The fifth season of We Gotta Talk just kicked off, and we’re already into some interesting beauty talk over here. I had an important question about facial filler for our first guest of the new season, Dr. Michele Koo…

Are facial fillers over? Should you dissolve your current fillers?

As with anything related to aesthetics, there is, of course, no one answer to this question. Everything depends on the look and feeling you want to achieve. But with all of the coverage I’m reading on beauty websites and social media posts of women talking about dissolving their hyaluronic acid (HA) fillers, I wanted to take this one to an expert.

To start, what is a hyaluronic acid facial filler?

A “filler” in aesthetic terms usually refers to a hyaluronic acid-based dermal filler that’s injected under the top layers of the skin. Used in lips, cheeks, and along the jawline or temple, they can add volume –or “fill” — to the face in places where someone has lost fat over time or to spots where they just want more dimension. Hyaluronic acid occurs naturally in the human body and dermal tissue, so these fillers have long been touted by medical professionals or injectors because they contain something already naturally occurring in the body.

Some common fillers are Restylane, Juvederm, Belotero and Volbella, but that is by no means an exhaustive list. As new formulations are approved by the FDA, you’ll see new brand name HA facial fillers hit the market (and your dermatologist or plastic surgeon’s office).

What’s the problem with facial fillers?

Well, for one, they can last a lot longer than the six to twelve months that patients are often told. So when people continue to get injections over a period of time, accumulation can occur. But don’t take it from me: Dr. Michele Koo, a plastic surgeon based in St. Louis, was just on the podcast, and she confirmed this truth. She also shared that it’s important to use them judiciously, so you don’t get “filler face.”

Her first tip? Know your injector and their philosophy. Are they all about a more natural look, or do they treat patients who consistently end of having a more “done” look?

Here’s Dr. Koo’s advice:

“I wouldn’t just go in there and randomly meet someone for the first time and not understand their philosophy. Make sure that you mesh.”

And especially for areas where the skin is thinner and more delicate, make sure they’re injecting small quantities at a time — as in, micro droplets.

“You want to do truly micro dots — one, for safety and two, because if you’re doing Sculptra, it does last so long you can overfill and make it look really odd.”

Here are the facial filler takeaways from our chat:

While Dr. Koo doesn’t believe that the facial filler era is over — she says they’re more popular than ever! — it is now more evident than ever that patients have to be educated and particular in what they’re asking for. Remember that results can last longer than the timeframe you may have been told. Never hesitate to ask all the questions. After all, your face is literally in someone else’s hands!

Listen to the full episode below! We dig into tons more about preserving skin health as you age, Dr. Koo’s favorite in-office procedures, and more!