The Great Dissolving

When TikTok creator Anna Paul decided to dissolve her lip filler 8 years after her first injection, she wasn’t after a new and improved look. The influencer just wanted her old face back. “I was looking in the mirror, and it wasn’t me looking back,” she says.

Paul, who posted the results to her 6.7 million followers on TikTok in October, says the response to her video was overwhelming. “The feedback from people has been positive, with most saying I look better with a more natural look,” says Paul. Not that she’s asking. “No matter what I do, I’ll have supporters and non-supporters giving me their opinions, but I signed up for that,” she says.

Living one’s life online means everyone has thoughts—whether you have two followers or 2 million. That's doubly true for plastic surgery transformations. Search for “cosmetic surgery” on TikTok, and you’ll find some of the most active comment sections online. Whether it’s a side-by-side medspa comparison or shooting-from-the-hip video commentary on which celebs have and have not had work done, the topic of plastic surgery is an endlessly fascinating (if a bit toxic) cornucopia of personal opinion. Apparently, everyone feels comfortable weighing in about your appearance if plastic surgery is involved.

That discourse, both good and bad, has created a feedback loop of aesthetic trends. Almost a decade ago, Kylie Jenner’s plump lips drove God knows how many people to make appointments with their local injector, creating a pouty, full look dubbed “Instagram Face.” A race to keep up with the Kardashians' surgical enhancements ensued—and everyone started to look the same. In the age of TikTok, however, cosmetic surgery trends are more so born from what people don’t want than what they do.

“I think there’s consistently a selective memory bias towards unattractive results, and that constantly drives people's requests,” says Renata Khelemsky, M.D., a double board-certified facial cosmetic surgeon, who operates out of New York and Florida. If “duck lips” and “handsome Squidward” mean nothing to you, just know that these are some of the less-than-complimentary descriptions online trolls have come up with to describe their version of less-than-ideal results. In an algorithmic world powered by controversy and emotion, treatment complications get boosted over perfectly adequate outcomes, and faceless strangers can dredge up insecurities with the tap of a thumb. So, it’s no wonder high-end clients are more skittish than ever—they don’t want to be called out, or worse, botched.

“Many patients have come to me over the last few years asking for me to dissolve fillers that they have gotten in the past,” says Marnie Nussbaum, M.D., a board-certified dermatologist specializing in non-invasive aesthetic rejuvenation and the founder of skin-care brand Lines. “They don’t feel themselves and actually perceive themselves looking older with this over-volumized face as opposed to younger. The word ‘caricature’ of themselves gets repeated over and over.”

In 2025, people are, indeed, going filler-free (or filler-light), but that’s just the tip of the syringe. A whole new set of beauty standards has emerged driven by TikTok discourse, the pivot to video, and the fear of being botched. And amidst this great dissolving, a distinct look has become the new ideal. Once you know what to look for, you’ll see it everywhere. Instagram Face is dead, so what’s next?

Migration Patterns

Doctors, injectors, and specialists agree: Clients are dissolving their filler. The more interesting question is why.

Some filler dissolvers, like Paul, have had a change of heart and decided to pursue a more natural look. Others claim their faces feel (or truly are) “overfilled,” says Dr. Khelemsky, likening the phenomenon to trying to get away with taking only a carry-on on a two-week vacation. “It's an overstuffed suitcase. You're trying to put another sweater into it, and there's one sweater popping out the back, and that's what happens with filler you're shoving in.”

This “stuffed suitcase” analogy illustrates a hot topic amongst many women who consider (or go through with) dissolving their filler: filler migration. Migration, which occurs when facial fillers like Juvederm and Restylane move beyond their intended facial area over time, can be caused by a variety of factors. Judesha Nuredini, a board-certified nurse practitioner who specializes in facial sculpting and lip fixes, cites individual anatomy, overfilling, injection technique, type of filler, and even daily habits as contributing factors.

Though there are some inadvisable migration self-diagnoses going around on social media, most people are just waking up to the idea that fixes and tweaks will give them the results they want—not more filler. “Filler just doesn’t dissolve,” says Charlotte, a 30-year-old New Yorker who’s in the midst of the process of reversing her injections. “Well, maybe it does for other people, but not in my world. It just migrates.”

