Avoiding Filler Fatigue – How to Look Natural

muscle relaxant solution injectables (woman with TGA approved muscle relaxant solution or restalyn or TGA approved Filler)

Filler Fatigue – The Long term use of too much filler – How to Avoid Overuse of Filler to get a Natural Looking Result

As has been a beauty trend for many decades, a ‘dab or jab’ here and there on the face of anti-ageing solutions or dermal filler can go a long way to helping you look younger, refreshed and less wrinkled – and stave off a facelift, eyelid lift or deep chemical peel for a few more years (unless you’re past the point where cosmetic injections alone can really make a difference for your skin or facial features). But everyone knows someone who has overdone the facial filler. The new buzzword for this trend is “filler fatigue.” Some of the key areas for filler mishaps occur in the lips, brow area and cheeks (“pillow cheeks”).  So if you want to look natural yet refreshed, there’s no denying you need to choose a good injector who understands that a little goes a long way – and how to leave you enhanced yet natural-looking. Here’s how to look natural avoid filler fatigue.


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“A little Dermal Filler is good,” notes Senior Injecting Nurse Sandra Wallace, “but too much filler can have dire consequences on your appearance. Over-filling the face, lips or brow can prematurely AGE your face rather than rejuvenate it.”

“When it comes to facial filler or lip augmentation injections, the goal is to have you look your best, but not radically different – and not overdone,” note our Injecting Team at Coco Ruby Skin & Anti-Ageing.

And our team knows how to get natural-looking results for patients, because they have over 2 decades each in cosmetic injecting experience and they work alongside some of Melbourne’s most sought Plastic Surgeons for facial and eyelid rejuvenation, including, Plastic Surgeons Dr Richard Sackelariou (Facelift and Necklift Surgery and Facial Rejuvenation and Rhinoplasty), Dr Geoff Barnett (Light Healing Round Block Facelift Surgery and Neck Rejuvenation procedures)

Our Cosmetic injectors see patients in Hawthorn East.  Find out more by sending an enquiry form below or phoning (03) 8849 1400.

Filler Fatigue: The Top Facial Filler Mishaps and Looking Overdone

Lip Augmentation: What can happen if you put too much filler in your lips?

Over-filling lips during a lip augmentation injection session – or using an unnatural-looking filler solution – is a common trap for inexperienced injectors, or where the Clinic focus is on performing cheap cosmetic injections quickly rather than customising treatments using a well-thought out injecting strategy for lip augmentation.

“Everybody sees people who end up looking ‘duck-like’ or with a ‘puffer trout’ type of smile,” notes Injecting Clinician, Sandra.  “Not everyone is a good candidate for lip augmentation using fillers. You need honest advise and a skilled injector who can assess your full facial anatomy and your facial expressions to assess whether or not you’re a good candidate for cosmetic injections and lip augmentation.”

  • Our Injecting Clinicians are very careful NOT to overfill the lips.
  • We take time to inject the lips with lip filler, and we check your results as we go – including evening out uneven lips or asymmetry or a gummy looking smile.

facial fatique, dermal fillers injection, too much filler in lips, lip augmentation, beauty buzzwords

Lip Augmentation: What makes our Coco Ruby Cosmetic Facial Filler Injectors at the top of their class!

  • We avoid over-filling your lips and we focus on keeping lip augmentation proportionate to the rest of your face.
  • We’d rather have you come in twice,  if necessary –  than overfill your lips on the first injecting session.
  • We also use very natural-looking, naturally soft-feeling filler solutions – not cheap lip fillers that can end up feeling like someone else’s lips were plastered on your face.
  • Our thorough understandings of the anatomy of the face, the condition of your skin and the best injecting strategies for your entire facial appearance help you avoid the common lip filler pitfalls – the’ joker smile’, “pufferfish trout’ or ‘pout trout’  or a ‘duck face.’

Brow Filler and Brow Augmentation: What can happen if you put too much filler in your brow, or in the wrong place?

Usually, Cosmetic Injectors will use anti-wrinkle solutions in the area between the eyebrows – known as the ’11’s’ – where furrows tend to leave people looking worried, tired or angry.

