Let’s talk about “pillow face” — that puffy, unnatural look you sometimes see with fillers. We’ll cover what causes it, how to avoid it, and what you can do if it happens.
What is pillow face?
“Pillow face” or “pillow face syndrome” is when a person’s face appears unnaturally puffy and bloated after getting facial fillers.
What causes pillow face?
A bad case of pillow face is enough to scare anyone away from trying fillers. But the cause of pillow face isn’t the fillers themselves — it’s the way they’re injected. Overuse or improper placement of dermal fillers is what leads to this unnatural, swollen look.
Potential causes of pillow face include:
- Overfilling: If a practitioner injects too much filler, it can cause the face to look plump and swollen.
- Incorrect placement: Fillers injected too close to the surface or in the wrong areas can create a puffy appearance.
Inexperienced injectors: Underqualified or inexperienced injectors may not understand the proper techniques and placement of fillers. - Thin skin: People with thin skin are more likely to experience pillow face because the filler is more visible. However, thin skin shouldn’t be a huge issue if the injector knows what they’re doing.
- Filler choice: Using a filler that’s too thick or attracts too much water (hydrophilic) for a specific area can also contribute to puffiness. But, again, this is usually due to the injector’s lack of experience or understanding of facial anatomy.
How can I avoid pillow face?
Getting beautiful, natural-looking results from dermal fillers isn’t just luck. Success depends on thoughtful planning, realistic expectations, and the expertise of your injector.
Here’s what you can do to avoid pillow face:
- Choose an injector who’s experienced and qualified. Look for a qualified, board-certified physician (like a dermatologist or plastic surgeon) or a highly experienced, certified injector working directly under physician supervision. Ask about their experience with facial fillers, review their before-and-after portfolio, pay attention to natural-looking results, and check reviews or ask your friends, co-workers, and family members for referrals.
- Don’t skip the consultation. Use this appointment to communicate your goals and concerns. A skilled provider will, in turn, thoroughly assess your facial anatomy, discuss your medical history, explain their proposed treatment plan (including which filler, why, where it will be placed, and the amount), and set realistic expectations for the outcome.
- Start slow and build gradually. Starting with less filler typically yields more natural-looking results. You and your provider can then evaluate the initial results together and decide if adding a bit more in a follow-up session makes sense.
- Trust the process. A reputable provider will always have your safety and aesthetic harmony top-of-mind. They’ll give you candid feedback on your goals and explain why they might suggest a different approach or even advise against something if it isn’t genuinely suitable for your unique features.
Does pillow face ever go away?
Pillow face isn’t permanent. Though social media may have you wondering, the good news is that you aren’t stuck with it forever.
If you don’t like the results of your fillers, you have a few options:
Wait for your filler to dissolve naturally.
Your body naturally breaks down hyaluronic acid fillers over time — they aren’t permanent. This process typically takes six to 12 months, depending on the filler used, how much was injected, your individual metabolism, and where it was placed (fillers in high-movement areas like the lips often break down faster). If the overfilled look is relatively mild and you don’t want to deal with getting another procedure, you can choose to let the filler metabolize naturally.
Dissolve your filler with hyaluronidase.
If you need a quick fix or the overfilling is more pronounced, you can ask your provider to inject hyaluronidase, an enzyme that breaks down hyaluronic acid. It starts working within 24 to 48 hours, but it can take up to two weeks for any minor swelling to resolve and the final result to become fully visible.
However, it’s important to know that dissolving very large amounts of filler may result in temporary skin laxity or a slightly crepey appearance once the volume is gone.
Note: Keep in mind that hyaluronidase specifically targets hyaluronic acid-based fillers (like the Juvéderm or Restylane product lines). It will not work on fillers made from other materials, such as Calcium Hydroxylapatite (CaHA), PLLA, or PMMA.
Can you get more filler after dissolving it?
Yes, absolutely. Many patients choose to have filler treatments again after dissolving a previous result — this time focusing on achieving the balanced, natural look they originally wanted. It’s generally advised to wait at least two weeks after your hyaluronidase treatment before injecting new filler. This allows the enzyme to become inactive and lets the tissue fully settle.
The Bottom Line
While pillow face is a real concern, it mostly comes down to who’s doing the injecting and how they’re doing it, not the fillers themselves. That means doing your homework (i.e., choosing an experienced injector and planning carefully) is your best defense against it. And importantly, if results aren’t quite what you expected, remember this look isn’t permanent, and it’s often fixable.
Let’s create a filler plan that truly fits you.
At Younique Surgery Center & Medical Spa, Dr. Mark Youssef and our team work closely with you to understand your goals and expectations. We apply skilled injection methods focused on producing a balanced, subtle rejuvenation that honors your natural look. Your personalized consultation is the first step towards results tailored to your younique needs.
