Dissolving filler isn’t just a trend—sometimes it’s the right decision.

Dissolving filler isn’t just a trend—sometimes it’s the right decision. In this episode of Cowboy & the Queen of Aesthetics, we discuss why more patients are choosing to dissolve, when it’s truly appropriate, and how to separate social media hype from sound medical judgment. Whether you’re considering dissolving your filler or simply want the facts, we’re breaking down the science, the risks, and the art of creating natural, balanced results.

Transcript

SPEAKER_01 0:05

Hello everyone, it's Melissa Giddens.

SPEAKER_00 0:08

This is Wyatt Irwin, a set of cowboy.

SPEAKER_01 0:11

And welcome back to another episode of Cowboy and the Queen of Aesthetics. Today we're going to be discussing something that's really going viral right now. And we're seeing it in our practice and we're seeing it all over the nation. And it is people wanting to dissolve their filler right now, more than ever before. And I guess the real question is why did we get here in the first place?

SPEAKER_00 0:33

You know, and then that, you know, that says a lot about where the the where the industry's at right now, you know.

SPEAKER_01 0:38

It really does, because filler didn't suddenly just stop working. Um, but it's the way that it's been used that's the problem.

SPEAKER_00 0:44

So today, y'all, what we're gonna do is we're breaking it down. Okay. Why people are dissolving and what really went wrong.

SPEAKER_01 0:51

And really what should have been done instead.

SPEAKER_00 0:54

So, miss, let's ask you real quick. So, what are you what are you seeing in your practice right now?

SPEAKER_01 0:59

So, you know, we are in a unique situation, Wyatt, but because we have ultrasound in our practice, and so we dissolve a lot of other people's bad filler or bad work, just because we're a referral source for Houston and Houston surrounding areas, which is is fine. And but I will say in general, more patients are coming in saying, I don't feel like I look like myself, I feel like I look puffy, I feel I feel like I look overdone, and I just kind of want to get it all gone and kind of start over.

SPEAKER_00 1:30

Yeah, and these people, you know, honestly, they they the people who had they had good intentions, you know.

SPEAKER_01 1:36

They did. I mean, no one really walks around talking about that they want to be overfilled. I think it just creeps up on us over time. And so then one day it's like, I don't recognize myself anymore. So, you know, people didn't change, but the results did. And so we're just sit seeing people want to get rid of it.

SPEAKER_00 1:56

So basically it sneaks up on them, right?

SPEAKER_01 1:58

It does. And then one day they just don't recognize themselves. It's like the people didn't change, but the results did.

SPEAKER_00 2:04

So let's be honest, though, you know, let's say it. Filler isn't the villain here.

SPEAKER_01 2:09

No, not at all. Filler has its place, and it's actually one of the best tools that we have, but it just has to be used correctly.

SPEAKER_00 2:17

So, I mean, what what really went wrong with everything?

SPEAKER_01 2:20

You know, I think that it's because we tried to use filler for absolutely everything.

SPEAKER_00 2:26

Yeah.

SPEAKER_01 2:27

And, you know, the place that we see most of the filler being dissolved is going to be in the under-eyes, which they should have never used filler there in the first place, because most patients are not candidates for filler per se there and lip migration, just being overfilled over time. And the product just tends to, it's either injected in the wrong spot or it's just there's too much in one area and it tends to migrate to another area. And so, you know, that's why I think that more attention is being paid now to biostimulators because we've overused HAs in a place that HA should have never been used to begin with. And so I think that's why, you know, biostimulators are where the market's headed. And I think that, you know, people are tired of looking overfilled. Like lines, fill it. Volume loss, fill it. Skin quality, fill it.

unknown 3:18

Yeah.

SPEAKER_00 3:18

So now instead of asking, you know, those things were just, you know, happening, you know.

SPEAKER_01 3:22

Right. It's like filler isn't the problem, but bad planning is. And we really need to pay more attention to, you know, skin quality and structure instead of just filling up lines and wrinkles.

SPEAKER_00 3:34

So, you know, let's do this. Let's go, um, let's go a little bit deeper into this. And, you know, like I said, just what specifically really went wrong?

SPEAKER_01 3:44

I think because we were more focused on treating the surface instead of the foundation. And it's like everyone got the same protocols. I think, you know, that's why we were using filler for too many things versus really addressing the the root of the problem, which in our practice we try to reserve filler for kind of the end of the relationship. In the beginning, we want to focus on skin quality and integrity first, because the prettier and the healthier the the canvas is, the less filler they're going to need long term.

SPEAKER_00 4:10

Yep. And that's what I was saying too, is like, you know, you know, everyone, you know, as far as the protocols and everything, but no two faces, you know, they they don't age at the same time.

SPEAKER_01 4:20

No, they're they don't age the same at all. And this is a big one. And this is where, you know, that volume stacking over time just went really wrong.

SPEAKER_00 4:29

Yep, a syringe here, and then another syringe there, you know.

SPEAKER_01 4:32

Exactly. And then five years later, it's just too much. So trends, I think, also are responsible for um this overfilled era. So trends just pushed bigger and more dramatic results.

SPEAKER_00 4:46

And I think you can agree with me on this too, too. I think patients thought that that was the main goal.

SPEAKER_01 4:53

Absolutely. For sure. More syringes became the solution for everything.

