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Mental Health

Ask the Therapist: Should I Get Fillers?

Ask the Therapist: Should I Get Fillers?


I’ve had HIV for 30 years and because of it I’ve had lipodystrophy. I want to have fillers injected in my face but my friends tell me I’m being overly obsessive about my sunken cheeks. What do you think? — Adam

This is a great question, Adam. The decision to get fillers is something I often talk about with clients. And it’s a big decision. So let’s get started. Imagine, if you will, a kindly therapist sitting across from you, wearing a cardigan sweater (therapist uniform). That would be me, and I say this with a gentle tone: As I am sure your friends have said, you are much more than any imperfections you might have — and which we all have, in one way or the other, by the way. What about your strengths, your quirks that make you unique, your loyalty to the people in your life? That’s what your friends value you for.

So ask yourself about your expectations for getting the fillers. Are you hoping that your life will change in some way? More friends? More dates? More success in some area of your life? What I first encourage you to do is to get clear with yourself on your expectations for what this procedure will mean for your life, and to consider whether your expectations are reasonable. Making cosmetic improvements doesn’t necessarily lead to major life changes. Just ask the next person you see who has clearly had one too many cosmetic procedures. (Or on second thought, maybe you shouldn’t.) Don’t set yourself up for disappointment if the change isn’t life-changing.

Having said that…you are the one who looks in the mirror every morning. And it sounds like you aren’t happy with what you see. It’s only human to want to look and present yourself in the best possible light. My clients with lipodystrophy tell me that their sunken cheeks are a reminder that they have HIV. And they express concerns that other people look at them and also see HIV. It’s their perception. But your perception is your reality.

If you feel that getting the fillers will make you happier with what you see in the mirror, then that is a reason to consider the procedure. If you think that looking better will give your self-confidence a little boost, then that’s a reason to consider. And that’s not unreasonable. It’s your face. Your bank account. Your life. And your choice. Be clear on your expectations. And then do what you feel is right for you.

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Dr Gary McLain