Is my lower lip filler migrated? Should I have it dissolved? (Photos)

Question

Hello, I had a modest amount of Juvaderm injected in my lower lip by a medical professional. I’m afraid its migrated, but have given it time since the injection to see if it settles. My provider says no migration, but the online community says yes. I’d love to get other medical professionals’ opinion and if it is migration, should I try and get it dissolved or wait? Thank you for any insight you can provide.

Anna Chacon, MD, FAAD · Answer

It’s understandable to be concerned when the area doesn’t look quite the way you expected, especially after you’ve given the filler time to settle. With lip filler, what looks like migration in a photograph can sometimes be swelling, the natural anatomy of the lip, uneven placement, or simply the way the filler is sitting within the tissue. True filler migration can occur, but it’s difficult to confirm from photos alone.

Since you had Juvéderm, which is a hyaluronic acid filler, it can be dissolved with hyaluronidase if there is a confirmed problem. However, I would not recommend dissolving it simply because there is a possibility of migration. Hyaluronidase can also affect desirable filler in the area, so it is better to first determine exactly where the filler is and whether it is actually responsible for the appearance.

If there is uncertainty, high-resolution ultrasound can be very helpful. It can identify the location and extent of hyaluronic acid filler and distinguish filler-related changes from other causes of swelling or contour irregularity.

My general approach would be: don't rush to dissolve it based solely on what you see online. If your treating provider feels there is no migration, that is reassuring, but if you remain concerned, an examination—and, when appropriate, ultrasound—can give you a much clearer answer before deciding whether any filler should be dissolved.

If you develop significant pain, unusual blanching or discoloration of the skin, or sudden changes after filler, that is different and should be evaluated urgently because vascular complications, although uncommon, require prompt treatment.

Kally Papantoniou, MD, FAAD · Answer

It is difficult to determine migration from photos alone, especially soon after treatment. Swelling and firmness are common after Juvederm and can take a couple of weeks or longer to fully resolve.

If you are otherwise healing normally, I would give it time to settle and continue following up with your injector. If the shape still bothers you once everything has healed, you can then discuss whether a small amount of dissolving is appropriate.

Is my lower lip filler migrated? Should I have it dissolved? (Photos)

Answers (2)

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