But some Injectors try using fillers in the brow area to fill in the concentration lines or brow furrows.  Or they try to restore volume in the brow area to rejuvenate the face. But it doesn’t always go to plan, and filler in the forehead can leave you with a sagging brow if too much filler is put in the wrong areas.

“Done improperly or using too much filler, this can lead to poor outcomes – including prematurely AGEING the face and leading to a sagging brow or even eyelid concerns,” notes Injecting Clinician, Sandra. filler fatigue - lip augmentation and dermall fillers injection beauty buzzwords

“Putting too much filler directly along the brow area needs to be handled with care,” agrees Sandra.

Our Injectors Dr Tina Perdon and Sandra Wallace are also seeing more patients who have had too much filler in the wrong areas.  They also see patients who are better off having facial surgery for some ageing concerns, or a combination of facial surgery and fillers.

Whilst our Coco Ruby Team has decades of experience and can usually help patients who have had a bad injecting result elsewhere, they prefer patients get the RIGHT injecting treatments at the start, rather than having to get corrective work done afterwards.

So avoid filler fatigue and incorrect injecting strategies by choosing an Injector with extensive experience or you’ll end up looking unnatural and ‘over-done.’

There’s nothing worse than ending up looking like you’ve had WAY too much facial filler.

“That’s why it’s so important to choose an injector carefully,” notes Sandra.  “It’s not just the quality of the injecting solution you need to consider in terms of injecting prices. It’s the skill of the injector and what you’ll end up looking like, afterwards, that’s important.”

Cheek Augmentation using Dermal Filler: What can happen if you put TOO MUCH filler in your cheek area or in the wrong places on the face?

Why is cheek augmentation using dermal fillers is rejuvenating?

  • Bones deteriorate and reduce (atrophy) over time.  This leaves faces looking drawn or skin looking like it is sagging ‘downwards’.
  • Filler in the cheek area adds volume and support to enhance the underlying skeletal structure (but remains in the dermal layers).
  • A slightly elevated cheek can reduce some wrinkles and sagging under the eye area and lower jaw area.

But TOO MUCH cheek augmentation using cosmetic filler injections isn’t the best of looks!

Seen too much of the ‘chipmunk cheeks’ look on the Celebrity Set?

There are far too many Hollywood stars – men and women – who have had obvious cheek augmentation using too much facial filler.  It ends up distorting the entire face, especially if combined with a ‘trout pout’ (an overdone lip augmentation using lip filler injections).

Filler Fatigue – Cheek Filler – distorted cheeks due to overfilling cheeks during cheek augmentation (“pillow cheeks”)

filler fatigue - lip augmentation, beauty facial injections beauty buzzwords cheek augmentation

Everyone loves a high cheekbone, but we’ve all seen the facial distortions that people who get TOO MUCH cheek filler end up with in terms of a lack of facial balance.

“Too much filler in the wrong area, or in the cheek area, can leave some faces looking distorted – like they have ‘pillow cheeks’ or ‘chipmunk’ cheeks. It’s just not natural and it can throw the entire facial appearance,” notes Injecting Clinician, Sandra, who’s available to see injecting patients in Hawthorn East.

“Too much cheek filler also has a tendency to make your eyes appear smaller,” notes Injecting Clinician Sandra, who’s available to see injecting patients at Coco Ruby Plastic Surgery in Hawthorn East.  “It’s about achieving the right balance, which takes a lot of experience and skill.”

How do you know if you’ve had too much filler in your cheeks?

  • Unsolicited comments about your ‘cosmetic injections’ or ‘cheek augmentation’ are usually a sign that you’ve had a bad job.
  • When friends comment on your filler treatment or ask if you’ve had filler, it’s usually a sign that what you’ve had done was extremely OBVIOUS.
  • That’s because a good cosmetic filler or dermal filler and facial injecting session leave you looking natural and ideally not overly detectable by people you see on a regular basis.

filler fatigue - bad injectors lip augmentation

A little bit of dermal filler goes a long way. It’s all about BALANCE and HARMONY – and strategic planning – not cheap, fast cosmetic injecting sessions where “one needle/one vial fits all.”

How much is too much dermal filler for your cheeks?

It really depends on your facial anatomy, but usually, 1 ml to 2 ml of a good quality cheek filler will do the trick to subtly enhance your cheekbones.

