MonthMarch 2015

Knowing When To Stop

At one facial aesthetics course I attended, the instructor said something interesting: “Patients won’t notice/remember what you’ve done. They only notice what you have not done.”

It didn’t seem very believable to me back then, but it turned out to be so true. The good thing about fixing teeth is that when one tooth is fixed, anything that is not fixed would be another tooth. For the face, it can be trickier. After you thought you have evened out patient’s wrinkle, she comes to you a week later and complains that the effect is gone. Of course it isn’t. What happened is that the patient forgets about what she looked like before the treatment and when she keeps looking at her face after the treatment and getting used to the new normal, she only sees what else needs to be done. The wrinkle is still visible. Can inject a bit more? What about my eyes? What about my cheek? A bit more for the cheek. I never knew I had such a small chin …

This mentality is not unique to women. While self-injecting on my own face, I was struck by the same thoughts and that’s when I began to understand these patients better. The treatment is “addictive”. For me, there is no “labour cost” when I self-inject fillers. I only need to pay for the filler and I can inject as much into my face as I wish. I can imagine that if I had no training or self control, I would almost definitely have ended up overdoing it.

It’s impossible for 1cc of filler to cause this. I believe it’s a case of DIY lip filler injection. While it’s easy to cringe and say WTF, the person who is doing it on herself really had no idea that she had gone from augmentation to deformation. I believe that fillers are readily available OTC in some countries. No wonder there are so many disasters out there.


Dental Phobia by Chan Joon Yee

What Happened To That Lump?

Tear Trough Injection

Depending on the depth of the filler injection, the deposit is usually palpable. It tells you the filler is there and it feels like a firm lump. Then, a few days later, the lump gradually softens until it disappears. Has the filler disintegrated? Well, before treatment pictures do not always tell you the answers. If the part that was filled is under the eyes, you can do a spectacle test. For instance, if you have a hollow under your eyes before treatment, you may feel that your cheeks can touch the lower rim of your glasses after the injection. You’ll feel that the cheeks will still touch the lower rim of your glasses after the “lump” is “gone”.

Well, it’s actually not gone. Hyaluronic acid (HA) fillers are actually hygroscopic. This means that they absorb water from your tissues. Like sponges, HA filler deposits will absorb water from your body. Like sponges, they will not swell much, but they will soften and give you the impression that it’s not there anymore.


Dental Phobia by Chan Joon Yee

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