I have a friend who is attractive and always well-groomed. She has had Botox/fillers for quite a while but recently her lips have got noticeably larger and are now just a bit weird looking and noticeably fake 
Part of me thinks she has a mirror so can see what she looks like and is clearly happy with this more pronounced ridiculous look, but then I wonder if people who have regular work often gets to this point where they can't actually see that when they've gone past the natural enhancement stage and need reining in with some honest advice. If it make a difference she is a nurse and does Botox/fillers for clients privately on the side. Should I say something or keep quiet for the sake of our friendship?