EP 21: What Happens to Filler After a Decade? | OR DIARIES

In this episode, I share a rare and revealing case: a patient I've followed for ten years, with over twenty sets of high-quality photos documenting her natural progression from filler to full surgical rejuvenation. Through her story, I break down what actually happens to hyaluronic acid filler over time - including uncomfortable truths that challenge some long-held assumptions in our field: that filler doesn't just sit still, that dissolution doesn't make it disappear, and that "poor placement" isn't always the explanation when filler signatures show up years later. Getting to directly observe this filler during her surgery gave me some of the most valuable, real-time data I've encountered, and it reframes how I think about managing prior filler in my surgical patients going forward. CONNECT WITH HOST Website: https://5c.co/ Instagram:   / chesnut.md   YouTube:    / @chesnutmd   LinkedIn:   / cameron-chesnut-a6910baa   WAYS TO WATCH/LISTEN YouTube:    / @5codespodcast   Spotify: https://open.spotify.com/show/1FZ7vpm... Apple: https://podcasts.apple.com/us/podcast... Instagram:   / 5codespodcast   TIMESTAMPS 00:00 - Intro 00:12 - Today's Case Setup 00:31 - Meet the Patient 01:03 - A Decade of Photos 01:31 - Filler Made Her Look Better 02:07 - Still Wanted Surgery 02:20 - Watching the Filler Signature Emerge 03:16 - Debunking "Poor Placement" 04:53 - Surgical Journal Entries 05:37 - What Surgery Revealed 06:52 - A Pattern Across Patients 09:09 - Candidate for Surgery at 40? 10:01 - The Dissolution Myth 11:22 - Managing Old Filler in Surgery 13:22 - Old Filler vs. New Anatomy 14:03 - Does Filler Move Over Time? 16:52 - Before & After Photos Coming 18:07 - Closing Thoughts ABOUT HOST Dr. Cameron Chesnut is the host of the 5 Codes Podcast and the founder of 5C, where he leads a team dedicated to integrative cosmetic surgery, regenerative medicine, and functional health. An internationally recognized facial plastic surgeon, Dr. Chesnut is known for producing natural, refined results that enhance rather than alter one’s appearance. His approach blends surgical precision with biological optimization and disciplined restraint, drawing patients from around the world who value excellence, longevity, and holistic care. On the 5 Codes Podcast, Dr. Chesnut uncovers the mindsets and evidence-backed strategies he lives by, helping high performers perform better, recover smarter, and feel their best in every area of life. DISCLAIMER The views shared on this podcast are my own and are not associated with, affiliated with, or representative of my clinical teaching role at the University of Washington School of Medicine. This content is for general educational purposes only and should not be considered individualized medical advice.