenly and is a doctor-prescribed injectable.

One of the licensed clinics where you can get a hyaluronidase injection is Amaris B. Clinic, where the injection will be performed by Dr. Ivan Puah, a doctor-trainer for injectables with an acute sense of aesthetics and facial harmony.

At Amaris B. Clinic, Dr. Ivan Puah is a firm believer that art is as important as science when it comes to medical aesthetics, in order to achieve the look you desire.

The filler alternatives you can consider for facial enhancement

ADR-C Facial Enhancement

Another alternative you can go for is the ADR-C Facial Enhancement. Also known as facial fat grafting, this procedure works by utilising your own fat source to improve facial contour and heal scar tissues – provided it’s done correctly by a legitimate medical professional.

How it works is essentially by harvesting fat from one part of the body – usually the abdomen or thighs – and planting the “borrowed” fat to another area where needed through syringe liposuction. Since this extraction technique uses your own tissue instead of foreign matter, your body is less likely to reject the transfer of fat.


For those who are concerned with extra fat making its way to the face, you can consider SmartLipo (laser lipolysis). Being one of the first clinics in Singapore to bring in this treatment from Europe in 2005, you can rest assured that Amaris B. Clinic has more than enough experience to perform this procedure.

A minimally-invasive fat-reducing treatment, SmartLipo is essentially a laser-assisted liposuction that melts excess fat cells into a liquified form so that it can be easily removed through suction. In addition, it even has the ability to stimulate collagen production which leads to skin-firming benefits.

SmartLipo is commonly used to eliminate stubborn fat pockets while rejuvenating the appearance of sagginess and improving loose skin, giving you a sculpted facial profile.

How Amaris B. Clinic can help you achieve a natural, younger-looking visage

Amaris B December 2020 Dermal Fillers Dr Ivan Puah

At Amaris B. Clinic, you can rest assured that your well-being is in safe hands as a patient’s safety, health, and results are always the team’s top priority. With every patient, Dr. Ivan Puah will consult and advise thoroughly on the suitable treatment plans after assessing your clinical conditions, needs, and expectations.

Backed by more than 15 years of experience in performing facial cosmetic enhancements as well as body sculpting procedures, Dr. Ivan Puah is the medical professional you can trust to recommend a treatment solution that gives you optimal, flattering results.

Dr. Ivan Puah is also a VASER® Certified physician and is one of a few doctors accredited by the Ministry of Health in Singapore to perform liposuction. He obtained his VASER® Fundamental and Advanced Body Sculpting training in Colorado and Argentina in 2008, and was trained in syringe liposculpture by esteemed French plastic surgeon, Dr. Pierre François Fournier.

You’d also be delighted to know that Amaris B. Clinic is cut from a different cloth than other aesthetic clinics you see in town. That’s because it now offers integrative medicine in tandem with body sculpting and medical aesthetics – this means the clinic now provides weight loss and fitness assessment, pain management, sports injury rehabilitation, and myotherapy as part of its range of services.

So if you’re looking for an aesthetic clinic where you can safely improve your facial appearance for a more youthful look, you can consider Amaris B. Clinic where a team of medical professionals will be dedicated to enhance your appearance, health, and fitness on all levels by fully personalising their approach to your treatment.

Amaris B. Clinic is located at 140 Arab Street, Singapore 199827. Call 6536 4211 or email [email protected] to schedule for a consultation.