The price of going back
Surgeons see upswing in people wanting to undo their cosmetic enhancements
Kylie Jenner’s lip fillers are over. Officially. Earlier this month, she told one of her 111 million Instagram followers: “I got rid of all my filler.”
The Keeping Up with the Kardashians star’s pillowy pout has been her signature since she first admitted to having injections in 2015, when she was just 17. Her enhanced look became a social media phenomenon and the key to the success of her lipfocused cosmetics company, estimated to be worth a staggering US$900 million, which has since triggered a tsunami of copycats. Jenner’s doctor, Simon Ourian, preened himself on the influence his work had on the star’s young followers, saying, “I saw a new trend of younger women who suddenly felt empowered to unapologetically want to look more beautiful.”
On the day of Jenner’s 2015 announcement, Leah Totton of Dr. Leah Clinics reported a “700 per cent rise in lip filler inquiries in 24 hours.” Jenner’s look was achieved with injections of fillers made of a labgrown version of hyaluronic acid, a gel naturally present in skin that holds up to 1,000 times its weight in water. The effects are temporary, lasting between three and 18 months.
However, according to lip specialist Rita Rakus, “the speed of the change in Jenner’s lips now means she has undoubtedly had her fillers dissolved,” which is done by injecting an enzyme called hyaluronidase directly into the lips. The number of patients wanting this kind of reversal has more than doubled in the past three years, says cosmetic doctor Tatiana Lapa, with most patients seeking a reduction in lip and puffy undereye fillers.
Indeed, Jenner is far from the only celebrity reversing her cosmetic procedures as fashions change to a more natural esthetic. Last year, actress Courteney Cox said she’d had all her facial fillers dissolved, while Victoria Beckham, who had her breast implants removed in 2014, wrote a letter to her younger self in Vogue with some sage words: “Don’t mess with your boobs.”
Yet the impression these A-listers give — that reversing unfashionable cosmetic treatments is as straightforward as taking a dress back to the shop — is far from the case, according to Charles Nduka, a consultant plastic, reconstructive and cosmetic surgeon. “Most body modifications are permanent,” he explains, adding that “you cannot ever completely undo an operation.”
Nduka says that “influenced by social media and celebrities, young people are making impulsive decisions they will come to regret. There are no quick fixes and reversing or revising treatments carries risks.”
“Not many clinics advertise that they will dissolve other people’s work, because it can be a risky procedure that requires specialist insurance,” adds Kay Greveson, a National Health Service nurse who also works at her own private clinic, while “a small number of people may suffer an allergic reaction to hyaluronidase, which can be severe and even anaphylactic” — symptoms may include itching, swelling, or even trouble breathing, which is why a pre-treatment allergy test is mandatory. Says Greveson, “Patients also need to be told that hyaluronidase may not dissolve all the filler evenly and may even temporarily dissolve some of their own natural hyaluronic acid.”
The risks do not end there, says Nduka, who warns that dermal fillers “can cause hard lumps called granulomasm,” which “form when the body sees filler as a foreign substance, so encapsulates it with scar tissue. This can make it very hard or impossible to dissolve the filler.” In addition, if patients have overdone procedures, the skin can become stretched and unable to go back to the way it was, which may require a more invasive surgery to fix.
But removing unwanted fillers is nothing compared to trying to overcome issues caused by bigger surgeries. Rhinoplasties (or nose jobs) are the most regretted of all cosmetic procedures. Surgeon Charles East, who specializes in complex revisions, says that even in the most expert hands, one in 10 patients will go on to have another procedure. East says the selfie craze is driving people to opt for surgery, but may also help explain why so many people are unhappy with the result and suffer “severe psychological damage. Selfies make your nose look 30 per cent larger than it really is,” he says.
The most common revision Nduka is tasked with are breast implants, with “nearly all” of those who walk through his doors “looking to downsize their formerly fashionable large implants, but they don’t always realize that stretched skin can lose its elasticity, so will sag around a smaller implant.