2 deep lines above lip remain after lip filler - how best to remediate it? (Photo)

Question

In April, I had just under a syringe of RHA2 injected into my lips. Afterwards, I noticed 2 very deep lines above and next to the left side of my lip. Upon informing the injector of the issue, she attempted to fill the lines with filler. I had her dissolve them thereafter as they created noticeable lumps. Fast forward to now, and the deep lines remain. Would love any feedback as to what the point of causation could have been and how best to remediate it! Thanks in advance! :)

Anna Chacon, MD, FAAD · Answer

Thank you for your thoughtful question and detailed history.

The appearance of deep lines above the upper lip, particularly after filler treatment, can result from a few contributing factors:

Possible Causes:
Pre-existing volume loss or dermal thinning: These lines may have already existed subtly and became more apparent after the surrounding area was volumized.

Technique-related: When filler is placed in the lips, it can occasionally highlight surrounding areas (like the perioral region), making untreated lines appear deeper by contrast.

Filler migration or overcorrection: If the filler placed into the lines formed visible lumps, it may not have been the ideal product or technique for that particular location.

Skin laxity or movement: The perioral region is highly mobile, and repeated muscle movement can etch lines that are resistant to simple volumization.

Treatment Options:
Microneedling with radiofrequency (RF): This helps improve collagen remodeling and skin texture in fine-lined areas.

Fractional or ablative laser resurfacing: CO₂ or erbium lasers can reduce the depth of etched lines and improve overall skin quality.

Botulinum toxin (in small doses): A "lip flip" or micro-dosing can reduce dynamic movement that contributes to these

Falguni Patel, MD, FACOG · Answer

Hello,

Sometimes after lip filler, due to swelling, small lines can appear around the lip until the swelling goes down. If the lines remain, I would suggest doing something like a chemical peel or microneedling treatment to help resurface the skin and help diminish the appearance of these fine lines to smooth out the skin.

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. It sounds like you’ve had a challenging experience with your lip filler treatment. The deep lines that developed after your initial injection could be attributed to several factors, such as uneven filler placement, migration of the filler, or a reaction of the skin to the filler. When the injector tried to correct the issue by adding more filler, it may have resulted in lumps or an uneven appearance, which was then addressed by dissolving the filler. Despite this, the persistence of deep lines suggests that the underlying issue might not have been fully resolved. It’s possible that the filler caused some distortion in the lip tissue or that there was an inherent structural issue that wasn’t fully addressed. To remediate the situation, it would be best to consult with a different experienced practitioner who can assess your lips and recommend appropriate treatments. They might suggest options such as additional filler adjustments, skin resurfacing procedures, or even non-invasive treatments to smooth out the lines and restore a more even appearance. I hope this helps and best of luck!

Mats Hagstrom, MD (license on probation) · Answer

My best guess is that there was some subtle facial crease in this area previously that was accentuated by the use of the fillers guide.
These are notoriously difficult to treat.
They usually form the result of skin redundancy due to contraction of muscles of facial expression combined with loss of skin elasticity due to age and to some degree sun damage.
These are difficult to reverse.
Careful injection of very small amounts of filler directly into the skin increase can help, but unfortunately often a bulge appearance.
Derma, abrasion, laser treatments, and the use of Botox may be attempted, but none of these are really all that great.
Botox should probably be avoided around the mouth.
These may not go away and they may get worse overtime.
Let all the filler wear off and see what your baseline is.
Would be helpful to have comparison pictures of before you had filler injections.
Best,
Mats Hagstrom MD

2 deep lines above lip remain after lip filler - how best to remediate it? (Photo)

Answers (4)

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