High time to take the fillers out?
Surgeons are seeing an upswing in people wanting to undo their cosmetic procedures, with Kylie Jenner the latest A-lister to ditch the fillers. Leah Hardy investigates the risks and repercussions
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.” This may not sound like headline news, but 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 lip-focused cosmetics company, estimated to be worth a staggering $900million (£685million), 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, Dr Leah Totton of Dr Leah Clinics reported a “700per cent rise in lip filler enquiries 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 London lip specialist Dr 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 Harley Street 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 aesthetic. 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, consultant plastic, reconstructive and cosmetic surgeon at the Queen Victoria Hospital in East Grinstead. “Most body modifications are permanent,” he explains, adding that “you cannot ever completely undo an operation.” Nduka, who runs the not-for-profit website safercosmeticsurgery.co.uk, 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.”
Kay Greveson is a nurse who works both in the NHS and at her own private clinic, Regents Park Aesthetics. “I’m seeing an upward spike in people who want their fillers dissolved,” she says. “Sometimes it’s because their lips are bigger than they’d like, but others might have complications,
‘Most modifications are permanent. You cannot completely undo an operation’
such as lumpy or asymmetrical lips. Not many clinics advertise that they will dissolve other people’s work, because it can be a risky procedure that requires specialist insurance,” she explains, 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. “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 granulomas”, 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 specialises in complex revisions and is responsible for restoring Mike Tindall’s nose, says that even in the most expert hands, one in 10 patients will go on to have another procedure.
Even Jennifer Aniston, who you would think has access to the best medical care, has had her nose worked on twice: first, to straighten a deviated septum, then a second procedure in 2007 to correct surgery “incorrectly done over 12 years ago”, her representatives said.
East says that rhinoplasties where noses have been made too small, or performed so badly that the cartilage has collapsed, are the most difficult to revise, requiring cartilage from the ear or rib to rebuild – an operation that takes four hours, and costs upwards of £9,000.
“If there is a lot of scar tissue from previous operations,” he adds, “the graft may not be able to get access to blood vessels and will die.”
Revisions can also cause infections, leave scars and result in skin that fails to fit the new nose, or
is damaged, goes black and falls off. 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. “You need to have your photograph taken from at least 1.5 metres away to see your nose accurately in pictures.”
East says he’s rescued patients who have had six or seven prior operations, but believes that “surgery is like marriage. The more times you try, the less chance there is of success.”
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 realise that stretched skin can lose its elasticity, so will sag around a smaller implant. They will need to have skin removed, which leaves ‘anchor’ scars around the bottom crease of the breast, and up to and around the nipple.”
And body modifications aren’t limited to those of the pumping up kind: tattoos are regretted by one in four, a recent poll found. “I see young people who have been influenced by stars like Cheryl Cole,” says Nduka. “They think, ‘I’ll get them all lasered off if I change my mind,’ but in many cases, even after expensive and painful laser sessions, they are left with ugly, permanent smudges.” Nduka recently performed surgery on a young woman who hated a huge illustration on her back: “Laser didn’t work so I had to cut out the tattoo. It left her with a foot-long scar, but she still preferred it.” So, a word of warning: think of yourself in 30 years’ time. Will you still want that cup size, or etching? If not, avoiding that needle or knife is a decision you really won’t regret.
‘Selfies make your nose look 30pc larger than it is’