A 65-year-old female patient presented with deep facial rhytides, particularly in the periocular and perioral regions. She asked:
- "My friends had Botox and hyaluronic acid fillers, and they look worse than before. Why do so many patients look fake after injections, with unnaturally large lips?"*
This is a valid concern, and it deserves a clear answer.
The Causes of an Artificial Appearance
The problem is not the Botox or the fillers themselves. The problem is multifactorial:
- The way these products are used.
- The quality and type of the materials used.
- The patient's aesthetic expectations.
- The aesthetic concept and experience of the injector.
We must also consider that beauty standards differ between countries and societies. What is considered beautiful in one culture is not always considered beautiful in another.
Beyond this, every patient has their own concept of beauty, and every doctor has their own aesthetic eye. This lack of standardization can create confusion. The reality is that every face has different features, different concerns and a different anatomy, which we must address individually.
Aesthetic medicine is meant to enhance, not to change how a person looks.
The Importance of Choosing the Right Material for the Right Area
Not all fillers are the same, and not all fillers are meant for the same area of the face. Fillers designed to be injected deeply into the cheeks, for example, should not be injected into the lips. Using the wrong filler in the wrong area can lead to an unnatural appearance and poor results.
The Importance of Discussion
If a patient wants very large lips, a sharply defined jawline, high and prominent cheeks or a very strong chin, we must discuss this openly. We must guide the patient towards the most harmonious and natural-looking enhancement for their face, without influence from friends, social media or filters.
When the same aesthetic standard and the same injection technique are applied to every face, the result is an artificial appearance.
The Role of the Injector
The injector must be properly trained in:
- Facial anatomy
- The ageing process
- Muscle dynamics
This allows the injector to determine where to inject, which product to use and how much of it.
When Injections Alone Are Not Enough
Sometimes the desired result cannot be achieved with injections alone. We may need to address the quality of the skin, or the patient may need aesthetic or plastic surgery, such as a facelift, neck lift or eyelid surgery. When patients are not aware of this, they may choose the wrong procedure together with their doctor.
In the end, the result depends on both the patient and the injector.
Conclusion
Botox and fillers are not the problem. The problem is how they are used, for what purpose, by whom and with which materials. The best results come from a doctor and a patient who communicate openly, respect the patient's natural features and choose the right treatment, rather than copying one standard of beauty onto every face.
- This article is for informational purposes only and does not replace a personal consultation with a dermatologist. Every patient's face is unique, and treatment plans must be individualized.*