Welcome to the inaugural edition of Stirring the Aesthetic Pot. I’m Nancy Higginbotham, COO at Rousso Adams Facial Plastic Surgery. This is my insider’s take on the aesthetic industry-part observation, part experimentation, and entirely honest. These are the treatments I’ve tested, the questions I get asked every day, and the moments that even Dr. Rousso and Dr. Adams have something to say about. All of it has their stamp of approval-or their side-eye. Let’s get into it. Because sometimes the anti-trend is the only trend that makes sense.

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Still Got Filler from 2017? You’re Not Alone

Let’s clear something up: filler isn’t the problem. Overfilling is. We’ve long been told that filler dissolves in 9 to 12 months. But recent MRIs tell a different story. In many cases, filler can linger in the face for 5 to 10 years after injection. That means what’s under the surface may be adding up in ways we didn’t expect.

I’m three and a half years post-lip filler and still loving the result because I didn’t stack sessions or chase trends. When you keep topping off filler before the old product breaks down, it migrates into the cheeks, under the eyes, and above the lips. That’s how people end up looking “off,” even if no one can quite say why.

The real culprit? Too many injectors who won’t say no. The best providers don’t just add. They assess. They pause. They plan. Because good aesthetic work should whisper, not SHOUT.

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When Filler Isn’t the Fix

“Sometimes, it’s not about adding more filler. It’s about knowing when to stop. Overfilling can actually make someone look older, not younger. There’s an art to recognizing when the right solution isn’t more volume, but a different approach entirely-like a facelift or skin tightening procedures. True facial rejuvenation comes from understanding proportion, movement, and natural anatomy-not just a syringe.”  -Dr. Austin Adams, Facial Plastic Surgeon at Rousso Adams Facial Plastic Surgery

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What to Ask Your Injector

Before booking more filler, ask these four questions:

1.  Do I need more filler, or should we dissolve what’s there?

P.S.- Dissolving filler isn’t as easy as it sounds. It’s not a one-and-done magic eraser-it can take multiple sessions, comes with its own risks, and sometimes that filler clings on like glitter after a bachelorette party.

2.  How do you evaluate for migration or buildup?

3.  Will this product layer well with my existing filler?

4.  What’s the long-term plan to keep my results natural?

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Contoured or Conned? The Skims Edition

Full disclosure: I love Skims. I wear the underwear. I’m loyal to the bodysuits. But this collagen face wrap? It’s a stretch. Literally and figuratively.

Kim K’s latest launch promises firming, lifting, and smoothing in a full-face, compression-style wrap. It’s made from collagen-infused yarn- which sounds impressive until you remember it’s still fabric, not skincare. Realistically, your skin’s not absorbing much of anything through what is essentially a stretchy sock for your face.

The funniest post I’ve seen? Sir Anthony Hopkins wearing it and channeling exactly the Hannibal character you’re picturing right now.

Let’s not confuse it with a traditional face mask-this is marketed as a face wrap. But let’s call this what it is: shapewear for your face. And personally, the only face shapewear I’m wearing is the bandage after my facelift.

Verdict: Great for the grid. Silly for the science.

One can dream that it only costs $48 to have the contouring of Kim. There’s a waitlist for it though… so what do I know?

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What’s Salmon Sperm, and Do I Need it?

Salmon Sperm Microneedling Is the Glow-Up No One Saw Coming

Yes, you read that correctly. Salmon sperm microneedling is a real thing. And before you make a face, hear me out. Technically known as PDRN (polydeoxyribonucleotide), this compound derived from salmon DNA is packed with regenerative benefits. When paired with microneedling, it helps calm inflammation, support collagen production, and leaves your skin with a glow so luminous it  feels like cheating.

And trust me-I’ve had over 20 microneedling sessions with everything from PRP to peptides. This one gives the best glow I’ve ever had. If you’re chasing that glass skin finish, this is it.

Other fun facts you didn’t ask for but are getting anyway:

•  In countries like South Korea and Italy, salmon DNA is injected into the skin like Botox for anti-aging and texture refining.

•  It’s not FDA-cleared for injection in the U.S., so we stick to topical use during microneedling to help it absorb.

•  Did you know this is Kim K approved? So we do agree on a few things.

The weirdest part isn’t what it is. It’s how good the results are. It’s a little science, a little fish, and a lot of glow.

>>>>  Pro tip: Don’t overthink it. Just trust the post-treatment mirror.

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The Skincare Drawer Nobody Talks About

We need to talk about that drawer.

You know the one-overflowing with half-used serums, TikTok must-haves, expired eye creams, and that one product you bought at 2 a.m. because someone said it would completely change your skin.

Here’s the truth: the internet is loud. Everyone’s suddenly a skincare expert. And most of them wouldn’t know how to treat real skin if it showed up without a filter.

If you’re confused, you’re not alone. That’s why one of the smartest things you can do is book time with a licensed esthetician-and bring the whole drawer with you. Seriously. Dump it on the counter. Let them help you sort through what’s worth keeping, what’s expired, what never worked in the first place, and what your skin actually needs.

Getting on a personalized, medical-grade skincare routine isn’t about buying a dozen new things. It’s about streamlining, simplifying, and using science-backed products that work with your skin-not just with your algorithm.

Join the anti-trend revolution. Stop hoarding hype. Start listening to professionals who live and breathe skincare, not likes.

Guilty!!!

Click here to see my drawer

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