Cheng-Xiang Peng,1 Wang Xv,2 Yin-Jie Ao3 

1Department of General Surgery Ward 3, Plastic Surgery and Medical Cosmetic Center, Yichun People’s Hospital, Yichun, People’s Republic of China; 2Plastic Surgery and Medical Cosmetic Center, Yichun People’s Hospital, Nanchang, People’s Republic of China; 3Plastic Surgery and Medical Cosmetic Center, the Affiliated Eye Hospital, Jiangxi Medical College, Nanchang University, Nanchang, People’s Republic of China

Correspondence: Yin-Jie Ao, Email wghayjjtys@163.com

Abstract: In recent years, Overfilled Syndrome and the associated “Bread Bun” phenomenon have garnered significant attention in the field of aesthetic medicine, particularly among younger populations. This article systematically reviews the causes, consequences, and management strategies of facial overfilling, aiming to provide a scientific basis for the prevention and correction of this phenomenon. The causes of overfilling involve technical, patient, and physician-related factors: technical factors include improper injection dosage, depth, and point design; patient factors primarily stem from the excessive pursuit of “perfect” facial features and unrealistic expectations; while physician factors are related to insufficient experience, lack of technical proficiency, and misinterpretation of aesthetic standards. The consequences of overfilling include aesthetic imbalance, health risks, and psychological issues. To effectively prevent and manage overfilling, this article proposes detailed preventive strategies, including preoperative assessment and design, patient education, intraoperative layered injection techniques, and regular postoperative follow-ups. For cases where overfilling has already occurred, non-surgical correction and surgical correction are the primary treatment methods. Additionally, psychological support and the application of portable ultrasound technology play important roles in the correction process. Future research directions include the development of quantitative assessment tools, optimization of prevention and management strategies, and the development of new filler materials and technologies. Through scientific preventive strategies, precise treatment plans, and ongoing research and innovation, the occurrence of overfilling can be effectively reduced, advancing facial filler procedures toward greater safety and naturalness.

Keywords: overfilled syndrome, bread bun, hyaluronic acid, hyaluronidase, portable ultrasound