October 28, 2026 | Facelift, Facial Rejuvenation, Fat Transfer
The Megan Fox posts started from a Letterboxd interview recorded a year ago and released this month, and at least one of the photos doing the rounds is tagged AI-generated on the account that posted it. No doctor is quoted in any of it (IBTimes UK has the timeline). I am not going to diagnose her. I am going to tell you what I check when a patient brings me the same question about her own face, because it decides whether I reach for a dissolver, a fat graft, or an operation.
Step One: Press on It
“Normal puffiness or swelling, typical in the mornings or after a late night and heavy salt intake, is soft. We can usually make some of it disappear with cold pressure, and it dissipates during the day.”
“Filler migration requires a history of filler. You have added volume in an area close to where the filler was placed, so it has, in quotations, migrated. It is palpable; filler can be felt outside of where it was originally injected.”
Step Two: Ask When It Swells
“Fillers can create a type of inflammation. It may not be constant, but the tissue around the filler itself may swell up.”
“Filler can also block lymphatic drainage and make morning swelling in the injected area even worse.”
“When patients use fillers, they see that they have to have this redone anywhere from every six months to one year. And what we’re also seeing is that not all of that filler goes away, but it’s migrating and flattening out, so it’s not giving us the volume exactly where we want it.”
Step Three: Decide Whether It Is Too Much, Not Just Moved
“I think we have seen that facial fillers have been quite overdone, and patients are really getting away from looking overfilled and want to look more natural. We have seen that these hyaluronic acid fillers may not dissolve completely, and they do tend to migrate. It seems like they create some kind of inflammatory response in some patients, creating nodules or inflammation. And of course, the feel of a filler is not quite like natural fat, which is squishy and soft, something whose borders you wouldn’t be able to identify the way you can with a filler.”
“Really, what I think is that there has been a huge tendency to overfill faces with fillers, and maybe that’s why it’s difficult to count.”
| What I find | What I do |
|---|---|
| Soft, worse in the morning, gone by afternoon | Nothing. Salt, sleep, a flight. |
| Firm, palpable, next to where the filler went | Dissolve it, wait, reassess |
| Overfilled for years, borders you can feel | Dissolve in stages, then restore volume with fat where it belongs |
| Volume loss under it all, skin that has let go | Fat grafting with a lift, not another syringe |
Step Four: The Forehead Is a Dosing Question
“I myself get botulinum toxin in the forehead, crow’s feet, and glabella lines every three to four months, just to maintain the wrinkle free appearance with a dose that still lets me express my face without looking abnormal.”
“Dose, dilution, injection placement, and product choice matter more than whether you are active or inactive. These are all customized depending on each patient’s consultation. For example, patients with very strong frontalis muscles, glabellar muscles, or masseters will require a higher dose than others.”
Where I Go When the Answer Is Not More Filler
“In my practice, I’ve seen more than a twenty to thirty percent decrease in the use of fillers, and a shift toward biostimulators and donor fat grafts instead.”
“Filler cannot really give us a natural feel. When properly done it can give us a natural look, but it’s often overdone. It can also not give us a long lasting result, and this is where fat has its benefits.”
The longer read on that shift is in fat vs fillers. The under-eye, where swelling and filler are most often confused, has its own post at tear trough filler, and the same discipline applied to another face is in facelift or not, Kristen Wiig photos. The commentary version of this post is on drworldwide.com; the injectables version is on the Southwest Plastic Surgery post.
Why Choose Dr. Agullo
Dr. Agullo is certified by the American Board of Plastic Surgery and the American Board of Surgery, completed his plastic surgery fellowship at the Mayo Clinic, and serves as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. He has been a Castle Connolly Top Doctor for thirteen consecutive years, 2014 through 2026. Facial fat grafting, filler dissolving and revision, and botulinum toxin dosed to keep expression are everyday work in his El Paso practice.
Ready to Talk?
Bring the photo that worries you and let me press on the spot. The exam decides the plan, and the plan is rarely another syringe.
Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com. #StayBeautiful
Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
