Speaker 1: There's a new trend on the red carpet.

Speaker 2: Celebrities opening up about dissolving facial fillers. I called my doctor, I was like, hey, when can I come in to take this out? And swearing them off for good. Ariana Grande telling Entertainment Tonight.

Speaker 3: I'm still clean, I'm still clean, but I love it and I support it, but I am still four years clean.

Speaker 2: Real Housewives of Beverly Hills star Yolanda Hadid posting about embracing a new aesthetic, writing that she's living in a body free of breast implants, fillers, Botox, extensions. And Courteney Cox talking about removing her fillers on the Los Angeles podcast.

Speaker 4: I was just doing too many fillers and then having to have them removed, which thank God they are removable. But I think I've messed, I messed up a lot and now luckily I can, you know, I was able to reverse most of that.

Speaker 5: I haven't gotten Botox in three years.

Speaker 2: Ryan Jowers is 26 years old and started his cosmetic journey almost a decade ago with fillers. What made you get fillers?

Speaker 5: I had always seen on social media, other influencers, Kylie Jenner at that time was I think 16 years old getting her lips done. And just seeing that kind of noise everywhere, seeing the influencers apply products to their lips that were beautiful and full was a big motivator. I was sort of looking for a look of super plump lips. I wanted them full, round.

Speaker 2: So you were thinking the bigger the better, right? Exactly. Yeah. Ryan was just 18 years old when he got his first injection of fillers in his lips. 18, you were so young.

Speaker 5: When my 18th birthday was coming up, cause that's the legal age to get it. I was determined. One day when I was in high school, I ran over to the med spa, got my lips done and went back to class right after that.

Speaker 2: This is what Ryan looked like at 17 before he had any cosmetic work done.

Speaker 5: Here we go.

Speaker 2: When you look at this photo and you see this version of Ryan, what comes to mind right

Speaker 5: away? Kind of sad. It was someone that I wasn't like happy to look at back then.

Speaker 2: The fillers, he says, changed everything.

Speaker 5: My favorite thing truly was the change. It was not necessarily the shock value, but being able to see something I didn't like, address it and move on and be happy with it.

Speaker 2: The trip to the med spa in high school was just the beginning.

Speaker 5: I had gone back two months later and then three months after that, I went back as well. And then I think it was probably four or five months after that. So my frequency built up for sure.

Speaker 2: These injectables sometimes described as dissolving over time.

Speaker 6: It's often said to be a temporary fix because the filler will naturally dissipate or dissolve. But we're learning more and more that many of these substances are persistent in people's body for longer than they may think. And that exposes people to risks that we are only beginning to understand.

Speaker 2: For years, Ryan says he kept getting more lip filler and eventually cheek filler as well until it all became too much.

Speaker 5: Lips are way out of proportion, cheeks. I felt uncomfortable. I felt an anxiety. I felt like I was being looked at and not seen. So I thought I'd give it time. And then two years later, I still didn't recognize myself. And that was really where I went down the change of dissolving and surgical intervention.

Speaker 2: So Ryan began to undo what he had spent thousands of dollars and years of his life doing. He had some of his fillers dissolved, then got a rhinoplasty. And at only 25 years old, a brow and eye lift. What was that process like?

Speaker 5: It was an interesting landscape. Being a younger man, it comes with a lot of judgment from plastic surgeons. You have to admit to someone not only that you made mistakes, but that you're not happy with the way you look. And that's a very vulnerable thing with anyone, whether it's a friend or a doctor.

Speaker 2: He says he sees now that he didn't fully understand how fillers work when he first started getting them.

Speaker 5: Our knowledge on fillers was not what it was today. It was that fillers aren't permanent. So you need more, you need more, you need more.

Speaker 1: There haven't been procedures like cosmetic procedures and aesthetic procedures that can actually alter young people's faces and bodies to the degree that we have today. There also hasn't been the pressure that young people are receiving on social media to look a certain way. So this is really unprecedented.

