Dents after lip filer. What is the best course of action? (Photo)

Question

Different practitioner advised different things to fix the dents that appeared at the corner of my mouth after a lip filler. They didn't even agree on whether or not the filler migrated... One said I *must* dissolve, as fillers never really reabsorb (?? I had no idea!) One said I can wait it out, then redo with better placement. One said that I can just have some filler placed in the dents, and I'll be fine. I want to choose the best course of action. But which one is it?

Anna Chacon, MD, FAAD · Answer

Dealing with complications from lip fillers, such as the dents you described, can indeed be challenging and requires careful consideration. Here are some steps and factors to consider when deciding on the best course of action:

### 1. **Assessment by an Experienced Practitioner**
   - **Consultation:** Seek a consultation with a highly experienced and reputable practitioner, preferably one who specializes in corrective procedures for dermal fillers. They can provide a thorough assessment of your lips and the filler placement.

### 2. **Understanding the Nature of the Issue**
   - **Filler Migration:** Determine if the filler has migrated. Migration can cause unevenness and dents. An experienced practitioner can usually assess this through physical examination and possibly imaging (such as ultrasound).
   - **Filler Type:** Know what type of filler was used. Hyaluronic acid (HA) fillers, for example, can be dissolved with hyaluronidase, whereas other types may require different approaches.

### 3. **Options for Correction**
   - **Dissolving the Filler:** If the filler has migrated or is causing significant issues, dissolving it with hyaluronidase is often the recommended course. This allows for a fresh start and can help avoid further complications.
     - **Pros:** Quick resolution of the problem, ability to start anew.
     - **Cons:** Temporary period without filler, potential need for multiple sessions to fully dissolve the filler.
   - **Waiting It Out:** Some practitioners might suggest that you wait for the filler to naturally reabsorb. However, this can take several months to over a year, depending on the type and amount of filler used.
     - **Pros:** Non-invasive, no immediate intervention required.
     - **Cons:** Prolonged period of dissatisfaction with appearance, potential for the filler not to fully reabsorb.
   - **Additional Filler:** Placing more filler to correct the dents might be suggested. This can be effective if the issue is minor and the practitioner is skilled at achieving a balanced look.
     - **Pros:** Quick fix, minimal downtime.
     - **Cons:** Risk of overfilling, potential for further complications if not done precisely.

### 4. **Making an Informed Decision**
   - **Second Opinion:** If you are getting conflicting advice, consider seeking a second or even third opinion from other highly qualified practitioners.
   - **Research:** Look into the credentials and reviews of the practitioners you are consulting. Experienced professionals with a good track record in corrective procedures are more likely to provide a satisfactory outcome.

### 5. **Post-Procedure Care**
   - **Follow-Up:** Ensure you have a follow-up plan with your chosen practitioner. This includes monitoring the results and addressing any further issues promptly.
   - **Aftercare:** Follow all aftercare instructions provided by your practitioner to minimize the risk of complications and ensure the best possible outcome.

Given the complexity of your situation and the differing opinions, the safest and most effective course of action is often to dissolve the current filler and start anew. This approach minimizes the risk of further complications and allows for a more precise and aesthetically pleasing result. However, this decision should be made in consultation with a highly experienced and reputable practitioner who can provide a tailored plan based on your specific needs and circumstances.

Sheryl D. Clark, MD, FAAD · Answer

Hello Petalo:

In the photos I can see that you definitely have migration of filler from the upper lip into the white cutaneous lip, causing the dents you notice. This can occur when too much filler in injected, which appears to be the case. I would advise that you have some of that filler dissolved. Your lips will look more natural and the dents should go away,

Please choose an advanced injector with many years of experience with lip fillers.

I hope this is helpful!

All the best from NYC,
Sheryl Clark MD, FAAD

Leonard Grossman, MD · Answer

The indents you’re referring to were not created by the lip filler. They’re a result of two things, the way your muscles are constructed around the lips as well as the aging process of the face. With your thinking face, yet  beautiful structure, I would recommend that you undergo fat grafting rather than a facelift, which will make you look considerably more youthful and just like yourself some 20 years ago. The indents can be corrected with fillers as well as a little bit of help from Botox. Hope this helps some good luck from Leonard Grossman M. D. Organic Plastic Surgery

Dents after lip filer. What is the best course of action? (Photo)

Answers (3)

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