Filler migration has become something of an online obsession recently. According to TikTok's Creator Insights tool, searches for “lip filler migration” in February were up 172 percent (although, compared to what time period, TikTok does not specify). No one besides a very few well-informed laypeople (and, of course, the pros), even knew it was a possibility—in fact, Google search interest was almost non-existent before 2022. “I feel like it was marketed to us as something to try out. And if you didn’t like it, the filler would naturally go away. But, like, what the fuck? That’s just not the case,” explains Charlotte.

"Many patients have come to me over the last few years asking for me to dissolve fillers that they have gotten in the past. They don’t feel themselves and actually perceive themselves looking older with this over-volumized face as opposed to younger. The word ‘caricature’ of themselves gets repeated over and over."

Peruse any social platform today and the algorithm will serve up plenty of filler discourse. You might might come across a viral podcast clip from Alix Earle, in which she discusses her decision to dissolve her lip fillers; an under-eye filler transformation thanks to improved injecting techniques (Dr. Khelemsky says practitioners are using ultrasounds to find old filler to dissolve); or even commentary speculating that Kylie Jenner may have had some of her cheek filler removed (most think she has).

However, there’s a lot of misinformation out there, and filler complications are far less common than your FYP would have you believe. “They're following a trend,” says Lisa Goodman, founder and CEO of GoodSkin, where she’s been extolling the benefits of a personalized approach to regenerative medicine and stem cells for years. “They are slightly misinformed that all filler is bad.” She has a point. When TikTok becomes the de facto source of information in a highly specialized—and to use an Internet term, “gatekept”—field like plastic surgery, the data is bound to skew anecdotal.

“The widespread discussion of lip filler migration on social media has provided valuable education but, unfortunately, has also spread misinformation,” explains Nuredini. “What I’ve noticed the most is users misidentifying natural lip anatomy as migration. I do think it’s essential to approach such discussions with sensitivity and avoid making unfounded claims.”

Perfectly Imperfect

How many people are actually dissolving their facial filler? That remains unclear. The American Society of Plastic Surgeons' 2023 ASPS Procedural Statistics Report, which is the most recent iteration of the annual missive, states that hyaluronic acid filler treatments actually increased by 8 percent over the previous year. If injectables are more popular than ever, what accounts for all those TikTok videos? One likely answer is the rise of the filler “re-do.”

“The expectations on filler rose in the post-COVID Boom,” says Dr. Khelemsky. “I saw a rise in patients coming in for filler redo. That obviously included, most likely, a session of reversal—but they weren't just reversing to back out.” Instead, she’s often tasked with dissolving, and then re-injecting clients who weren’t happy with their filler originally. “In other words, there was less tolerance for little lumps, little bumps, little contour irregularities,” she explains.

Filler redos are the norm, rather than the exception, when it comes to dissolving. “I have since been back to have my filler put back in, but in a much smaller amount,” explains Paul. “Unfortunately, the effects of having filler for eight years meant that my lips had stretched a fair bit (this is quite a common side effect), so rather than looking full and plump they were quite flat and thin. The goal of getting more filler was to make it look as natural as possible and for me to be happy when I looked in the mirror.”

This desire for a more “natural” and “subtle” look is a key theme in today’s quickly changing world of filler. These buzzwords are used by clients to describe their desired results, by practitioners to describe trends, and even by The American Society of Plastic Surgeons—across all areas of the industry, not just injectables.

"I get the exact opposite request these days: 'I want to look natural. And by natural, I mean, I'm okay with people not even realizing I've had filler done.'"

“I'm seeing an increased request of incremental sessions,” says Dr. Khelemsky, who cites this as more of a trust-building exercise than a necessity. Clients’ tastes have also done a 180 in recent years. “I get the exact opposite request [these days]: ‘I want to look natural. And by natural, I mean, I'm okay with people not even realizing I've had filler done.’” The beauty industry is essentially experiencing the same demands that launched the “stealth wealth” fashion movement. Instead of, say, a cutout Y2K dress or BBL, people are begging for a 100-percent cashmere sweater or “ballet body” enhancements, a top surgery trend marked by “balanced and subtle aesthetic improvements,” according to the 2023 ASPS Procedural Statistics Report.

Dana Omari, the plastic surgery and pop culture content creator behind the wildly popular @igfamousbydana watchdog account, has also worked as a registered dietitian in medical spas and plastic surgery for 10 years. As such, she views the filler dissolving trend as an indicator of a larger mood change. “Everything is getting smaller,” she says of high-end clients and treatment-friendly celebrities.

