What Plastic Surgeons Say You Should Expect

With all the changes in cosmetic surgery trends — from lip injections to implants and filler removal — we asked plastic surgeons about the process of dissolving fillers and whether there are any risks associated with the reversals that are making headlines.

This is what experts recommend that people know before getting procedures so that they are happier with the results and less likely to have complications or want to have them removed or reversed at a later date.

The process of getting fillers — and dissolving them

Fillers, or dermal fillers, are gel-like substances that are injected to temporarily plump up the skin. They can be created from hyaluronic acid, which is a substance found naturally in our skin and tissues. Other types of fillers include calcium hydroxylapatite, which is found in bone, or poly-l-lactic acid (PLLA), a synthetic material.

The injections are typically used to smooth fine lines and crow’s feet (the wrinkles that we get around our eyes) as well as increase fullness into the lips, cheeks, chin, under-eye hollows, jawline, and the back of the hand. Generally, this popular procedure is a temporary improvement to add volume back into the face to reverse thinning that can happen with age, and it isn’t FDA-approved for use on every part of the body.

The injections can cause side effects like bruising, redness, pain, itching, swelling, and rashes. There is also a risk of more serious side effects like the possibility of an allergic reaction or accidental injection into a blood vessel, which can be potentially life-threatening. However, these effects are rare, and fillers are considered safe treatments.

“These injectables, or hyaluronic acid fillers, are temporary fillers and can last anywhere from three to 12 months, depending on the specific filler and the patient’s ability to metabolize it,” said Dr. Joshua Lampert, a plastic surgeon and member of the American Society of Plastic Surgeons.

Although people are often told fillers will dissolve on their own, the evidence is starting to show that they stick around longer than previously thought. They may also migrate over time from the original site of injection. That can lead people to end up with too much filler in their faces; others can lose their ability to tell what looks natural and what does not, also resulting in an “overfilled” look.

The good news is that many popular types of fillers can be reversed using an enzyme called hyaluronidase.

“The most common side effect of hyaluronidase injection is swelling, irritation, and redness around the site of injection,” Lampert told BuzzFeed News. “Hyaluronidase injection does have a small risk of a more serious allergic reaction and systemic effects.”

For non-hyaluronic acid fillers, a steroid injection might reverse the effects of fillers, or fillers can be surgically removed. Some fillers, including hyaluronic acid–based dermal fillers, can dissolve on their own using hyaluronidase.

Like getting fillers themselves, there are side effects when you dissolve them, regardless of whether they’re in the lips or the face.

According to the American Board of Cosmetic Surgery, moderate lumpiness or asymmetry can occur after getting fillers, which is why people either remove them or get them reinjected to fix issues.

The hashtag #lipdissolving has 73 million views on TikTok and #dissolvingfiller has 28 million views, with many people posting their stories about their experiences. Some people can have wrinkly lips after dissolving the fillers, particularly if the tissue has been overfilled for a long time.

That said, many seem satisfied with the filler-dissolving results.

“Most people who have facial filler dissolved are very happy they did,” said Dr. Anthony Youn, a board-certified plastic surgeon in Michigan who has a large following on YouTube.

Removing butt and breast implants

In general, the process of getting and removing fillers in your face or lips is easier than getting and removing breast and butt implants. Implants are made of substances that will never dissolve in the body, and they can also rupture or cause scar tissue to form and harden around them.

Unlike a Brazilian butt lift, or a BBL, which involves liposuction of fat from one area of the body and injecting it into the butt, implants involve placing devices containing silicone to change the shape, appearance, and contour of the butt. (BBLs are considered one of the more dangerous procedures because of the risk of placing fat in the wrong area. Although they can be safe if done by the right surgeon, some doctors say they no longer perform them.)

Because you can have breast or butt implants for decades, people have a lot longer to discover that they are causing health problems or are no longer working for their current body size or shape. What’s more, implants have a specific lifespan and generally need to be replaced over time anyway.

One reason people have breast implants removed is otherwise unexplained symptoms like fatigue, anxiety, chronic pain, and endocrine, autonomic, and nervous system dysfunction. Breast implant illness is thought to be a possible long-term complication of breast augmentation, typically with silicone implants; breast implant removal may alleviate symptoms. While generally considered safe after decades of research, breast implants have, in rare cases, been linked to squamous cell cancer or lymphomas in scar tissue, and the risk is higher with certain implant types.

For people who do decide to have breast implants removed, the amount of time it takes the area to heal often depends on how much scar tissue has formed around the implants, swelling, and postoperative changes.

