Is my lip filler migrated? (Photo)

Question

October 2021 i had filmed art filler lip.filler 1 ml and 2022 april i had top up 1.2 ml and november 2022 i had another 1 ml and since then m lips never dissolved at all seems it is heavy on my upper lips..i wonder is it migrated and what can i do fir.this ? Thank you

Kenneth D. Steinsapir, MD · Answer

Understand that many fillers are runny (marketers call them “smooth”). These products are designed and popular as lip filler because they minimize bump formation. However migration is an issue for all of them. That is the basis for the lip shelf. While it is common for lips to be treated with 2 ml of filler, it is rare for these lips to look natural. One milliliter split between the two lips is usually sufficient for lip volume without calling attention to yourself that you are getting lip filler. I very much prefer Restylane for this service. Generally I like to remove the old filler and let the tissues settle for 2 weeks before placing the new service. Less is more.

Bao Ngoc N. Tran, MD · Answer

From your pictures it does look like the filler is injected too close to the vermillion border causing the spillage and migration. A lot of the injectors these day have been favoring this style of injection to exaggerate the border and therefore size of the lips. They do look slightly over done. The upper lip is supposed to be slightly smaller than the lower lip. I would dissolve and start over.

Camille Cash, MD · Answer

It appears that the filler may have migrated causing the fullness above your lip line.  You can either wait for it to be metabolized gradually or have it dissolved using hyaluronidase.  Be sure to see an expert injector for treatment.

Mats Hagstrom, MD (license on probation) · Answer

In my clinical experience, injecting, fillers for over 25 years I’ve never seen that fillers migrate.
I don’t believe fillers migrate and the concept is a poor excuse for justifying badly done work.
From the small amount of information provided it looks like you were over treated with too much emphasis on your upper lip.
For most individuals HA fillers last for about six months.
Some individuals have persistent results that last much longer.
We don’t really know why this happens, but some individuals may have some permanence, especially after multiple use of fillers.
When people have what appears to be permanent changes, it is most likely not due to persistent, fillers still being in the body, but rather the bodies response to the treatment, especially repeat, micro, trauma, leading to inflammation and scar tissue formation.
We don’t know why some people have a persistent results that are different than other patients. You can try reversing the filler or simply wait until it dissipates on its own. 
If you’re up for having fillers in the future, consider being more selective in regards to provider choice. 
It’s not the product, it is who does the treatment and the patient’s candidacy that the determine the outcome.
Best,
Mats Hagstrom, MD

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