Examples of the FROZEN look after too much dermal filler might include the following celebrities.

“You can always come back for a second treatment if you want a bit more augmentation,” says Dr Tina Perdon. “But you want to keep it balanced from the start. Our team at Coco Ruby is very adept at knowing how much of any particular solution – and what brand to choose – to get patient’s a positive and natural-looking result.”

Find out more about what dermal volumisers (facial fillers) and lip augmentation injections can DO to balance out your face, correct an uneven smile, reduce tear troughs and help you look your optimal best without surgery.

You’ll get an honest opinion from our top 3 injectors on the Coco Ruby Skin & Anti-Ageing team – all experts in customising injecting strategies to meet the individual needs of every patient.  And if you’re not a suitable candidate? Our team will let you know.

Facial Rejuvenation Guide Download

Send an enquiry form today or phone our Patient Care Team on (03) 8849 1400.

If you’re considering scheduling a Quality Facial Injectables Plan that involves anti-ageing and wrinkle-reduction injections, you’ll want to know that repeating injectables over time like  Anti-Wrinkle Injections & Facial Dermal Fillers are generally considered to be well-tolerated by healthy patients.

The research into injectable treatments and repeated injectables suggests these treatments can enhance your appearance or correct for a facial feature imbalance or bone and lip atrophy, and are typically well-tolerated. As with any cosmetic procedure or medication, patient selection is key, and even carefully selected patients may occasionally have unexpected and unanticipated reactions to injections. So just aim to choose carefully, consider the risks in details, and make your decisions based on the available medical data.

It’s important, however, that the recommended injected solutions are approved for use in Australia, and that you get your injections from an experienced and highly skilled Injecting Clinician who has sterility, patient comfort and overall well-being in mind.

But there are some risks to having dermal filler injections or repeated injections, so be sure you read and understand these before you have a procedure. Your Clinician will provide you with details and be sure you ask any and all questions you may have before deciding on whether or not to get filler injections or anti-wrinkle solutions.

Although there are dermal filler injection complication risks, even in the hands of great cosmetic injectors with years of experience, most potential complications are mild and transient.

That noted, some injecting procedures carry higher risks (liquid rhinoplasty, for example). And some of the risks of cosmetic injections are serious (read the blog about danger zones of cosmetic facial injecting).

More serious risks and serious complications are fortunately rare; and if you choose a clinic with good sterilisation protocols and highly skilled injectors, your risks can typically be minimised to some extent.

Risks from dermal fillers are not non-existent, though, so be sure you ask about the range of risks of dermal fillers before consenting to this cosmetic procedure.

Medical studies on the topic of Filler Fatigue & Cosmetic Injectables –  filler tolerance and risk

Research on Injectable Facial Fillers or Dermal Volumisers

Injecting Study References relating to Repeated Dermal Fillers & Anti-Wrinkle Injections

  • Parayanthala, V.M., Santhakumar, S. and Arumaugam, S. Determination of oxidative stress-related toxicity on repeated dermal exposure of hydroxyapatite nanoparticles in rats. Int J Biomater 2014; 2014: 476942.
  • Lemperle, G., Gauthier-Hazan, N. Foreign body granulomas after all injectable dermal fillers:  2 treatment options. Plast Reconstr Surg 2009 Jun; 123(6): 1864-73.


Researchers in India were concerned about whether or not bone fillers were causing any long-term damage.

The fillers made of hydroxyapatite nanoparticles are smaller than 50 nanometres ( a human hair is 80,000 nanometres). Researchers questioned whether they could conceivably accumulate in organs.

  • When tested in animal studies for 28 days, blood, liver, and organs showed no accumulation of the nanoparticles.
  • The antioxidant defense mechanisms were not changed, indicating the use of the fillers was well-tolerated.

Facial Injectables, Facial Fillers and Granulomas

Injectables may cause the appearance of granulomas in some people (a granuloma is a collection of immune function cells which are known as histiocytes).  Usually, granulomas occur because of an infection in the skin. Even this rare potential side effects may be overcome by medical treatment, and at Coco Ruby Skin & Anti-Ageing, the Doctors and Senior Nurse Injectors are all trained in how to best manage any potential rare complications.

