On March 29, Meredith West, a physician assistant with a Master of Science and 15 years of experience in plastic surgery and injectables, shared a joint reel with Mountcastle Medical Spa, a Virginia-based medical spa, on her Instagram profile.

Ryan and Eva’s “before and after” photos in the film seemed to show a dramatic change in their physical appearance, with the married couple appearing somewhat “puffier” than they had in the past.

“I assume they’ve both had recent cosmetic procedures,” Meredith captioned the Reel.

“I think Eva might have had facial surgery (possibly a facelift +/- fat grafting), and they both probably had Botox and facial fillers,” the spokesperson said in her explanation.

The most popular type of injectable fillers are made of hyaluronic acid

According to the NHS, botulinum toxin injections, like Botox, relax the facial muscles to minimize wrinkles and lines like frown lines and crow’s feet.

Overuse of both Botox and fillers can lead to negative effects. According to Nurse Gemavie, overdosing on Botox can lead to excessive muscle weakness, which can cause problems with facial expression and lead to an unnatural appearance.

According to dermatologist Jessica Weiser, “we see a good amount of [overdone filler], unfortunately,” Allure reported in March 2023. “That classic pillow-face appearance—very puffy with strange anatomic proportions” is how it appears.

While a myriad of factors contribute to the condition, poor judgment on the part of select injectors is, no doubt, a root cause, Allure reported.

“I think they both looked amazing before and didn’t need anything other than a little preventative toxin and maybe some biostim (i.e., Sculptra) for collagen stimulation,” Meredith said in the caption of her hypothetical Ryan-Eva cosmetic procedure reel.

Of course, medical-grade skincare products, including CO2, radiofrequency, laser, and microneedling for upkeep and prevention, are all included.

Aesthetics physician Jonny Betteridge is among the medical professionals who have commented on the Barbie star’s physical transformation.

In a Reel that was uploaded on March 28 and garnered 2.2 million views, Jonny talked about the actor, 43, and how his face has changed over time.

“He’s always had very masculine-looking features, well-structured, cheekbones, a squared, jawline, and a wide chin,” the doctor admitted as he analyzed Ryan’s pictures from earlier years.

Dr. Parsa conducted a volumetric analysis to measure a 33-year-old patient’s fillers

Jonny continued: “The certain part of his face which is very characteristic of his appearance and that’s this mid-face flatness.

“Again, you can see this here where the face has a sunken-like appearance.

“Most patients that I see for dermal filler treatments need some form of mid-face restoration and I carry that out by placing dermal filler in these four points.

“Aiming to restore the cheekbone structure and restoring volume.”

The aesthetics expert continued by saying that the Canadian native’s appearance has become more “overfilled” in recent years.

“It’s clear to see the change in his facial proportions and the fullness to his mid-face and cheeks,” Jonny said. “This is further exacerbated [by] dynamic movement of the face when someone smiles, and this appearance is classic of what I see when someone’s had too much filler put in this area.”

One person said, “Me and my fillers panicking [right now].”