I feel jowly and fillers no longer seem to help. What's going on?

I find that there are two reasons for this: 1) It may be time for a facelift, and 2) the issue at hand may actually be the result of overfilling. It may be time to remove some of the old filler!

What? Take away filler? How can that help?

Let's take a look at facial filler history. When Restylane and Juvederm first came out, the focus for facial fillers was on the naso-labial folds and marionette areas with direct filling in that area. The plan of treatment at that time was to eliminate as much of the folds with direct injection of fillers into that area. That approach worked well for most patients, and many were happy with the improvement. Then came a paradigm shift when the filler companies introduced the products of Juvederm Voluma and Restylane Lyft for the upper facial areas. By filling the cheeks and upper face first we discovered that patients needed much less filler in the lower face. This results in a more natural and balanced face.

At Hass Plastic Surgery and MedSpa, we notice that patients who have received more fillers in their naso-labial folds and marionette lines relative to their cheeks can get to a point where there's a heaviness of the area causing a puffy or boggy appearance. Luckily, this can be addressed by injecting an enzyme that dissolves the filler! It may seem counter-intuitive, but the results have been amazing. We will inject the enzyme and see immediate results that continue to evolve over the following day or two. Once we feel comfortable with the correction we then plan judicious placement of fresh filler to further improve the overall look.