A good injector can screen for potential problems relating to injectables and will also have quality treatment protocols in place – along with expert knowledge – should any rare side effects occur.

A great injector will also help you to avoid Filler Over-Use Syndrome.

repeating injectables over time - best injecting GP nurse practitioner melbourne for fillers

Do you have any other questions about injectables? Give our Patient Care Adviser or expert Injectors a call on (03) 8849 1400 and get your questions answered.

Injectable cosmetics and How to get Natural-Looking Filler Injections.

Why Natural Looking Fillers are So Elusive and Why Celebrity Fillers Go Wrong at times

People sometimes fall in love with their filler injection treatments. The ‘love of fillers’ sentiments exists primarily because of how well fillers can reshape a face or refine a feature to improve one’s appearance. But over-filling is a common syndrome that’s more commonly known as “dermal filler fatigue.”

  • Too much dermal filler is technically called “over-volumisation” of the face
  • It typically occurs in the area of the lips or cheeks and sometimes the brow or temples
  • Great filler strategies can reduce ageing and improve the face, but too much filler can leave people looking grotesquely out of balance and even older than they were, to begin with.

A great cosmetic injector will go slowly, use a little at a time, and educate you about their injecting strategy. A bit of volume can go a long way to subtly enhance the face and reduce one’s signs of ageing.  

So a bit of dermal filler injections is a good thing for patients with specific feature concerns, eye bags or uneven features. And toxins are also a good way to relax frown lines and reduce a gummy smile.

Yet why do so many celebrities and others get it wrong and end up being over volumised in their lips or cheeks or temples?

natural-looking filler injections, celebrity fillers gone wrong, overfilling lips with dermal fillers or cheeks

Being Conservative is Best for Cosmetic Injections and a Natural Looking Enhancement

If you or your injector isn’t conservative with cosmetic facial fillers, it’s easy to think ‘more is more.’ You can readily end up looking ‘overfilled’ and – well – unnatural – and out of facial balance. It’s a medical substance, not a fashion purchase – but having too much filler is far more visible socially than buying far too many shoes!  That’s why choosing your cosmetic injector carefully is SO important. You really DON’T want to fall for cheap, inexperienced or overzealous injecting clinicians.  Be careful who you choose and discuss strategy and injecting substances at every session to avoid a swap-a-roo of good filler for something less quality.

Instead of searching for cheap injections, our blog team believes you need to choose an experienced, conservative cosmetic injector.  You’ll definitely want a Cosmetic Injector who has an artistic eye for balance and facial harmony, as well as a thorough understanding of anatomy and patient safety. It’s also wise to choose a safety-conscious Cosmetic Injecting Clinician who takes pride in offering a sterile procedure AND pride in getting you a result that LOOKS great but doesn’t look ‘overdone’ or ‘over volumised.’

natural looking fillers vs fake looking fillers, dermal fillers

Un-Natural Looking Fillers are too Common and give Fillers a bad rap, unnecessarily.

A bit of filler in the right place can work magic for your facial features.  But a lot, or in the wrong place, and your face can become unnatural and noticeably out of balance.  Too much cheek filler or lip filler or filler in the wrong places, and some people end up looking quite distorted or even grotesque.

Celebrities who Over-Love Their Filler Injections – Filler Fatigue Femme Fatales

Recently in an article in Elle Magazine, actress Courteney Cox admitted she had fallen prey to the ‘too much filler syndrome.”  So she eventually opted to have her fillers dissolved. This is not the simplest of processes. However, it is a key reason our injectors ONLY use temporary fillers and it’s a benefit of these injections that temporary fillers may be more reversible than permanent fillers.  And temporary doesn’t mean short-lived – some last as long as 6 to 12 months or even longer if the right product is used in the right place by the right injector.

The article also noted that one or more of Courteney’s friends had commented that she’d ‘perhaps gone a bit too far‘ with cosmetic injections (not an easy thing to tell a friend, is it?!).

But the question we should really be asking, is NOT how much better she looks after the treatment or in the photo in the right referenced below (if sequential), but HOW she ended up having “filler fatigue” in the first place? And how much does the angle, hairstyle, camera lens and lighting impact what a person looks like in a photo? 

