The Pillow Face Pandemic

Has the pillow face filter joke gone too far?

You’ve no doubt witnessed the rise of face altering filters on Instagram. Most are designed for a little fun, while others created to blur out pores, straighten noses, and voluminise lips and cheeks are heavily influencing aesthetic trends. 

While the most recent to be making the rounds, the pillow face filter, may seem like a bit of a joke, it’s sparking a larger conversation as treatment demand continues to rise, as does the request for dissolving treatments as a result. 

Dr Aliaa Yusof is an experienced cosmetic physician who’s seen an increasing number of over-filled patients and believes Instagram trends are partly to blame. 

“Patients are often driven by images they see on social media of celebrities or beauty accounts and think filler is the answer for all their aesthetic desires. 

“Whether this phenomenon is injector driven or patient driven remains a debate but personally I feel that it is both. As cosmetic injectors we are medical advocates for our patients but sometimes it is hard to say no to patients’ requests of “just a little bit more filler,” says Dr Aliaa. 

Dr Aliaa Yusof

Overfilling and the ‘pillow face’ look isn’t just an issue of taste as these popular treatments bring more than just aesthetic risks. 

“Overfilling doesn’t only pose psychological risks to the patients, but also physical complications such as long term swelling or a puffy look, over-stretching of the overlying skin, compression of surrounding structures such as blood vessels, blockage of the lymphatic drainage, and latent infections. 

“The most commonly overfilled areas I dissolve have to be lips and tear trough fillers. These areas are very delicate with a complicated anatomy, which makes it prone to complications such as filler migration and long term swelling due to overfilling. 

“It is not a coincidence that these are also the top two most requested filler treatments by patients!”

Nurse Ally Hanby, injector at Cosmetic Avenue, has also experienced a surge in cases of over-filled patients and suggests it’s the younger demographic who’s most influenced by the ‘pillow face’ trend. 

Nurse Ally Hanby

“I dissolve at least one patient a week!”

“The vast majority of millennials and gen Z are more social media savvy and utilise such platforms as Instagram and Snapchat where the pillow face filter and other similar filters can be found. It’s these patients who are usually in their early 20s to mid 30s that I find are the group that aspire to this particular trend.”

While the dissolving of filler is a safe and relatively pain-free treatment when performed correctly, it shouldn’t encourage patients to throw caution to the wind as Dr Aliaa suggests the emotional toll can be the ultimate down-side. 

“I find that it can be a very emotionally and psychologically challenging process, especially for patients who have been used to their over-filled look for quite a number of years. The changes post dissolving can be quite dramatic for some.”

Nurse Ally agrees that taking things slowly gives the patient the best outcome. 

“When a patient presents for dissolving, I always consult first. Very rarely do I perform treatment on the same day. Some patients have had years of filler build up and are used to seeing themselves a certain way. A cooling off period between consult and dissolving is suggested so that the patient has time to digest the information and prepare mentally.

“It can be quite confronting to go from having lips to suddenly having no lips!”

Though the distorted features being achieved through filters is guiding trends, Dr Aliaa suggests that misconceptions about fillers and the anatomy is also a leading cause of over-filled faces. Rather than a single botched treatment being to blame, the ‘pillow face’ look can also be a result of treatments over time. 

“We used to think that fillers last for 6-12 months but there is now mounting evidence that this might be a misconception. 

“Our faces are multidimensional, unique and complex, not everything can be solved with a little bit more filler. As injectors, we have to educate our patients and utilise every tool in our toolkit to deliver the best and natural outcome, while respecting anatomical and ethnic nuances.”

While the popularity of treatments like lip, cheek and tear trough fillers continues to rise, the future of aesthetic medicine is also evolving at a pace that aims to stay ahead of trends for better patient safety

“In a recent global conference, we discussed the evolving technology in the industry and the use of imaging devices to detect fillers in the skin such as using MRI scans and ultrasound machines. Ultrasound-guided filler dissolving is also now becoming more popular as it gives us better accuracy when dissolving certain unwanted fillers in the face,” shares Dr Aliaa. 

“Overall, I feel that we, the cosmetic industry, are definitely moving in a more positive direction in line with the current climate in beauty promoting more sustainable, natural, diverse and inclusive space. It’s definitely a turning point for us.”


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