Lip filler migration? (Photo)

Question

Been getting lip filler for almost 3 years now, originally had 2 syringes of ultra plus over time to get a look I loved. RN injector suggested volbella for longer wear, had 1/2 syringe of that & my lips have never been the same, lost the lifted peaks and started looking saggy, especially droopy in the center. RN dissolved center of lips, worked our way back up with 2x1/2 of ultra plus. Now im still finding my outer corners saggy and lumpy, especially behind my upper lip. What can be done?

Raffy Karamanoukian, MD, FACS · Answer

Filler migration, swelling, and granulomas can cause significant discomfort and cosmetic ramifications. Our office specializes in the use of enzymes and filler reversal techniques without hyaluronidase to help improve the results of botched cosmetic fillers, whether caused by Juvederm, Restylane, or foreign fillers. Our plastic surgery institute provides expertise in filler removal. We begin by examining the facial fillers and assessing the likelihood of fluctuance or liquid volumization. If appropriate, we use Hylenex, or other filler reversal agents to reduce swelling and filler migration. Hylenex can be targeted into the areas of concern using multiple layered injection techniques. If the filler does not completely resolve, then additional concentrations may be employed. The technique has the potential to reduce the filler and may slightly impact normal hyaluronic acid. Treatments are repeated and results can improve immediately and with time.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jonathan Kulbersh, MD · Answer

This may be due to filler placement, but it's unlikely the filler migrated. However, I'm also not sure when you had your last injections. There may still be some swelling impacting your results. I recommend following up with your injector about your concerns. Hope this helps.

Sheryl D. Clark, MD, FAAD · Answer

Hello from NYC to Canada!:

In your 3rd and 4th photos, one can see some filler about the vermillion border of your upper lip. We call this filler migration, and it happens when lips are overfilled, especially with certain fillers. The other photos show loss of the normal lip contours, and upward and forward projection especially of the upper lip, beyond what is ideal when an imaginary line is dropped from the tip of your nose toward your chin.

In many areas of life, when some is good, there is a tendency to think more is better, but even Goldilocks learned that this is not usually the case. Just ask any balloon!

Spa 35 - Boise · Answer

It appears your lips are overfilled. I would return to your injector (or another experienced injector) to have it dissolved and start fresh. Often if they get overfilled you lose the definition of the upper lip. Good luck, I hope this helps!

Lip filler migration? (Photo)

Answers (4)

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