Over Filled Cheeks – When Cheek Enhancement Goes a bit too far, a face gets out of balance. Filler fatigue ahead!

Too much cheek filler? Or in the wrong place? Your face may appear puffy and over-volumised in the cheek area, where proportion and balance really matter.

celebrity-filler-fatigue courteney-cox-dermal-fillers

Courteney is beautiful, with or without filler, as shown above in the photo from Elle and Pinterest.

But if the photo above is an accurate portrait of her enhancements per the article, then the balance and apex of the cheeks is not exactly right nor in proper proportion.  There are ratios to be honoured when it comes to injecting strategies and beauty, yet above all, the injector needs to consider the individual face that sits before her. And that means dynamic facial analysis as well as structure and anatomy and the patient’s concerns.

And re the photos shown in magazines, we can never be sure about photographs these days, as so many photo editing systems abound.

Beauty and Cheek Projection

High, defined cheekbones with nice curvature lines DO enhance the entire face, reducing eye bags and bringing attention to the eyes. But sadly, over-filling cheeks or lips – or injecting volume in the wrong places leads to to an unnatural apex or cheek/eyelid juncture.   This can results in the ‘filler fatigue’ type of puffy face or fish lips appearances that scare a lot of people off of fillers (unnecessarily as it’s likely up to 80% of fillers are done so subtly you can’t tell someone has had them done). Yet subtle volume improvements can take an average looking face or an uneven face and make it more attractive or symmetrical by slight adjustments of curvatures and shadows.

The overfilled look in the photo on the left, however, does indicate that her cheeks are a bit over volumised but at the same time, she has a different expression in the photo on the right, and her hair is covering more of her cheeks. 

Celebrity Filler Fatigue less is more with dermal filler Courtney Cox in Elle magazine photo from PINTEREST

Tips for Natural-Looking Filler Injections and avoiding filler fatigue

Less is definitely more when it comes to fillers. Minor filler injection can go a long way to getting a good result, but too much looks fake or distorted

What had her looking over-injected in the first place was, according to our blogging experts, likely the tendency that both injectors and patients have in falling prey to the ‘more is more’ philosophy rather than the ‘less is more’ promise. And “less is more” has never been more applicable to cosmetic treatments than to injectable cosmetics and related beauty strategies.

Whether she insisted on additional filler beyond where she looked good, or whether her injector simply used too much, the wrong type of filler or injected too often, is something our blogging team can only guess about.

But clearly, she does look better with less, only she probably would have looked great with just the right amount of filler.

How to get natural-looking lip or cheek enhancements with injections:


  • Start with choosing the BEST injector who takes a conservative approach
  • Longevity and quality results should be a priority over a ‘bargain’ – after all, this is medical cosmetic therapy and you’ll face your face in the mirror and in selfies every day
  • Choose an injector and clinic where sterilisation, on-brand injecting specs and other safety measures are a priority over cutting costs to offer discounts
  • You DO get what you pay for if you choose a good cosmetic injecting clinician and cheap injections are often at the expense of cutting corners at some process of the treatment procedure)
  • Ask questions to be sure your Injector knows their anatomy inside and out!

Natural Looking Cheek Filler Or Lip Augmentation Cosmetic Injection TIPS:

In addition to choosing your injector carefully:

  • Always insist on temporary fillers
  • Aim for a little bit of enhancement at a time until you and your injector feel you have the right enhancement
  • Ask to see the packaging of what you’re having injected and do your homework on the quality of the brand
  • Going back to a Cosmetic Clinic to adjust the volume of a feature, whether lips, cheeks or chin, is easier than going backwards with dilution approaches, which can sometimes be risky for some patients.

It’s far better to get an Injector who is focused on getting natural-looking filler enhancements – and to ask for photos to ascertain their work BEFORE you trust them with your injections.  And again, insist on looking at the package of what they are injecting you with to be sure it’s a great quality filler and not something you’ll have trouble with down the line.

At Coco Ruby Skin & Anti-Ageing, our Injectors all pride themselves on subtle enhancements that improve the appearance but avoid looking ‘overfilled’ or ‘over volumised.’ We also use only reputable, high-quality brand dermal fillers for injections, but with a range of products to suit the specific area to get a natural-looking, natural-feeling result.

natural looking filler injections and blepharoplasty surgery

Photos sometimes LIE (Lighting, Contrast, Resolution, Angles and Expressions will all take their toll in the outcome of a photograph AND in comparison photos).

