How Others See Over-Treated Faces: Eye-Tracking Research

A 2025 study used eye-tracking cameras and rating surveys to see how ordinary viewers react to faces digitally altered to look over-treated. In most cases, exaggerated changes to the eyes, cheeks or a combination of areas made faces look less attractive, and the eye changes had the strongest negative effect. For anyone considering injectables, the message is simple: balance and restraint tend to read better than "more."

Why this was studied

As filler treatments have become more common, so have appointments to dissolve or reverse them. Clinicians increasingly talk about an overfilled appearance, sometimes described as facial overfilled syndrome, where repeated or excessive treatment leaves the face looking heavy, puffy or unnatural.

What has been less clear is which areas of the face drive that impression. If researchers can show how specific changes affect the way other people see a face, injectors and patients have firmer ground for deciding when to stop. That was the gap this research team set out to address.

What the researchers did

The team, led by Joanna Kempa and including several well-known facial anatomy researchers, recruited 50 volunteers: 30 women and 20 men. The volunteers were not patients being treated. Instead, they looked at front-facing images of male and female faces that had been edited to imitate exaggerated treatment in three regions: the eyes, the cheeks and the lips. Some images combined more than one change.

Each volunteer rated the faces on five-point scales for attractiveness, unattractiveness, masculinity and femininity. At the same time, an eye-tracking system recorded where their gaze landed and how it moved across each face. This pairing lets researchers compare what people say about a face with where their attention is actually drawn.

What they found

According to the study's summary, the main results were:

• Eyes: Raising the outer corner of the eye, an effect sometimes seen with over-lifting, sharply reduced attractiveness in both male and female faces.
• Cheeks: Exaggerating the cheekbone area generally lowered attractiveness and masculinity, especially in male faces, while slightly increasing how feminine a face appeared.
• Lips: In female faces, added lip volume increased attractiveness only marginally and did not meaningfully change perceived femininity.
• Combinations: When several areas were altered together, the drop in attractiveness was largest, and the eye change was the main reason.

The authors concluded that their results support "balanced aesthetic treatments to prevent overcorrection." The published summary does not give detailed statistics or eye-tracking measurements, so we cannot say how large each effect was.

How strong is this evidence?

This is a perception study, which is a useful but limited kind of evidence. It tells us how a group of viewers responded to edited photographs under controlled conditions. It does not tell us how real treatments performed, how safe they were or how long results lasted, because no one in the study was actually treated.

Several other limits are worth keeping in mind:

• Fifty raters is a modest number, and their cultural background shapes what they find attractive.
• Still images taken from the front do not capture how a face moves when talking, smiling or seen from the side.
• Digital edits are an approximation of over-treatment, not a reproduction of what happens in real tissue.
• We were able to review only the published summary, not the full data, so finer details may change the picture.

Even so, the direction of the findings fits what many clinicians observe in practice: changes that disrupt the natural shape of the eyes, or that stack up across several regions at once, are more likely to look "done."

What it means for you

The most practical lesson is that the goal of injectable treatment is usually harmony, not maximum change in any single feature. A face is read as a whole. When one area is pushed too far, or when several modest changes add up, the overall impression can shift in ways the person may not notice in the mirror day to day.

The eye findings are especially relevant. The area around the eyes is where viewers often focus first, so even small distortions in brow or eye shape can stand out. Cautious dosing, careful placement and a willingness to under-treat at first are reasonable responses to that.

The lip result is also worth noting. Modest lip enhancement did not harm attractiveness in this study, but it did not dramatically improve it either. That supports a measured approach rather than chasing volume. Our article on avoiding an overfilled look explains how filler can build up over years and why periodic photo reviews help.

Finally, it is fine to decide that no treatment, or less treatment, is the right choice. Good skin care, sun protection and patience can be just as sensible as another appointment.

Questions to ask at your consultation

• Which one or two changes would make the biggest difference to how my face looks overall?
• How will we judge whether I have reached a natural result, and when would you recommend stopping?
• Can we compare my photos from today with photos taken a year or more ago?
• If I have had filler before, is there any reason to wait, reduce or dissolve before adding more?

Frequently asked questions

Does this mean injectables always look unnatural?

No. The study tested exaggerated changes on purpose. It suggests that over-correction tends to backfire, not that conservative treatment does. Results vary from person to person, and a careful plan aims to keep your features recognisably your own.

Why might I not notice that I look over-treated?

People adapt quickly to their own reflection, and gradual changes are hard to see from day to day. Standardised photos taken over months or years give a more honest comparison, which is why many physician-led clinics take them at every visit.

Is eye-tracking research used to plan individual treatments?

Not directly. Eye-tracking is a research tool that helps explain how people look at faces in general. Your own plan should still be based on an in-person assessment of your anatomy, how your face moves and what you hope to change.

If you are weighing whether a small change, a pause or no treatment is right for you, the team at HealthPark Medical Aesthetics in Sydney is happy to talk it through with you at a consultation, with the aim of keeping any result balanced and natural.

Source

Kempa J, Kasielska-Trojan A, Antoszewski B, Rohrich RJ, Lim TS, Cotofana MV, Alfertshofer M, Cotofana S. Measuring the effects of facial regional changes following excessive aesthetic treatments: a survey and eye-tracking-based investigation. Journal of Plastic, Reconstructive & Aesthetic Surgery, 2025. Read the study