Dermal fillers – gel-like substances that are injected under the skin to smooth wrinkles, restore volume or create contours – have been around for a while. Some historians posit that humans have been toying with the concept since the late 1800s, but the first FDA-approved filler arrived in the US in the 1980s. Crude early versions, which involved injecting bovine collagen into the face, have undergone multiple upgrades to result in the stuff we have in 2023. The injectable, which is usually hyaluronic-acid-based, is an easy sell: virtually no downtime, relatively low-risk, and with entry-level pricing (well, in the grand scheme of cosmetic upgrades).
Dr Yannis Alexandrides, the founder of 111 Harley St, treated Parker with a surgical facelift to counter fillers. “We keep seeing more and more over-injected faces,” Alexandrides says. “We’ve seen problems with fillers, such as swelling, especially in the areas under the eyes. You can see the product doesn’t dissolve, and it can create cysts, lumps or granules.” When he started operating on Parker’s face, he found some undissolved filler as a result of “migration”: a complication that causes movement under the skin to areas outside of the injection point. You don’t want that.
Men, while traditionally a lot less forthcoming about their cosmetic procedures, have been big participants in the filler boom. In 2021, management consultancy McKinsey forecast that men’s use of injectables would double in the next five years, and in some LA clinics, men comprise up to half of clients. “If you think about the male CEOs of the world, nobody has a weak chin,” says Dr Kimberly Lee, a Beverly Hills plastic surgeon with actors, models and execs on the books. “Men are just very hush-hush and clandestine about this.”
Gary Thompson, a fashion and beauty blogger who runs the popular account @theplasticboy, started getting fillers at 28 to even out his cheekbones. “When I first had it done, I was like ‘Oh, my God, this looks amazing,’” he says. “It gives you that instant result. And then you’re at home, and you’re like, ‘I want more.’” He had further rounds of injections and top-ups in his jaw, lips, and cheeks, but then he wondered, “Am I looking a bit crazy? A bit puffy? I felt like I didn’t look as sharp.”
He decided to remove the fillers in his cheeks and lips, a process that involves getting an enzyme called hyaluronidase injected into the same spots to dissolve the injectable, usually over a few sessions. Temporarily, it can make you even more swollen than before. “I looked like I’d been stung by a bee,” says Thompson. “It was a bit scary. When you’ve had it in for so long, you forget what your face actually looks like.”
Since filler’s boom, the big, pillowy look isn’t so au courant. People striving for a ’90s supermodel face aren’t trying to add volume anywhere on their face or body. Some dermatologists also cite the shift from Instagram to TikTok as part of the story. Whereas volume can look great from certain angles in a photograph, an over-filled face can look artificial – or worse, downright weird – in videos. The “Instagram face” phenomenon, coined by writer Jia Tolentino, saw “volume on volume”. Now, that’s been replaced with a gaunter, more video-ready facial silhouette. “Snatched”, if you will.
“In part, this is the Bella Hadid buccal fat trend of the past six months, but it’s also so connected to the Ozempic trend, and the story of going back towards a more extreme, thin aesthetic,” says Allie Rowbottom. The LA-based author found herself leaning into injectables after the death of her mother, and later scaled back her filler and Botox use. Her latest novel, Aesthetica, tells the story of a former influencer who weighs the decision to undergo a risky procedure that will undo all her cosmetic surgeries. “Everyone was so excited about filler, but now there’s almost a disdain seeping in. People are much more interested in surgical procedures, like getting a facelift earlier.”
