• Dr. Carin Litani

Perception Drift

Did you ever wonder why some people go too far with their cosmetic treatments? To the point that they are almost unrecognizable? We see these people all around us…on TV, in magazines, in spin class and all over instagram! This phenomenon is very real and is known as perception drift.


This happens when your brain adjusts to your improved face after a cosmetic procedure and the new face becomes baseline. Your brain looks for more flaws to correct, adjusts to the new baseline, and the cycle continues until your new face is no longer yours! I strongly believe that more is not necessarily better and I always take pre-procedure photos and review them to show appreciation for the improvement and encourage stopping or delaying further treatments. I advocate facial rebalancing to bring back those youthful proportions rather than erasing lines. Chasing lines and inflating folds creates all sorts of unnatural proportions and just makes one look weird. I love when a patient tells me their friends (and mother!) asked if they changed their makeup or hairstyle rather than identified where filler or botox was placed.

Remember when Courtney Cox started looking odd? She freely admitted she went too far and felt better when she dissolved all her filler and started fresh with the goal of looking the best version of herself at her current age.


We can’t turn back time but we can embrace aging and roll with it. We need to start early with skincare, sun protection, and a healthy diet. Women start losing bony support of their face at the age of 25! (later for men of course) It becomes more noticeable at the age of 35. So consider starting fillers around that time, between 25-35. You won’t need much and no one will know you did anything but you will feel better and you’ll notice there won’t be a difference in photos over 10 years as you keep up yearly-ish minor treatments.


Everyone ages differently depending on genetics, facial structure, sun exposure, smoking history, occupational hazards, etc. I know some women that should start treating their glabella lines (the "elevens" between the eyebrows) in their early twenties while some women do not even need treatment in their 40s. Your dermatologist (or plastic / ENT / oculoplastic surgeon; point is a physician that trained in facial anatomy and cosmetic procedures over the years long course of their medical education and training ) knows when it’s appropriate to start and should freely say “no” and “enough” to avoid a “Courtney Cox effect;” otherwise known as perception drift.