Filler migration or something else? How can I treat these bumps 8 years after having filler? (Photos)

Hello Emma,

Thank you for sharing your concern — I can completely understand how frustrating it must feel to still be dealing with filler-related bumps so many years later. It’s actually not uncommon for filler migration or residual nodules to appear even years after treatment, especially if a thicker or longer-lasting filler was used. Over time, fillers can shift slightly, become encapsulated, or form small granulomas due to the body’s response.

If dissolving with hyaluronidase hasn’t fully resolved the issue, it may be because either (1) the filler is not fully hyaluronic acid–based (and therefore resistant to dissolving), or (2) the remaining nodules are actually fibrotic tissue that developed around the filler.

There are a few possible next steps:

Ultrasound imaging can help confirm whether there’s still filler present versus scar tissue or inflammation.

If filler remains, repeat targeted hyaluronidase injections (guided by imaging) can sometimes help completely break it down.

If it’s more of a fibrotic or inflammatory reaction, a short course of topical or injected corticosteroids, or low-dose oral anti-inflammatories, may help flatten and soften the bumps.

In rare cases, minor surgical excision may be considered if the area remains firm or persistent despite all other measures.

It’s important to know that this is treatable — it just takes some patience and the right approach depending on what’s truly under the skin. With proper assessment, most people are able to achieve a smoother, more natural contour again.

You may benefit from an eccentric lip lift. This does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners. This may help you with the bumps that you are dissatisfied with. This takes 1 hour to perform under local anesthesia and costs $4,000.

Best Wishes,

Gary Horndeski, M.D.