Afraid of filler? Let’s talk about it. Dr. Heather Iverson, Naturopathic Doctor and injector in Nanaimo, Parksville, Langley and Comox Valley, explains why dermal fillers have a bad rep and what fears are justified.
Dermal fillers have been in the spotlight in a negative way lately. Social media posts circulate photos of “pillow face” or videos warning that fillers will “ruin your face.” In reality, much of the negativity stems from misunderstandings, unrealistic expectations or unqualified injectors. As a Naturopathic Doctor and cosmetic injector serving patients in Nanaimo, Parksville, Langley and the Comox Valley (Courtenay), I want to address these concerns head‑on, provide clarity about risks and benefits and share why a natural, conservative approach remains at the heart of my practice.
What exactly are dermal fillers?
Dermal fillers are soft, gel‑like substances injected under the skin to replenish lost volume, smooth lines and enhance contours. Our faces consist of skin, fat, muscle and bone. With age, all four layers change — bone recedes, muscle thins and fat descends. The result is hollowing around the eyes, flattening of the cheeks and deepening folds. Dermal fillers compensate for this volume loss by filling specific areas and creating a smoother, more youthful silhouette.
Most fillers are composed of hyaluronic acid (HA), a substance naturally found in your skin that attracts water and retains hydration. HA fillers are popular because they look natural, can be tailored to different facial regions and, importantly, can be dissolved with hyaluronidase if the result is unsatisfactory. Other filler families include calcium hydroxylapatite (a mineral similar to bone), poly‑L‑lactic acid (PLLA) and polymethyl methacrylate (PMMA). Each has unique density, longevity and ideal uses.
Why we lose volume
Collagen and fat naturally diminish starting in our 30s. Collagen, which gives skin its elasticity, declines about 1 % per year after 20; by 50, we’ve lost roughly 30 % of our facial collagen. Reduced collagen results in laxity, sagging and the “deflated” look many patients describe. Lifestyle factors such as sun exposure, smoking and stress accelerate the process. Hyaluronic‑acid fillers are the only non‑surgical option that directly replace this volume — skincare, creams or lasers cannot “plump” hollow temples or cheeks the way a filler can.
Related Reading: The Truth About Collagen: Benefits, Supplements, Injections
So, do dermal fillers ruin your face?
Understanding the recent negative chatter surrounding dermal fillers
In my practice, I’ve noticed that the loudest concerns come from overfilling, migration, bruising and worries about long-term side effects. Let me break down each one:
Overfilled “pillow face”
One of the main complaints circulating online is the so‑called pillow face — an overly round, swollen appearance from excessive filler. This happens when injectors attempt to treat every fold or line rather than focusing on key structural points. Overfilling disrupts natural proportions and leads to a puffy, unnatural look. Experienced practitioners avoid this by using conservative volumes and understanding facial anatomy. Overfilling can lead to thickened skin and distorted contours. This is why I take a “less is more” approach, often favouring staged treatments and building gradually over multiple sessions.
Related Reading: How to (properly) build your lip filler
Filler migration
Another concern is filler migration — when product moves away from the injection site and collects in an unintended area. Migration typically results from superficial placement, using an inappropriate filler type or overfilling areas. Because facial ligaments create separate compartments beneath the skin, each zone can safely support only a limited amount of volume. Respecting these boundaries is critical to avoid product migration and maintain the face’s structural integrity.
Certain areas, such as around the eyes and mouth, also carry a higher risk of migration due to their sphincter-like muscles. The constant movement in these regions can push filler beyond where it was placed, which is why they require softer products, alternative treatment approaches, or in some cases, may be best avoided altogether.
Adequate training and technique reduce this risk substantially. Migration is more likely if someone massages the area aggressively post‑treatment or receives fillers from an unqualified provider. In our clinic we choose products with the right viscosity and instruct patients on gentle aftercare to minimize movement.
