Plastic Surgeon Warns: The Lasting Damage Dermal Fillers Can Cause

Lip and facial fillers are now a routine part of the beauty industry, often marketed as a quick, low-risk way to turn back the clock. But one Beverly Hills reconstructive surgeon says the “temporary tweak” reputation is misleading — and, in some cases, dangerously so.

“You cannot fill your way back to youth,” says Dr. Kami Parsa, an oculoplastic and reconstructive surgeon. “Even subtle, repeated enhancements can create permanent changes — and sometimes irreversible damage — resulting in the dreaded ‘pillow face.’”

The TikTok That Got 12 Million Views

In July 2024, Dr. Parsa posted a TikTok that has since been viewed over 12.4 million times. The short clip showed MRI scans from a patient who had received more than a dozen syringes of hyaluronic acid (HA) filler over six years.

HA is one of the most common filler substances, used to plump lips, smooth wrinkles, and restore lost facial volume. But what the scans revealed was unsettling: large green patches marking clumps of filler still sitting under the skin — years after injection.

When measured, the amount totaled nearly 28 cubic centimeters, more than double the original quantity. According to Dr. Parsa, HA’s hydrophilic nature — its ability to attract and hold water — combined with tissue expansion over time can cause fillers to grow in volume rather than fade away.

“Less Is More”

Although brands promote HA fillers as dissolving naturally within six months to two years, Parsa warns that residual amounts can linger for a decade, especially in people who top up their treatments regularly. Over time, this can lead to stretched skin, distorted proportions, and an overstuffed look — the hallmark of overfilled syndrome.

“We see beautiful patients from all over the world who’ve been overfilled for years,” Parsa wrote online. “I feel like a broken record, but you cannot fill your face to youth.”

He shared before-and-after images of one patient who required multiple corrective procedures to reduce chronic swelling from excessive filler use.

What Is “Pillow Face”?

Overfilled syndrome, often nicknamed pillow face, develops gradually. Instead of simply refreshing a person’s features, too much filler changes the structure of the face, creating puffiness and a cartoonish, unnatural appearance. The effect directly contradicts the beauty ideals fillers are meant to support.

The Public Reaction

Parsa’s viral post sparked intense debate in the comments:

• “When fillers first came out, injectors told us they’d only last six months,” one user said. Parsa responded, “That’s what the filler companies told us, too.”

• Another commenter shared: “I got lip filler once, and I swear it’s still there years later.”

• A third added, “Finally! This is being talked about. The amount being used without warning is insane.”

• Others vowed to avoid cosmetic injectables entirely, with one saying: “I’ll keep my face as it is. Injecting stuff like that feels too scary — like putting poison in your skin.”

The Takeaway

While fillers remain a popular choice for those seeking non-surgical cosmetic enhancements, Dr. Parsa’s message is clear: proceed with caution, and remember that more isn’t always better. The effects can be longer-lasting — and more transformative — than most people expect.

Were you surprised to learn fillers can stay in your face for up to a decade? Share your thoughts and help spread the conversation.