These first movers are focused on every angle of their face, rather than just a single feature. In fact, Dr. Khelemsky claims she never used to photograph the before and after of her clients’ side profile results—now, it’s all anyone asks for. Similarly, Dr. Nussbaum has noticed that overall, breast implants are shrinking (an observation corroborated by the 2023 Procedural Statistics Report). Even veneer requests are taking on subtlety, says Omari, as dentists increasingly leave a small gap here and a charming asymmetry there, in veneer patients. Blindingly arctic white chiclets are out, pearly off-white teeth are in.

We’re All Looking at Ourselves Too Much

“Women used to bring in photos that were usually in the spirit of ‘the bigger the better,’” says Dr. Nussbaum. “Today, women realize—as do many high profile individuals—that we need to stay true to our natural features and simply enhance with a gentle hand in order to feel and look our best.” These changing preferences for “natural” or, as many surgeons have dubbed it, “undetectable” results didn’t develop in a vacuum. They reflect the media we consume and the culture we live in.

If Instagram Face’s hyaluronic acid–filled plump lips and sculpted cheeks are built for taking selfies, today’s top procedures are meant to look good on video. “In the 2016 era, the Kardashians never smiled, right? They knew exactly what face to make, exactly how to angle their eyes, and they just made that face in every picture,” says Omari. “Now, when you're talking on Zoom, Reels, or TikTok, you can't do that.”

Everyone wants to look tighter, brighter, and wide awake on camera and, counterintuitively, the pivot to video has revived an unlikely cosmetic procedure: the facelift. “People are curious about facelift as an option,” says Dr. Khelemsky, especially younger than “when their mother had it.” Traditionally, the procedure is performed on patients in their 60s. Now, they’re increasingly popular among those in their 50s, 40s, even late-30s. “We theorize this is due to social media pressures and the constant forward-facing camera of zoom meetings in life post-Covid,” says Dr. Nussbaum.

"In the 2016 era, the Kardashians never smiled, right? They knew exactly what face to make, exactly how to angle their eyes, and they just made that face in every picture. Now, when you're talking on Zoom, Reels, or TikTok, you can't do that."

It’s true, we’re all looking at our own faces way more than at any other time in history. Between Zoom calls, Reels content, and FaceTime, you can’t escape the front-facing camera, which coincidentally exaggerates every sag, wrinkle, and asymmetrical quirk. Better surgical techniques for facelifts also mean less downtime post-procedure, allowing younger clients in the middle of their career to return more quickly to work.

What Comes After Instagram Face?

“We had this whole Instagram Face era,” says Omari. “And now people don't know what to call this. Is it Facelift Face?” The “Face” in question is an increasingly common amalgam of today’s top procedures. Wide eyes (thanks to a bleph), a taut v-shaped jawline (that’s where the lower face lift comes in), and “natural” plump lips (probably a filler redo) combine for a hard-to-put-your-finger-on post-treatment look. It’s a visage that passes the comment section sniff test and looks great on video. These new, impossible-to-detect tweaks evoke “she looks incredible” comments rather than “duck lips” trolls—and more of these new-and-improved features are rolling out by the minute.

“It’s the Devil Wears Prada Cerulean speech,” explains Omari. “People were really, really afraid of face lifts. And then they find out, oh Lindsay Lohan probably had a face lift, and she had it at 38—then they think, Maybe this is something I should look into. We see it on celebrities. And then it ends up being something we consider.”

It's worth noting that today's new trends are not the be-all, end-all of plastic surgery. "What clients don't understand is that the [early facelift] surgery is not a one time fix," says Dr. Khelemsky. Goodman agrees, noting that many surgical and injectable results only last seven to 10 years. "People wanted shortcuts. Don't take shortcuts if you don't want to have things to fix all the time, because I fix a lot of things, and it's always the same story," she says, citing her practice's "bone, muscle, skin, fat, and fascia" approach as a helpful model to get to the root of individual issues.

Much like how an Oscar de la Renta cerulean gown eventually becomes a lumpy blue sweater, the tweaks, nips, and tucks done on famous faces in L.A. will inevitably find their way into doctor’s offices and medspas across the country. Instagram Face may be dead, but there’s a new set of beauty treatments on the make. Only time will tell how long they can outrun the For Your Page and stay undetectable.

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