While cosmetic skin fillers have the potential to give you a big bang for the buck in a positive way; if not done properly they can also give you a bang for the buck in a negative way—an explosion, if you will. Bad cosmetic skin fillers decisions are not uncommon.

The most common filler nightmare causing an unattractive look are either bad lip injections, or too much filler in and around the mouth and smile lines ignoring the cheeks, and temples. Or both. This leads to the dreaded “trout pout” or a “horsey” look. That is why your doctor needs to do an comprehensive filler evaluation and give you a plan.

In some parts of the country—I’m looking at you SoCal in general and Hollywood in particular—this look is more prominent, and sometimes even desired by patients who are used to seeing other women with similar filler distribution. As we discussed previously, these are women who are often very thin and have lost a lot of facial fat. Filling the central lower face only causes an abnormally large lower face, and lacks the youthful upper cheek fullness. Many times, if the physician tries to discuss cheek and temple filling, the patient thinks it will make her look fat, and resists.

And then there are the disasters. I see these images of cosmetic skin filler disasters and wonder what they were thinking. I bet you have seen them too. Interestingly, often these people think they look good because they are focusing on a particular problem, lip wrinkles for instance, and not looking at the whole picture.

Look at the whole picture.

Next: A word about lips