A medical surgeon gained widespread attention after sharing magnetic resonance imaging (MRI) footage that demonstrated how a patient’s hyaluronic acid fillers had expanded and shifted autonomously over time.

The video left thousands of viewers shocked, with many admitting that their own fillers never seemed to dissolve.

As explained by the American Board of Cosmetic Surgery, dermal fillers are gel-like substances injected beneath the skin to enhance facial features, smooth out wrinkles, soften folds, and restore lost volume.

Every year, over a million men and women choose this popular facial rejuvenation procedure.

Hyaluronic acid-based injectable fillers are the most commonly used type and are typically considered a temporary solution. These fillers generally last between six and eighteen months.

Dr. Kami Parsa, an oculoplastic surgeon based in Beverly Hills, California, went viral after posting a TikTok video on July 12. The video, which now has over 7.2 million views, featured an MRI of a patient’s face showing how it had changed over six years due to hyaluronic acid injections.

The patient, a 33-year-old woman, had received over 12 milliliters (12 CC) of hyaluronic acid filler during the six-year period. The MRI video, with a grey face and green dots lighting up the cheeks and lips, showed the distribution of the filler.

Dr. Parsa did not clarify which exact procedures the patient had undergone but did reveal that a volumetric study determined the total amount of filler in the patient’s face had reached 28 CC — more than twice the amount originally injected.

“This demonstrates that hyaluronic acid fillers are hydrophilic,” Dr. Parsa explained. “They both attract water and promote tissue growth.”

The MRI sparked concerns among viewers, with one TikTok user commenting, "I just don’t see how this wouldn’t completely destroy the lymphatic system."

Others expressed frustration at the widespread, unregulated use of fillers, with one viewer writing, “Finally, this is being talked about. The mass production and insane usage without warning. I need to know more. What about Botox?”

Dr. Parsa responded by reassuring that Botox, when used correctly, is safe, as it has a long track record of use.

The video also highlighted how the amount of hyaluronic acid fillers injected into a patient had more than doubled over time. Viewers shared their own experiences, with some admitting that their fillers hadn’t dissolved as expected. One user noted, “I’ve had my lips done three times with 0.5 ml each time, and five years later, they’re still the same.”

Others added similar stories, with one person revealing they had chin fillers a decade ago, and still, no touch-ups were needed. Another shared their experience of lip fillers that had lasted for eight years without fading.

As fillers become increasingly popular, celebrities who overuse them often face criticism. Ryan Gosling and Eva Mendes were the subject of backlash earlier this year when old and new photos of them were compared online.

On March 29, Meredith West, a physician assistant with 15 years of experience in plastic surgery, posted a joint reel with Mountcastle Medical Spa on Instagram. The video included “before and after” photos of Ryan and Eva, showing noticeable changes in their appearance, with the couple appearing somewhat “puffier.”

“I assume they’ve both had recent cosmetic procedures,” Meredith wrote in the caption.

She speculated that Eva might have had facial surgery, possibly a facelift, and both might have received Botox and facial fillers.

The most widely used injectable fillers are still those made with hyaluronic acid.

Botulinum toxin injections, like Botox, work by relaxing facial muscles to reduce wrinkles such as frown lines and crow’s feet. However, excessive use of Botox or fillers can have negative effects. Overuse of Botox can cause severe muscle weakness, affecting facial expression and creating an unnatural look, according to Nurse Gemavie.

Dermatologist Jessica Weiser shared with Allure in March 2023 that overdone filler treatments are quite common, resulting in a "pillow-face" appearance—puffy faces with disproportionate features. Poor judgment from some injectors is considered a major contributing factor.

Meredith commented that Ryan and Eva likely looked great before any procedures and suggested they only needed a little preventative Botox and possibly some biostimulators, such as Sculptra, for collagen stimulation.

To maintain results, many experts recommend medical-grade skincare, including treatments like CO2, radiofrequency, laser, and microneedling.

Aesthetics physician Jonny Betteridge also commented on Ryan Gosling's transformation. In a viral video posted on March 28, Jonny analyzed Ryan’s appearance over the years.

Ryan has always had masculine features, including strong cheekbones and a broad chin, Jonny said. However, in recent years, his face has changed, with a notable fullness in the mid-face and cheeks. This suggests that Ryan might have undergone mid-face filler treatments around 2021.

Jonny noted that Ryan's face now appears more “overfilled,” particularly in the cheek area, which he associates with an excess of filler. This change in proportions is further emphasized when Ryan smiles, revealing a typical outcome of overuse in this area.

One viewer jokingly said, “Me and my fillers are panicking right now.”