Related Reading: Filler migration: why It happens & what to do when it does
Long‑term side‑effects
Long‑term risks such as lumps, granulomas and changes to facial structure are rare but can occur if fillers are misused or if the wrong product is selected for a given area. According to the American Society of Plastic Surgeons (ASPS), severe complications are uncommon, but potential issues include lumps, infections, asymmetry or, in very rare cases, vascular occlusion leading to skin loss or blindness. The Cleveland Clinic notes that most side‑effects are temporary and include swelling, redness and bruising; serious complications such as infection or necrosis are rare. I don’t note this to scare you, but to reaffirm that some caution is justified when it comes to dermal fillers. Choosing a qualified injector drastically reduces these risks.
Long‑term side‑effects
Long‑term risks such as lumps, granulomas and changes to facial structure are rare but can occur if fillers are misused or if the wrong product is selected for a given area. According to the American Society of Plastic Surgeons (ASPS), severe complications are uncommon, but potential issues include lumps, infections, asymmetry or, in very rare cases, vascular occlusion leading to skin loss or blindness. The Cleveland Clinic notes that most side‑effects are temporary and include swelling, redness and bruising; serious complications such as infection or necrosis are rare. I don’t note this to scare you, but to reaffirm that some caution is justified when it comes to dermal fillers. Choosing a qualified injector drastically reduces these risks.
Black market injections?
One of the most dangerous trends is purchasing fillers online and self‑injecting. Reports highlight fillers containing non‑sterile substances like hair gel, leading to allergic reactions, infections and even skin death. Never to buy dermal fillers on the internet because they may be fake, contaminated or harmful. Always obtain fillers from a trained medical professional in a regulated clinic.
In Canada, fillers are highly regulated as are the providers who inject them. Along with choosing a reputable cosmetic injector in BC, you should also inquire about what type of dermal filler they use.
Not all fillers are the same—the brand you choose truly matters. I trust Revanesse® above all because it’s Canadian-made, backed by world-class manufacturing since 2002, and designed with different formulas for different treatment areas. It’s smooth, precise, and integrates naturally into the skin. After years of using it, I’ve seen consistently happy patients, with safe, reliable results that look natural and last. For the delicate undereye area, I also trust Redensity II by Teoxane. It’s formulated specifically for tear troughs, giving a rested, refreshed look without bumps or discoloration.
Each injector will have specific filler brands they trust and feel most comfortable using. While all Health Canada–approved fillers are considered safe and effective, they can differ slightly in their manufacturing processes, texture, and how they integrate with tissue. Choosing a provider who deeply understands their preferred products—and how they perform in different areas of the face—is just as important as the injection technique itself.
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The benefits of fillers—and why nothing else does quite the same
Despite the negative headlines, dermal fillers remain one of the most popular cosmetic treatments worldwide. In 2023 the ASPS reported 3.44 million dermal filler procedures, up 4 % from 2022, and 4.71 million botulinum toxin treatments. Their popularity is driven by several unique advantages:
- Efficient results: Immediate results with minimal downtime.
- Versatility: Fillers can enhance cheeks, smooth nasolabial folds, define jawlines, restore temple volume, plump lips and even rejuvenate hands. HA fillers come in different consistencies; firmer formulations lift deep structures, while softer gels smooth superficial lines.
- Reversibility: HA fillers can be dissolved with hyaluronidase, giving patients peace of mind.
- Longevity: Depending on the product, location and individual metabolism, results last between six months to two years. Recent MRI studies show that cross‑linked hyaluronic acid fillers can persist beneath the surface much longer; a 2024 review detected residual HA in patients up to 8‑15 years after treatment, and another case report noted filler still present 2 and a half years post‑injection. Some long‑term follow‑ups even report longevity of up to 12 years in specific facial compartments. While the visible plumping effect fades over time, traces of filler integrated into deeper tissue can continue to attract water and hydrate the area.
- Subtle, natural results designed to address specific concerns.
Facing filler fears
It’s healthy to approach any medical procedure with caution. Below are common questions my patients ask and how I answer them:
| Concern | Clarification |
| “Fillers look fake.” | Overfilled faces often seen online are usually the result of large volumes, low‑quality product or inexperienced injectors. Using conservative amounts, respecting facial proportions and spacing treatments prevents this.
