Two year old filler - are these lumps filler migration? How can this be fixed? (Photo)

The nodules may be due to filler migration. However, nodular granulomas and scar tissue formation are somewhat more likely in my opinion. For this kind of adverse reactions, I have had gratifying results in treating individuals who have come to me from elsewhere using an algorithm of varying combinations, concentrations, and amounts of intralesional anti-inflammatory injections to shrink the nodules. You would be wise to consult with an experienced, board certified cosmetic dermatologist. Hope this helps and best of luck.

Lip bumps this long after filler injections is usually granulomas or scar tissue if the filler was silicone or fat injections. Hyaluronic acid would be long gone by now. Intralesional kenalog diluted into the nodules would help resolve them nicely but may need 2-3 injections done 3-4 weeks apart at a cost of roughly $150 per session.

Lumps that develop or persist years after lip filler treatment can be due to several factors. In many cases, these represent residual filler material that has not fully broken down. Hyaluronic acid fillers typically dissolve within 6–18 months, but in some people they can last longer, especially if higher volumes were placed or if the product integrated deeply.

Other possibilities include:

Filler migration – when the product moves slightly from the original injection site, creating unevenness or palpable bumps.

Nodules or fibrosis – scar-like tissue that can form around the filler.

Natural lip gland or tissue irregularities – which may feel more noticeable after filler.

Treatment options may include:

Hyaluronidase injections – an enzyme that can dissolve hyaluronic acid-based fillers quickly if the product is still present.

Massage or conservative management – sometimes recommended for minor lumps.

Surgical removal – rarely needed, but an option for firm nodules not responsive to hyaluronidase.

A careful in-person evaluation is required to distinguish between residual filler and scar tissue, but in many cases, hyaluronidase can significantly improve or resolve lumps even years later if filler material remains.

The lumps that are illustrated in your photo could be from superficial filler or granulomas. Since your treatment was two years ago it is more likely the latter. If it is superficial filler than injecting hyaluronidase should dissolve it and improve the appearance. If they are granulomas then an injection of steroid should help them shrink. See an expert injector near you for an evaluation.

Filler migration is a term coined by Doctors, who are not qualified to inject people with fillers. Still immigration is something that is used as an excuse for a poorly performed injection. Fillers do not have feet and cannot migrate. When someone has an unusual collection of a filler in any given spot where it is not wanted, it is there because it was injected there. The filler in your lips was probably notice to be there from the point when the swelling had gone down. The good news is that you don’t necessarily have to do anything about it because it is not visible unless you turn your lip inside out. If it truly bothers you, however, you could have a dissolve with a small amount of hyaluronate. I hope this helps and good luck from ?leonardgrossman?, MD, organic Plastic Surgery, New York City.