Posted by Dr. Anil R. Shah
When starting as the Admin Assistant at Dr. Shah’s office, I knew that one of the benefits of the job I was eager to explore was the easy and ample access to fillers and neuromodulators of all shapes and sizes. Lip filler, cheek filler, botox, I wanted to try them all.
However, I was incredibly nervous for a number of reasons. There are the obvious nerves that come with any medical treatment of course, but past that I was terrified at the potential sensory experience of getting botox and filler.
While I’ve never received the formal diagnosis, I’m firmly aware that I have autism.
It’s a genetic trait, one my sister has been diagnosed with, and one our grandfather had as well. My autism impacts countless aspects of my day-to-day life. Social cues can sometimes be difficult for me, I spend far too much time learning about and consuming information about my special interests (ask me about the Everest Disaster of 1996, please ask me about the Everest Disaster of 1996) but by far, my largest setback is my hypersensitivity to sensory stimuli.
Lights are often too bright, certain pitches of sound can incapacitate me, and touch…
Oh my god, Bad Touch.
The experience of feeling something my brain considers “wrong” is enough to make me want to crawl out of my skin and run screaming into the ocean. What would filler feel like to me? Would I feel the foreign material in my body? How long would I be actively aware of it? Would it eventually fade into the background radiation of my body’s sensory experience, or would I always feel the gel every time I pursed my lips or touched my cheek?
Last week, I bit the bullet.
I had an impromptu consultation with Jonathon, one of our expert injectors here at the office, and we went over all of my concern spots (uneven cheeks, heavy smile lines due to weight loss, the beginnings of static lines on my forehead, etc.) and he made a gameplan for our first treatment: cheek filler, piriform filler, a minor amount of filler in my nasolabial folds, and a conservative amount of Dysport on my forehead and around my eyes. Next time we’d tackle lips, re-up the Dysport, and tweak any spots we weren't totally satisfied with this go around. There was also some discussion of laser treatment to address my hyperpigmentation and redness. God bless Jonathon.
For anyone who may be Neurodivergent like me, or even just has general sensory hypersensitivity, I want to offer in as explicit detail as I can what exactly my injection experience was like, as I’ve personally been hard pressed to find anyone describe the sensory experience of neuromodulators and filler outside of the bowels of Reddit.
Dysport:
The injections themselves weren’t bad. It was a series of quick, sharp pinches that didn’t feel any different than a usual shot. Maybe akin to a sharp mosquito bite? Unlike Botox, which takes upwards of two weeks to see the effects, Dysport begins to kick in within days. After being injected on Wednesday, by Monday my usually very dynamic forehead is all but still.
It’s a bizarre sensation, but not necessarily a bad one. I keep finding myself raising and lowering my brows over and over again just to prove that I still can. It isn’t easy, though. On a sensory level, it feels like someone has gently placed a hand on my forehead, it’s there at all times and I have to push against it to raise my brows. I can tune it out, but the moment I start actively thinking about it, the hand is right back on my face. At times, that hand can be relaxing. Due to my autism, I’m facially masking all the time. My expression is always schooled just so, my brows usually just a little raised to show active interest. The Dysport has completely stopped that. For the first time in I don’t know how many years, I’m not masking at work. It’s a little terrifying, to be completely honest. How fascinating though, that it took a neuromodulator to stop concealing parts of my identity in the workplace?
I’m not always comfortable with the “hand on forehead” sensation, but I’ve found that taking my own hand and manipulating my forehead manually helps significantly with mentally resetting if it ever gets too overstimulating.
Filler:
God, getting filler is weird.
Do you know you feel it? You feel the filler going inside you.
Cheek filler is injected deep into the face, to my understanding along the bone, to help lift and plump the cheek. It’s a hard, thick filler, the kind that sticks around.
Chat, I felt it on my bone.
Do you know how bizarre of a sensation that is? Most people haven’t felt someone touch their bone before. It touched. My bone.
Bad touch. Bad touch.
The pain from the actual needle itself was a bit worse than the Dysport- Jonathon mentioned he used a cannula in the site to help better control the product- but that sensory experience was pretty immediately overruled by the experience of a foreign object getting injected into my body and onto my bone.
Bad touch. Bad touch. Bad touch.
Imagine the sensory experience of a thick gel getting pushed out of a syringe onto the back of your hand. Now imagine it happening inside of you.
Due to the proximity of the syringe to your ear, you can hear the gel being pushed through the needle, along with the click, click, click of the syringe itself. What’s wild is I could hear the sound somehow inside of me, like the vibrations somehow traveled through the needle. While this wasn’t at all distressing for me, it was certainly unexpected.
The filler Jonathon used contained lidocaine, a numbing agent, which was a double edged sword as I both didn’t experience any initial pain from the injection, but my bone went numb. You don’t realize you have feelings in your bones until you don’t.
Christ.
It was about 30 total minutes of numbness, and I won’t lie- it wasn’t great. I felt somehow invaded, I felt weird, and then once it wore off it was sore for the next several hours, weirdly enough in my jaw of all places. For the rest of the evening I kept remembering how the sensation felt and had the get it out getitOUT skin off SKIN OFF reaction maybe four times throughout the evening. They were brief, but they were present. But, by morning it was settled and the sensation had passed.
And my god, the results.
The volume I lost from my weight loss was back in a thoughtful and mindful way. I looked refreshed, I looked like I’d had a great night’s sleep, and it handled insecurities on my face I didn’t even realize it’d tackle. The cheek filler vastly reduced my hollow undereyes, and the piriform filler helped with some minor imbalances on my lips. And the best part? You couldn’t tell.
Jonathon is a master of his craft. When I went home that night, I accosted my best friend and roommate:
- Me: “Tell me what you think I did to my face today.”
- Roommate: “Uhhhhh-”
- Me: “I did something.”
- Roommate: *squints harder*
- Me: “No guesses?”
- Roommate: “...There are specks of blood on your cheeks, so I’m assuming something there?”
I forgot I was a bleeder.
All in all, it was worth it, at least to me.
I don’t know if everyone with sensory hypersensitivity should get fillers or neuromodulators, but no part of me is regretful of the decision.
I’m still hesitant to get my lips done- Jonathon mentioned they can feel lumpy for several weeks until the filler fully softens into your face, and I’m not certain I’m comfortable with that long of sensory alteration- but no part of me will ever regret the cheek or piriform filler. I was so self-conscious about my smile lines for so long after I lost my weight, I feel like I’ve gained a level of autonomy over my body I’ve been missing since I lost 80 pounds in 2023.
As for the Dysport, it’s offered me a strange freedom I couldn’t have ever foreseen. Masking is exhausting, both physically and mentally. This sensation, this calming of the muscles, forced relaxation, has shown me just what the extent of the energy I’ve been placing into it has been. My god, what freedom to actually relax.
Whether these procedures are right for you is your call. Schedule a consultation with your provider of choice, I highly recommend a plastic surgeon’s office over a medspa, and sit down with someone to discuss. If you’re neurodivergent, I also highly recommend speaking with your therapist first. Not only are the sensory issues prevalent, but you might experience body dysmorphia from the procedure, and you should absolutely be mentally prepared for that.
I’m glad I made the decision to move forward. While my autism touches most every aspect of my life, I never want it to stop my life. And my god, I’m so happy I chose satisfaction over fear.
If you are considering fillers or neuromodulators and want a thoughtful, personalized approach to treatment, schedule a consultation with the team at Shah Facial Plastics to discuss your goals, concerns, and treatment options.
