The “Less is More” Approach in Dermal Fillers: A Cautionary Tale from Dr. Kami Parsa
In the world of aesthetic medicine, dermal fillers have become a go-to solution for those looking to rejuvenate their appearance without undergoing surgery. However, a recent revelation by Dr. Kami Parsa, an esteemed oculoplastic and reconstructive surgeon, has sparked a crucial conversation in the field: the importance of moderation when it comes to hyaluronic acid (HA) fillers.
What Lies Beneath: The MRI Revelation
Dr. Parsa, who also serves as an international board member of CMAC, made headlines when he used an MRI scanner to show what dermal fillers look like underneath the skin. The image he shared depicted a patient who had received over 12 syringes of hyaluronic acid filler injected into her face over a span of six years.
The MRI scan revealed something startling: the areas where the fillers had been injected showed up as green, indicating the presence of the filler material. When Dr. Parsa measured the total volume of filler present, it amounted to nearly 28 cubic centimeters—more than double the amount that had originally been injected.
The Science Behind the Expansion
So how did 12 syringes of filler turn into 28 cubic centimeters? The answer lies in the hydrophilic nature of hyaluronic acid. HA fillers have a strong affinity for water, meaning they can absorb and retain large amounts of it. This property, combined with the natural tissue expansion that occurs as a response to the filler, results in a much larger volume than initially anticipated.
Dr. Parsa’s findings underscore a significant point: while hyaluronic acid fillers are marketed as a temporary solution that the body will gradually break down, the reality is that they can last much longer than expected. This extended longevity, coupled with the volumizing effects of water retention, can lead to unintended consequences.
The Consequences of Overuse
One of the most concerning outcomes of excessive filler use is the alteration of facial contours. What begins as a subtle enhancement can, over time, result in a condition known as “overfilled syndrome” or the dreaded “pillow face.” These terms describe the unnatural, puffy appearance that can occur when too much filler is injected, distorting the natural structure of the face.
Dr. Parsa’s video highlights a crucial lesson for both practitioners and patients: less is more. The goal of cosmetic procedures should always be to enhance one’s natural features in a way that is both subtle and harmonious. Overusing fillers not only risks an unnatural appearance but can also lead to long-term changes in facial anatomy that are difficult to reverse.
The Need for Proper Education and Caution
While dermal fillers remain one of the most effective tools in aesthetic medicine, Dr. Parsa’s findings serve as a reminder of the importance of proper technique, product knowledge, and a deep understanding of facial anatomy. It is essential for practitioners to stay informed about the lasting effects of HA fillers and to approach their use with caution.
Patients, too, must be educated on the potential risks of overfilling. It’s easy to be swayed by the promise of quick results, but as Dr. Parsa’s work shows, these results can come with unexpected and sometimes undesirable consequences.
Conclusion: Embracing the “Less is More” Philosophy
In an era where instant gratification often takes precedence, the concept of “less is more” may seem counterintuitive. However, when it comes to dermal fillers, this philosophy is proving to be the key to achieving truly beautiful, natural results. Dr. Kami Parsa’s research offers invaluable insights into the long-term effects of HA fillers and serves as a critical reminder that moderation is not just advisable—it’s essential.
As the field of aesthetic medicine continues to evolve, it is imperative that both doctors and patients approach cosmetic procedures with a balanced, informed perspective. By embracing the “less is more” approach, we can ensure that the outcomes of dermal filler treatments enhance, rather than detract from, the natural beauty of every individual.
My 2 cents worth on this article:
What the article failed to address is the specific brand of filler used, the type of filler (whether it was a harder or softer formulation), its exact placement, and the depth at which it was injected. While it's true that excessive filler can result in an overfilled or unnatural appearance, not all fillers behave the same. Choosing a high-quality filler brand with robust medical backing is crucial, alongside the expertise of a skilled practitioner. The persistence of the filler in this case might indicate the use of a less reputable brand or a filler that was too firm for the targeted tissue layer. In my practice, I have treated patients who have received 10-12 mL of filler over several years, and even those who have had up to 10 mL in a single session, without any adverse reactions or complications. I credit this to my meticulous technique and my commitment to using only the best fillers available.