Related Reading: How much filler will I need? |
| “Fillers are dangerous.” | Severe complications are rare and are minimised by using sterile product, proper technique and choosing a licensed medical professional. We perform thorough consultations, review your medical history and can use ultrasound‑guided injections when appropriate. |
| “I’m afraid of lumps or long‑term issues.” | Lumps or granulomas most often occur when non‑HA fillers are placed superficially or by untrained injectors. HA fillers can be dissolved if a lump appears. I select products based on anatomical layer and use small amounts to reduce risk. Related Reading: Are bumps and lumps normal after lip fillers? |
| “How long do fillers last?” | HA fillers last 6–24 months depending on area and products, while biostimulators like Sculptra can last 2 years or more. Longer‑lasting products mean fewer appointments and sustained benefits. |
| “Will I need fillers forever?” | Stopping filler treatments simply returns you to your baseline appearance rather than making your face worse. |
How choosing the right BC cosmetic injector calms filler fears
My goal is to enhance your natural features, not change who you are. As a Naturopathic Doctor, I value balance and the body’s innate healing mechanisms. Here’s how that philosophy translates into injectable treatments:
1. Comprehensive consultation: We begin with a detailed discussion about your concerns, medical history and goals. I examine your facial structure, skin quality and expressions to identify where volume has been lost.
2. Conservative dosing: It’s easier to add more later than to undo too much. I often start with half syringes and schedule follow‑ups rather than injecting multiple syringes at once.
Related Reading: Lip Filler: Should I get a half or full syringe?
3. Layered approach: Strategic placement of filler deep near the bone re‑creates youthful support and avoids heaviness. For fine lines or subtler areas, I use softer products. For overall harmony, I sometimes combine HA fillers with Sculptra®, mesotherapy and/or neuromodulators. It’s important to me that my patients understand the limitations of cosmetic injections and take a holistic approach to aging. This is why I offer longevity supplements and share my personal approach to healthy aging.
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4. Ongoing education and safety: I regularly update my skills through advanced training in facial anatomy and injection techniques. By combining evidence‑based coursework with hands‑on cadaver lab sessions, I ensure that my practice reflects the latest research and best practices. Certification and anatomy knowledge are non‑negotiable. Check out my credentials here.
5. Individualised treatment plans: Every face is different. I address structural changes, skin quality and lifestyle factors to create a bespoke plan.
Related Reading: Why I’m Okay With Botox & Filler As A Naturopathic Doctor
The bottom line: informed decisions lead to beautiful results
Filler treatments are not “one size fits all.” They can restore lost volume and refresh your appearance when used judiciously. The recent surge of negative posts has raised awareness about the importance of qualified injectors, but it has also created unnecessary fear. By understanding how fillers work, knowing the differences between HA volumizers and biostimulatory products like Sculptra and selecting a clinician who values natural harmony, you can achieve subtle, long‑lasting improvements.
If you’re considering natural dermal fillers in BC or are searching for a trusted cosmetic injector in Nanaimo, Parksville, Langley and the Comox Valley (Courtenay), I invite you to schedule a consultation. We’ll discuss your concerns, review options and craft a personalised plan that aligns with your unique facial structure and aesthetic goals.
Dermal fillers in Nanaimo, Parksville, Langley & the Comox Valley (Courtenay)
Fillers don’t have to look “fake.” In fact, the best filler work is usually invisible. It’s the kind of result where people notice you look great, but can’t put their finger on what has changed. If you’d like to explore whether fillers are right for you, I’d love to meet you. Here’s where you can find me:
- Cosmetic Injections in Nanaimo – Xposé Salon and Lounge
- Cosmetic Injections in Parksville – Parksville Wellness Collective
- Cosmetic Injections in Langley – Self Love Beauty Lounge
- Cosmetic Injections in Courtenay – Clinic 5 Collective
Remember: knowledge is power. By dispelling myths and understanding the facts, you can make informed decisions and feel confident about embracing your natural beauty.
