Juvederm in marionette lines 5 years ago - do I have filler migration? (Photo)

Hello, my name is Dr. Burko and I am a Plastic Surgeon at SY Aesthetics in NYC. Typically, the effect of fillers lasts 6-12 months. Your injections were 5 years ago, so I would think that the filler is gone by now. The only way I can make an accurate judgement is by seeing it in person so that I can also feel with palpation. My recommendation is for you to see a trained plastic surgeon who can make an assessment and offer you their best treatment plan.

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

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Thank you for sharing your question and posting your photo. The area you are concerned with does not look like filler. That comes from aging. It’s possibly that the filler was hiding part of that region but has now dissolved. You could repeat your treatment. Make an appointment with an experienced board-certified oculofacial surgeon.
Good luck,

Although an examination would tell more, it is unlikely that the areas in the photograph is filler migration. It appears more likely that you are showing early signs of aging with some laxity and possibly buccal fat pad protrusion. Although injections can somewhat mask these issues I would recommend seeing a board certified facial plastic surgeon or plastic surgeon who can preform an in person exam and offer you options for treatment.

Plain Juvederm is an ordinary, simple HA filler best reserved for treating shallow wrinkles and fine lines; more robust HA fillers, such as Juvederm Voluma XC, for example, are used to replace volume, as well as lift and elevate and smooth deeper folds. So, five years for plain Juvederm, whose effects typically last for between six to eight months, to be hanging around all this time would be unusual to say the least. More likely, the five years that have past have given given rise to time-related volume loss and gravitational effects that account for the newer issues delineated in the photos. You would be wise to consult a board certified cosmetic dermatologist injector. Best of luck.

Juvederm typically lasts 12 months or so, which would make it unlikely that you are noticing filler migration 5 years later. I encourage you to visit with an experienced injector near you for an evaluation. If it is indeed filler you can elect to have it dissolved with hyaluronidase.