Compared to face fillers, taking implants out may result in a more dramatic change, including loose skin and a change in shape. Additionally, the removal of implants requires a surgical procedure that can be more complicated than implant placement.

“Breast implant removal, or explant, often leaves the breast with a deflated area of central hollowing, significant subsequent breast and skin laxity, loss of projection, loss of conical shape, and proportional excess in the lateral breast,” Lampert said. “Breast implant removal alone places the patient at significant risk for resultant breast skin excess with rippling and nipple inversion, as the pocket collapses down to the chest wall.”

After the procedure, drains may be placed under the skin to drain any excess fluid and blood. Generally, healing can take up to a year — but for many people, the results are worth it.

“I must say, I’m very, very, very, very happy,” Chyna said right after her removal procedure.

Other celebrities, like Ashley Tisdale and Yolanda Hadid, have also said that health issues in general improved after they had implants removed. Tisdale had her breast implants removed in 2020 after “minor health issues,” including food sensitivity and gut issues. Hadid’s implants were leaking in her body after being ruptured, causing symptoms.

Removing butt implants may also result in changes in appearance.

“Other implants that can be removed including gluteal implants all present with the problem of skin and soft tissue stretch once removed,” Lampert said. “Over time, any implant stretches and thins the overlying skin. Once the implant is removed, the overlying skin and soft tissue can present with severe skin laxity. Implant removal can lead to indentations, contour irregularity, a depression, hanging loose skin or folds.”

What to know before getting any procedure

One thing you should know before getting any appearance-altering plastic surgery or procedure is that trends come and go and your body may change over time in a way that becomes a mismatch for the procedure. What’s more, new information can surface about the long-term effects of a treatment — like fillers or breast implants — that can make them less desirable over time.

When Khloe Kardashian had her face fillers dissolved in 2016, she said, “My face was so fucked.” Cardi B said she got her silicone butt injections removed after realizing how dangerous (and illegal) the procedure was. (These types of injections have been linked to a number of deaths, particularly at the hands of irresponsible practitioners without medical training; some injectors have been charged with manslaughter.)

Some trendy procedures, like buccal fat removal, are irreversible. While the procedure can lead to a sculpted look, it often doesn’t age well due to the natural loss of fat in the face with time.

After being in practice for over 18 years, plastic surgeon Youn has a list of surgeries he won’t perform or no longer performs (including face fillers).

“There are many cosmetic procedures today, especially ones being performed on younger people, which I would exercise caution because of the risks of either complications or desire to reverse them in the future,” Youn told BuzzFeed News. “These include the upper lip lift, BBL, butt implants, fox eye surgery, and certain types of breast augmentation.” (Fox eye surgery is a type of brow lift that involves reshaping the eyes to give them an upward tilt.)

It also helps to understand that many cosmetic surgery trends are driven by unrealistic standards and pressure to look “perfect.”

According to a 2015 International Society of Aesthetic Plastic Surgery study on outside influences on cosmetic procedures, 95% of patients considered getting plastic surgery after consulting an online source, including social media. Additionally, promotion from celebrity social media accounts can spark an interest in cosmetic procedures.

In a 2017 study published in the journal Aesthetic Plastic Surgery, researchers at Rutgers University looked at Google Trends, which tracks the interest in a topic over time. They followed searches for “Kylie Jenner and lip fillers,” “Joan Rivers and plastic surgery,” and “rhinoplasty.” They found that Google searches about lip fillers jumped after Jenner announced she got Juvéderm fillers.

As a result of comparison, social media can influence body dissatisfaction levels and attitudes toward cosmetic procedures; 55% of surgeons reported seeing patients who requested plastic surgery to improve how they look in selfies.

The rise in Zoom meetings and the use of FaceTime and other video meetings — where you need to look at your face on screen the entire time, often in poor lighting — fueled interest and a rise in cosmetic procedures too.

Vilde Holm Raggan, 30, from Oslo, Norway, had a breast augmentation at 23 after thinking it would help her feel less insecure.

“I was feeling insecure about my body and I had low self-esteem. I grew up with the Barbie body image and magazines that made you feel crap about yourself,” Raggan told BuzzFeed News. “I thought boobs would make me love myself.”

Raggan decided to get her implants removed when she turned 30 and shared the process on her TikTok, holding up the implants that were in her body. “I went from being insecure because I didn’t have boobs to being ashamed that I had fake boobs,” she said.