Filler Fears Frequently Asked Questions
What are dermal fillers?
Fillers gently replace that lost support. They can:
- Restore cheeks and temples
- Smooth nasolabial folds and marionette lines
- Define the jawline or chin
- Refresh tired under-eyes
- Add hydration and shape to lips
No skincare product, laser, or neuromodulator (like Botox®) can replace volume the way dermal fillers can. That’s their unique role.
Do dermal fillers hurt?
This is one of the most common fears I hear, and one of the easiest to clear up.
With numbing cream and fine-tuned technique, most patients describe fillers as uncomfortable rather than painful—often around a 4/10 on the pain scale for lips, and even less for other areas. Any discomfort is brief, and most people are surprised by how quick the process feels.
Swelling or tenderness may follow, but typically resolves within a few days. If pain is holding you back, I encourage you to come in for a consultation. I’ll walk you through the process step by step so there are no surprises.
What’s the difference between Sculptra™ and fillers?
Both Sculptra™ and fillers like Revanesse® are injectable treatments, but they work in very different ways.
- Dermal fillers: give immediate, precise results. They’re sculptable and can be reversed if needed. Perfect for restoring specific areas like cheeks, lips, or under-eyes.
- Sculptra™: is a biostimulator. It doesn’t give instant results; instead, it stimulates your body to make more collagen over time. Results are gradual, more global, and often last two years or longer.
Will lip filler give me “duck lips?”
Not when it’s done thoughtfully. The “duck lip” look you see online usually comes from poor technique or too much product too quickly, not from filler itself. My approach is subtle and tailored, adding just enough structure to support your natural lip shape without overwhelming it. Lip filler isn’t only about volume; it can also correct asymmetry for better balance, soften lines and wrinkles around the mouth, and hydrate lips from within (thanks to hyaluronic acid’s ability to attract water).
The goal is always lips that look natural, healthy, and harmonized with your features. The key is balance—making sure your lips remain proportional to your face and building results gradually if needed.
Curious about half vs. full syringe, cost, or brand options? I’ve broken it all down in my complete lip filler guide.
Why Revanesse®?
I trust Revanesse® for several reasons:
- It’s a Canadian company, founded in 2002, with world-class manufacturing standards.
- The product is smooth, precise, and integrates beautifully into the skin for natural-looking results.
- My patients have been consistently happy with their outcomes for almost five years.
How long do fillers last?
One of the biggest benefits of fillers is their longevity. Depending on the product and area treated, results can last anywhere from 6 months to 18 months.
- Shorter-acting fillers (like those often used in lips) allow you to try something subtle without a big commitment.
- Longer-acting fillers (for cheeks, chin, or jawline) mean fewer touch-ups and longer-lasting results.
- Sculptra™ often lasts up to two years or more because it builds your own collagen.
For most patients, this flexibility is a huge plus. You can adapt your treatment plan as your features and preferences evolve.
How do I keep my results natural?
The key to natural results is the provider. Here’s what I focus on:
- Balance: restoring what’s been lost instead of adding what was never there.
- Subtlety: often less is more—you don’t need a full syringe everywhere.
- Personalization: no two faces are alike, so every treatment plan is unique.
My goal is always for you to look like yourself, just a little more refreshed. Patients often say, “I feel like me, but brighter.” That’s the best compliment I can get.
Should I be worried about filler “trends”?
It’s smart to be cautious when the internet is full of dramatic before-and-afters. But many of those stories come from overfilled looks, unqualified providers, or treatments done overseas.
Here in BC, with regulated products and experienced injectors, dermal fillers are overwhelmingly safe. If you ever feel uncertain, book a consultation. Ask questions, look at before-and-after photos, and make sure your injector’s philosophy aligns with your goals.
Social media has made cosmetic injections more visible than ever, but not every trending treatment is right for everyone. The best results aren’t about chasing what’s popular, they’re about supporting your natural features in a way that is balanced and sustainable.
My approach is thoughtful and personalized, never a quick fix for a passing trend. Done well, cosmetic injections should enhance—not disguise—the real you.
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