SPEAKER_00 4:57

So sometimes dissolves problems solved.

SPEAKER_01 5:01

No, and this is a problem. Isn't that right? Or no?

SPEAKER_00 5:03

Okay.

SPEAKER_01 5:03

No. I think you know, this is where we have to be honest, Wyatt, because dissolving filler removes filler, but it doesn't fix skin quality. It doesn't fix collagen loss, it doesn't improve laxity, it doesn't help with structural issues.

SPEAKER_00 5:18

And all that. So they're basically they're back at baseline.

SPEAKER_01 5:21

They are. And sometimes they're even worse because now we can see those underlying issues that maybe these fillers were masking. So you can dissolve filler, but you can't dissolve aging.

SPEAKER_00 5:32

So what so what's the right approach? What would be the right approach?

SPEAKER_01 5:35

I think strategy and not being reactive. I think strategic and not just a set appointment for one thing. And I think it's having a plan. I think an aesthetic plan is huge in being successful long-term for patient outcomes for sure. So start with structure. Let's look at the bone support, the deep fat compartments. Then we go, you know, to the muscles, and then we talk about the skin. So we want to stimulate collagen with our biostimulators like sculpture, radius, and regenerative therapies like PRP. And then we need to look at lasers, microneedling with radio frequency, resurfacing to improve the canvas. And then layer slowly over time, not all at once. You don't start with volume, you kind of earn volume.

SPEAKER_00 6:28

Stop that. Makes completely sense. So where are we now?

SPEAKER_01 6:31

I think we're moving into more of an intelligent era and out of the overfilled era. Less products, better placement, more regeneration.

SPEAKER_00 6:41

So it's not about doing more, it's about doing it better. The right way, you know. Cause like I think I agree with you too. There's just, you know, there's been so many folks been overfilled or doing this or doing that and stuff. But like you were saying, going more to those biostimulators. And once again, it's not about doing more, it's about doing it better, right?

SPEAKER_01 7:00

It is. And so that's exactly right. And so it just looks better because when you see someone and their facial volume looks like they're 25, but their skin integrity looks 60, it's very confusing and it's misput. And so you really should only do filler at the end of a journey with a patient. So you want their filler to look appropriate for their skin age, if you will, if that makes sense.

SPEAKER_00 7:25

It definitely does. So, like, you know, we're we're this is a question too. I might have too is where does filler, in your opinion, where does it still still shine at?

SPEAKER_01 7:35

Where does filler still shine? Why it still shines in the chin, the jawline, strategic mid-face support in the temples. You know, I use it conservatively in the lips, but I really reserve the under-eye area for biostimulators such as the PRP and just really supporting the skin and the tissue there more than just trying to fill it up.

SPEAKER_00 7:55

Yeah, so it's still it's still part of the plan. We're just not seeing as much.

SPEAKER_01 7:59

Absolutely. It's just not the whole plan, right?

SPEAKER_00 8:02

Right, exactly.

SPEAKER_01 8:03

And it's like filler didn't fail, but our strategy did fail.

SPEAKER_00 8:07

And I think too, is like once you understand that from a perspective of a patient practice perspective, you start making better decisions too.

SPEAKER_01 8:16

You do, because the goal was never, you know, more. It should have been just better. And I think that's where we we kind of screw up.

SPEAKER_00 8:26

No, I agree. And you know, and done right. And, you know, no one knows why, you know, you look so good.

SPEAKER_01 8:32

Um, no one should be able to tell what you've had done, right? And so sometimes patients walk out and they're like, oh, my husband didn't notice or my friend didn't notice. And like, that's the point. You don't want people to notice. You just want people to think, wow, that patient really radiates light. She looks like she's had a nice nap. Did she change her hair color? Or did she get a new makeup? Or, you know, did he go on vacation? You don't want people to be, you know, specifically point out, well, she had chin filler and cheek filler and jawline filler, because that's when we're we just look unnatural and it just doesn't fit.

SPEAKER_00 9:05

No, and and like, you know, I agree with you too, is like no one wants that. Once again, I think we are going away. We are definitely going away from that just full fake look, if you will. But, you know, from just kind of talking here today is like said, there's still there's still room for filler. We just want to make sure, like said, we're, you know, we're doing it the right way in the correct areas. And I guess once always goes back to what's right for the patient.

SPEAKER_01 9:29

You're exactly right. You nailed it. That's it. Strategy, strategy, strategy.

SPEAKER_00 9:34

All day long, all day long. Well, miss, do you have anything else you'd like to add here before we wrap up this podcast of Cowboy and Queen Aesthetics?

SPEAKER_01 9:42

No, I don't. I think that we did, I think, you know, that just educating patients on the difference in biostimulators versus fillers and making sure that patients understand that their skin integrity and quality is really where they should start, not just coming in wanting a face full of filler.

SPEAKER_00 9:56

Absolutely. And the difference for sure on that. So I love that.

SPEAKER_01 10:00

100%.

SPEAKER_00 10:01

Well, y'all, well, thank you all very much for this attending this episode of the Cowboy and the Queen of Aesthetics. Please let us know if y'all have any questions, DM us or anything. We're always here to take any questions. We'll talk to y'all soon. Have a blessed day.

SPEAKER_01 10:16

Thanks for joining us on the Cowboy and the Queen of Aesthetics.