IF These are real photos and not retouched, and IF these are sequential, then indeed, she does look better in the second photo on the right in the comparison photos.

But one must also see where the hair is resting on her face (covering more of her cheek area in the photo on the right) and one must know for a fact that the photo on the LEFT was not distorted by an edit or resizing in a photo editing program. And often, that cannot be ascertained.  Also, she’s smiling closed-mouth in one photo and open-mouthed in the other.  This is known as ‘dynamic facial changes’ relating to expressions, and it WILL impact your facial filler outcomes (and your facial filler outcomes WILL be impacted by your natural expression).

natural looking fillers lip filler cheek filler augmentation natural vs fake

The key message about Filler Fatigue and the trend of Celebrities to use too much at times?

Choosing a great cosmetic injector who will be conservative, balanced, and strategic, is imperative to get a good enhancement or wrinkle reduction solution.

Fortunately our Senior Injectors at Coco Ruby are ALL about getting patients a natural look. They have tips and techniques to provide strategic enhancements using dermal filler in the right amounts and right locations to get a lovely natural-looking result and improvement in your appearance.

They are careful to avoid the exaggerated look that so many people fall prey to when they insist on ‘more’ of a good thing.

Dermal Filler is BEST used minimally in just the right places, in just the right amounts for a natural-looking enhancement or feature correction.

And that includes the Cheeks and Lips, where over-filling mistakes are readily on display.

  • Individual results do vary, and fillers can only do so much – but less is more when it comes to dermal filler injections.
  • Go slowly and get a bit of filler in one to three places, then a bit more a few weeks later after the filler injection effects become more settled or visible than to demand a lot of enhancement in a single injecting session.
  • It requires some patience, but patience will pay off in giving you a better appearance with fewer risks of needing a revision or dissolution.

Don’t fall prey to wanting MORE MORE MORE when it comes to filler injections for your lips or cheeks.

  • Have you been the victim of wanting TOO MUCH filler (or to an injector who has over-done your dermal fillers (lips or cheeks)?
  • Do you want an honest opinion about your best corrective approach or filler options?
  • Your Injector’s skill and dermal filler injecting strategy for lips and cheeks can make the world of difference for your results, which ideally take into account your full anatomy AND expressions.

If you’re considering filler injections and want a PRO injector with decades of experience, someone who you can trust to get a natural-looking outcome – schedule a no-obligation cosmetic injecting consultation with the Coco Ruby Team.

Just send in an enquiry form today or phone us on (03) 8849 1400.  And remember, a little bit of filler goes a long way – and less is more with filler injections.  

Facial Rejuvenation Guide Download

NEXT STEPS to fight Filler Fatigue

Our Melbourne Cosmetic Injectors are highly regarded for:

  • Over 15 to 20 years each of experience in cosmetic injections
  • Quality Brand Temporary Injectables Solutions approved for use in Australia
  • Advanced Aesthetic Injecting Training
  • In depth understandings of Facial Anatomy for Best Results
  • Quality Treatment Plans
  • Strategic Injectables placement
  • Minimising any potential discomfort during treatment
  • Aligned with Melbourne’s top Plastic Surgeons

Our Senior Injectors have from 10 to 20 years of cosmetic injectables experience.

All of our Injectors are renowned for quality work – and for not being over-zealous.

This ensures you get natural-looking feature enhancements & wrinkle reductions using injectables that can help rejuvenate your entire facial appearance – plus long-lasting results that won’t look ‘overdone.’

There’s nothing worse in the cosmetic injectables arena than seeing someone who’s been the patient of an over-zealous injector or an inexperienced injector (and there are DANGER ZONES for injectables you’ll want to know about also).

Our highly experienced Injecting Team is also supported by working in the same Hawthorn Clinic as Melbourne’s leading Plastic Surgeons who help plastic surgery patients at Coco Ruby Plastic Surgery.


Give us a call on (03) 8849 1400 or send an enquiry today and get started on a Quality Injectables Treatment Plan with a senior Clinician.


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