Understanding deep facial pads and filler capacity with Vancouver Island’s cosmetic injector, Dr. Heather Iverson, ND.
If you’ve ever said that “filler looks fake” this article is for you. Filler can be undetectable and if it isn’t, the culprit is usually simple—every fat pad in your face has a limited capacity; inject beyond the natural limit and your filler begins to look unnatural. Here’s the science-backed roadmap I use to keep the results of my Vancouver Island and Langley patients looking naturally refreshed—not overfilled.
What exactly is filler face?
Filler face or pillow face describes the unnatural, over-inflated appearance caused by injecting more hyaluronic-acid filler than your tissues can safely hold. Excess volume blurs natural contours, often lowers the mid-cheek,and can even stretch the skin long-term. Studies show a sharp rise in dissolving dermal filler—not because patients regret treating volume loss, but because their fillers have migrated, feel heavy and/or have become unnatural looking due to excess volume.
Related Reading: Profile Balancing with Dermal Filler
So, how much filler will I need?
This is a complicated question to answer. Let’s take your midface for example—your cheeks aren’t one big balloon, but are a 3D puzzle of superficial and deep fat pads arranged like stacked orange wedges. As we age, the deep pads deflate first, allowing the superficial ones to slide downward under gravity. That downward shift is why the nasolabial fold deepens and the under-eye hollows appear. Injecting deep—right on bone—restores the internal scaffolding and lets smaller, more superficial tweaks finish the job.
| Deep Fat Pad | Approx. Native Volume (mL) | Estimated Safe Filler Capacity (mL) |
| Sub-Orbicularis Oculi Fat (SOOF) | 1.5 | 0.5 – 1.0 |
| Deep Medial Cheek Fat (DMCF) | 4.0 | 0.5 – 2.0 |
| Buccal Fat Pad (BFP) | 10.0 | Not typically filled |
| Deep Lateral Cheek Fat | 2.5 | 0.5 – 2.0 |
| Pre-maxillary Fat Pad | 1.0 | 0.3 – 0.5 |
| Temporalis Fat Pad | 2.0 | 0.5 – 1.5 |
| Infra-orbital Fat Pad | 1.0 | 0.2 – 0.5 |
Think of each pad as a tiny water balloon. Over-fill it and two things happen: 1) the balloon bulges, altering facial landmarks; and 2) the gel may migrate into nearby tissue planes. Conservative dosing—often 0.2 – 0.3 mL per bolus—is enough to make a visible difference without distorting shape.
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More (at once) isn’t better. Building slowly is the protocol.
When filler volume exceeds tissue capacity, collagen fibers stretch like an over-worn sweater. That can soften ligamentous support, allowing filler to drift downward or sideways. Overfilling also increases risk of vascular compression, swelling, and the dreaded doughy texture that looks smooth in a photo, but unnatural in motion.
As your cosmetic injector, I’ll never chase a one-visit “wow” transformation. Instead, I:
Say no. Cosmetic injections are not the end all and be all, I’ll be the first to admit they have limitations. If there’s a better treatment for your goals, I’ll tell you—even if it means referring you to someone else. Sometimes, skin surfacing treatments like IPL or microneedling are the better option for addressing your specific concern—or should be considered in combination with injectables.
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Dose conservatively. It is easier to add more filler than to dissolve (but don’t worry dissolving isn’t a big deal either and we will talk about that in a second). I prefer to begin a patient’s treatment plan with minimal product and build slowly from there. Follow-up appointments allow us to reassess (4-6 weeks after your visit), when swelling subsides and we can see your true results. Trust the process—the best results take a bit of time.
Keep hyaluronidase handy. Every provider must keep hyaluronidase (the enzyme used for dissolving filler) on hand any time they are injecting filler. While we’ll aim not to use it unless necessary, dissolving unwanted filler is not as big of a deal as you may think. If old product migrates, features have become disproportionate or new filler feels heavy, dissolving is quick and effective—peace-of-mind for us both.
Related Reading: Filler Migration: Why It Happens & What To Do
Dermal Filler in Parksville, BC
Dermal Filler in Courtenay, BC
Looking for dermal filler in Nanaimo, Parksville, Courtenay or Langley, BC? You likely have questions and I likely have answers. If you don’t see the answer you’re looking for below, I am one email away: info@drheatheriverson.com.
What if I exceed the safe volume?
We can dissolve unwanted filler with hyaluronidase. Most corrections will require a couple of treatments. Once dissolved, we can usually re-treat the area conservatively after six weeks. Trust me, it’s better to dissolve and correct than to ignore and add more.
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Do men need more filler than women?
Yes—men often have larger deep medial cheek pads, so upper limits may edge 0.2–0.3 mL higher, but placement matters more than volume.
How much should dermal filler cost in BC?
Dermal filler injections typically cost between $600–$750 per syringe on Vancouver Island. I pride myself on providing my patients transparent pricing and individualized treatment options. While you should never make decisions regarding cosmetic injections based on pricing, I am happy to work with you to determine what is possible—and still respect the integrity of the facial anatomy—within your current budget.
Respecting Your Face’s Architecture: Built-In Safety Limits
Dermal filler is a precision tool, not a magic putty. Your skin, ligaments, and facial muscles all have biological “guardrails” that cap how much product—and how much weight—they can carry before collagen fibers overstretch and tiny retaining ligaments start to lose grip. Once those support beams are fatigued, no amount of extra gel will lift them back into place; in fact, piling on more may push filler sideways or downward, exaggerating jowls and under-eye puffiness.
Bottom line: we stop where biology tells us to stop. By honouring these limits, scheduling intentional follow-ups, and keeping dissolving enzyme close at hand (this is required of any provider by the way!), we preserve the integrity of every layer today—which protects your results, and your confidence, for years to come. Again, cosmetic injections have limitations. And if I don’t think any of the injections that I offer will deliver the results you’re after, I’ll refer you to someone who can help with the right treatment.
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Dermal Filler with Dr. Heather Iverson, ND
By respecting each fat pad’s natural fill capacity and layering treatments gradually, we can prevent tissue stretch and reduce the risk of filler migration. I have spent extensive time refining my skills as a cosmetic injector with additional courses and advanced cadaver-labs, to ensure I provide my patients precise injections (and dissolving) that respect the integrity of your natural facial anatomy.
If you’re ready for undetectable injections, book your personalized consultation at one of my four locations: Nanaimo, Parksville, Courtenay, or Langley.
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