Lip Filler Migration Query. Is this caused by 'empty pockets' above my lip? (Photo)

Question

I’ve had lip filler done by two different practitioners over the past 3 years. Both times the filler has migrated above my lip and I’ve had to have it dissolved. I have been told by my current practitioner that as my lips had migrated before, I now have ‘empty pockets’ above my lip, which makes it much easier for filler to migrate, hence why it’s migrated a second time. Is this the case? She’s suggested that she just inject the lip but not the boarder of lips until they have healed.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  You do not have empty pockets above your lips but rather either the type of injections provided, or the amount of filler placed resulted in the filler reaching above your lip border.  Hope this helps.

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

Kenneth D. Steinsapir, MD · Answer

Work with an injector who uses a higher G prime filler like Restylane. Most lip fill is done by mediocre injector. They like runny filler like Juvederm and Belotero. These are less likely to form bumps but much more likely to migrate causing your issue.

Mats Hagstrom, MD (license on probation) · Answer

I do not agree with your providers assessment.

In 30 years of injecting various fillers I’ve never seen the filler migration. It is in my opinion an excuse for poor techniques or treatments that didn’t turn out the way the provider I had hoped for.

Fillers don’t migrate.

Fillers do not create empty spaces and having fillers in one area doesn’t create fillers nearby to go to that area.

I suggest you focus your efforts on finding the most experienced provider in your area and let that person do what they do best.

Talented experienced providers take ownership of their work and when it doesn’t turn out correctly they don’t blame it on the product or the patient.

Best,

Mats Hagstrom MD

Lip Filler Migration Query. Is this caused by 'empty pockets' above my lip? (Photo)

Answers (4)

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