Facial Overfilled Syndrome: A Narrative Clinical Review

Several human studies show positive signals, while research methods and sample sizes continue to develop.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background Facial Overfilled Syndrome (FOS) is an increasingly prevalent iatrogenic complication resulting from the excessive or inappropriate use of dermal fillers. Clinically significant for causing facial distortion and unnatural dynamics, it is frequently compounded by profound psychological distress and aesthetic perception biases. Aim This narrative clinical review aims to summarize the etiology, clinical features, diagnostic approaches, and management strategies of FOS, establishing a structured framework to emphasize the importance of prevention through anatomical knowledge and individualized treatment planning. Methods A comprehensive literature search was conducted in PubMed, Google Scholar, and CNKI using keywords such as "facial overfilled syndrome", "facial overfilling", "overfilled face" and "dermal filler complications". Relevant original studies, clinical trials, meta-analyses, and reviews published until October 2025 were included and synthesized into a narrative framework. Results The pathogenesis of FOS extends beyond mere volumetric excess, driven by a complex triad of anatomical mismatch, biomechanical dysregulation, and the cumulative payload of repeated treatments. Clinical hallmarks include resting distortion and unnatural facial animation. Management must be highly individualized; while targeted, ultrasound-guided hyaluronidase injection remains the est

Evidence level

Several human studies show positive signals, while research methods and sample sizes continue to develop.

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