Speaker 2: Ryan says the surgical lifts were his best option.

Speaker 5: I'm happier now with the way my face looks, given that surgery was an intervention or an option of altering my chin, altering my nose, altering my face in a way that naturally would have not been possible or achievable through a MedSpot procedure. You can kind of see our point of entry and vectors here that help pull this structure up.

Speaker 2: Not afraid to be vulnerable with his journey, posting his recovery and before and afters on TikTok. His videos viewed hundreds of thousands of times.

Speaker 5: Like I felt like if I lifted my brows anymore, the droopiness would just be like grotesque.

Speaker 2: What was the reaction on social media?

Speaker 5: It's very negative. Really? Truly, yeah. And it comes from any wheelhouse of, I see no difference. You should have spent that money on something else clearly or before was better. Why would you botch yourself? And I don't agree with any of them and I've been putting up with negative comments regarding my decisions for a long time now. My face is altered, but I recognize myself and I see a version of myself I'm happy with.

Speaker 6: The face is one of the most complicated areas on the body in terms of blood vessels, nerves and muscles. And I think that what people don't realize is one of the reasons why it requires such expertise is because the risk of complication is so high and the risk of disfigurement is so high that you have to make sure you're doing it with someone who knows exactly what they're doing.

Speaker 2: 30-year-old Jessie is doing just that, consulting a plastic surgeon. She says the jaw filler she got at another clinic a year ago had visibly migrated.

Speaker 7: So you had mentioned that you had some filler dissolved. Yeah. Can you tell me whereabouts that was on your face?

Speaker 3: Yeah. So I got my jawline and recently it shifted from a massage, so it's up here.

Speaker 7: From a massage it shifted?

Speaker 3: Yeah. Oh, that's interesting.

Speaker 2: And then a little on the other side. Dr. Dilip Bhanani.

Speaker 7: Just make sure the bed is flat.

Speaker 2: A double board certified facial plastic surgeon is now removing that filler as part of a previously scheduled lipo procedure.

Speaker 7: 15 years ago it was only patients 50s and 60s and 70s, but now we're definitely seeing 30s and 40s coming in, like almost a quarter of my patients right now.

Speaker 2: And they're not just coming for injectables.

Speaker 7: We are seeing a lot of younger patients coming in, especially in their 40s now coming in for facelifts or even like early 50s.

Speaker 2: And that smoothness that someone would get with a facelift, how long does that last?

Speaker 7: It'll last as long as you do. So let's say make you look 10 years younger with a facelift. It's not that we stop you from aging, but you'll always look 10 years younger than if you never did the procedure. A little bit of swelling, potential bruising for a couple of days, okay?

Speaker 2: He says every case should be looked at individually and has reservations about treating very young patients. If somebody were 18 and they walked into your practice and they either wanted Botox filler or an actual procedure, cosmetic procedure, cosmetic surgery, what would your practice do?

Speaker 7: We basically filter out those patients. I think 18 is probably a little younger, but there are some patients who are congenitally have eye bags and very deep, deep set eyes, and they want to look more fresh. I can help you, right? But I'm going to go super conservative and discuss with you your options. I think if you're coming in 20 to 25, I don't think most people are going to be a facelift candidate.

Speaker 2: So what are the possible dangers that come with a facelift?

Speaker 7: With any procedure, there's always four risks of bleeding, infection, scarring, and nerve damage.

Speaker 2: Ryan hopes telling his story will help those who are just starting their cosmetic journeys.

Speaker 5: I'm grateful for my experience, even the bad of it, because that's how I got here. Through that, I was able to learn and make better decisions when it came to permanent solutions.

Speaker 1: It's important to uncouple the idea that a perfect appearance is going to lead to a perfect life. And normalizing that, I think, is very important. Focusing on self-care and mental health is just as important as skincare or a beauty routine that makes you feel beautiful.

Speaker 7: Our thanks to Stephanie. For more on this story, watch the full Impact by Nightline facelift after fillers, now streaming on Hulu.