On April 7th 2021, ASAPS Past President Dr Naveen Somia was interviewed by ABC Radio host Josh Szeps on the rise of women having bloated, puffed up lips due to too much lip filler and whether or not social media is to blame for it.
Josh Szeps: It used to be rare that you’d see a person with lips upturned in this bloated, puffed up, disfigured, cosmetic-accident-gone-wrong duck face type of look. [It’s] Not so rare anymore. The trend is obvious and plastic surgeons are noticing it, too, and raising some red flags. Is social media to blame for the uptick in lip fillers? Dr Naveen Somia is a specialist plastic surgeon and the Past President of the Australasian Society of Aesthetic Plastic Surgeons (ASAPS). Hello, Dr Somia. Thanks for being here.
Dr Naveen Somia: Thanks for having me, Josh. Good morning.
Josh Szeps: How much are lip fillers on the rise?
Dr Naveen Somia: It’s one of the very popular procedures that we see and facial beauty is defined by lips, beautiful skin and beautiful eyes. So if you look at that fundamental premise, lip fillers are on the rise. And what we are seeing is increased amounts of lips that have been done disproportionately, and the proportion of beauty has been distorted. That’s what you’re talking about.
Josh Szeps: When did this procedure come into widespread use in the first place?
Dr Naveen Somia: It started off around the early 2000s, and it was gradually making its rise up the popularity chart, but with the increased safety of the products and increased penetration of the market, the widespread use of lip fillers, and the social acceptance of lip fillers obviously influenced by media, social media influencers and the like, we’ve seen a significant uptick in the use of lip fillers.
Josh Szeps: Are you still a practising surgeon, by the way?
Dr Naveen Somia: That’s correct. I am.
Josh Szeps: How do you manage the request for lip fillers versus your own discomfort with people overdoing it?
Dr Naveen Somia: When patients who come to me, I usually tell them that in proportion lies beauty. Just because big lips look good on celebrity X, it does not mean it will suit your face. So we tell patients, “This is what I’m happy to do, but we’ve not focused on increasing the volume.” So if you come and ask me for three ml of lip filler, it’s not going to happen. Occasionally, we do get patients who believe that more is better, but we usually tell them, “No, less is better. And proportionality is the key to enhancing beauty.”
Josh Szeps: Is there a form of body dysmorphia that comes into play here?
Dr Naveen Somia: At an informal level there will be some degree of body dysmorphia coming in because we know that about less than 5% of people in the general population do have a degree of body dysmorphia. So whether it’s manifest in a very overt way or covert way, it’s very difficult to understand because when people come asking for lip fillers, there are no red flags as such. If it becomes a pattern where people insist on having more filler despite your aesthetic judgement, that’s when you should be raising the red flag.
Josh Szeps: Am I just being a silly old fuddy-duddy? I was talking earlier on the show about Rita Ora, who is apparently in Sydney and I thought, “Oh, I must be old because I’ve never heard of who this person is, but they have 16 million followers on Instagram, and they’re being written about in the newspapers as if everybody knows who Rita Ora is.”
Perhaps I’m just down the memory hole of having three year old twins where I’m not paying attention to pop culture, but is this another example of that? Where having big, obviously worked on protrusions on the bottom of your face so that you can’t close your mouth, is that just the norm now and I need to get over it? Or is there something else going on here? Dr Somia is this just that I’m noticing the bad ones and there’s much more of it going on than I realise?
Dr Naveen Somia: Yes, it’s correct. To start off by saying that lip filler is a medically invasive procedure with significant risks. So if it’s done well, you’ll have a beautiful lip that you’ll never notice. Whereas if it’s done badly, you will either see distortion of aesthetics or worse, medical complications. If done badly, your artery can be blocked, skin can fall off, if accidentally injected into an artery, it can even cause blindness or a stroke. So it’s a serious problem if it’s not done very well. Yes, there are a lot more people who have lip fillers, but the ones we see are the ones who have either got it done badly, or people who do not want normal-looking lips.
Josh Szeps: What is being injected?
Dr Naveen Somia: The product is called hyaluronic acid, which is more like a gel. It is a naturally-occurring substance and every joint in our body has HA, but this is bioengineered to last longer. So it typically lasts for about 12 to 18 months. And that’s kind of what plumps up the soft tissue of the lip.
Josh Szeps: And are you saying that it goes away after 12 to 18 months?
Dr Naveen Somia: That’s right. The body absorbs it, because it’s a naturally-occurring substance in the body. It absorbs and excretes it, but after 12 months it’s gone, it’s deflated.
Josh Szeps: Is it possible that people are requesting an overinflation so that they’ll look perfect in two or three months time after it’s subsided?
Dr Naveen Somia: I don’t think the degradation is that rapid, in two to three months. It does take a while to settle down. So people don’t tend to over-correct using fillers because the amount of the filler is engineered in such a way that if you put in 0.1 ml, 0.1 ml will stay.
Josh Szeps: I see. What strikes me as interesting here, which I guess you have to get your head around as a specialist plastic surgeon yourself, Dr Somia, is the difference between attempting to correct something that one regards as a defect in one’s looks, versus attempting to turn one’s face into a paradigm of beauty that is really quite new. I think a lot of these people are actually trying to aspire to a look that doesn’t have anything to do with the way that any human naturally looks.
Dr Naveen Somia: That’s correct, Josh, because people do chase after specific features of a well-known celebrity, because that looks good on that particular person. It does not necessarily mean it will look good on you.
Josh Szeps: But does it even look good on that person is the question. Or are we all swimming in a soup of social media frenzy where we agree that because someone is extremely rich and famous, the way that they look is worthy of being emulated, even if in the abstract, if you isolated that famous person’s face and just made them a nobody you’d think they look weird.
Dr Naveen Somia: There’s a bit of that. But unfortunately the world in which we live in is full of visual images of good people and good-looking people too. So what happens is that it almost becomes your default. If you ever look at any of the artwork from the masters and the olden days, not a single anatomical structure was made disproportionate.
Everything was made into a proportionality to fit in with the beauty. All we’re seeing now is people who have got lips massively bigger than what they should be. So there’s a certain distortion happening that sadly through social media influencers, paid or otherwise, on impressionable people. And then you’ve got practitioners who are willingly injecting two or three mls of lip filler. Then you’re looking for an epidemic of distortion.