Do fillers migrate but never fully go away?

Question

I recently have seen videos and heard from several plastic surgeons that filler never fully goes away, it just migrates, especially if it is not under bone. Should a filler patient be concerned that this will eventually cause jowling and sagging?

Monica Boen, MD · Answer

When fillers are injected by a board-certified doctor who has extensive training in the treatment, they will not migrate. Hyaluronic acid fillers, which are the most common, contain hyaluronic acid that dissolves over time. The fillers do not remain in the dermal structure, which is why you must repeat your treatments at regular intervals to maintain your results. Regular use of these products does not lead to skin sagging when performed properly. Make sure you are working with a qualified injector and these risks will not be a concern.

Jason Emer, MD · Answer

Thank you for your question, botox results last up to 3 to 4 months and can be softened with Venus Legacy and Thermage treatments. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Kenneth Hughes, MD · Answer

Fillers should not migrate downwards after injection due to gravity.  Therefore you should not be worried about jowling and sagging if you use a board certified plastic surgeon or dermatologist for injection.   If aggressive massage is performed in the first few days following injection, sagging may be possible.Hyaluronic acid gel fillers such as Restylane, Juvederm, etc. will dissolve over time; that's the reason for having to time your injections at the midpoint of their duration, which varies from one filler to another.

Philip S. Schoenfeld, MD, FACS · Answer

When injected properly and with appropriate post procedure instructions your filler once place should not migrate.  In terms of longevity of filler, each filler has variable time periods where the filler is still present.  In most cases filler will dissolve to almost imperceptible levels and certainly not accumulate enough to lead to jowling or sagging.

Eric M. Joseph, MD · Answer

In our experience with microdroplet Silikon-1000, there has been no incidences of migration. Migration of filler may occur if your doctor injects a very large volume with each puncture. Properly administered fillers do not lead to jowling and sagging. Thank you. Dr Joseph

Michael I. Echavez, MD · Answer

There are many different types of fillers and they last different lengths of time.  Many fillers do go away over time, but some of them do remain.  If fillers are placed correctly, they should not migrate or cause jowling or sagging.

Louis W. Apostolakis, MD · Answer

This all depends on what filler is used.  The vast majority of fillers used are made of something called hyaluronic acid (HA).  Juvederm and Restylane are the two most common brands of HA.  These products will dissolve in time and will not lead to jowling or sagging.  HA doesn't migrate, you can "push out" the edges with massage early on, but it won't altogether move to a different location.  HA fillers can be dissolved on purpose when using a product to dissolved it (hyluronidase).  The dissolving is very quick in this case taking only hours.  Otherwise, HA fillers last from weeks to a few years depending on the location, the patient's genetics, and filler brand chosen.  Other fillers are permanent and, in my opinion, should be avoided.  Silicone is an example.  It is legal in the US because of its usefulness in treating detached retinas.  People (doctor and other) use silicone "off-label" for cosmetic injections despite a history of complications and FDA warnings against its use in that manner.  My recommendation is to stick with using HA fillers and a doctor who is talented at injecting them.  HA fillers produce tremendous results for quite a number of problems.  A reputable injector will know what sort of results you can expect with your specific concerns.  The key is to select your battles, some problems can be treated with great success, others not so much.  An honest injector will steer you away from treatments that are not likely to succeed so you can focus your efforts on successful treatments.

Camille Cash, MD · Answer

If injected properly fillers should not migrate.  Longevity of the filler will vary by product, but regardless it should not cause sagging or increase in the jowls.  See an expert injector near you to learn more.

Robert L. Kraft, MD, FACS · Answer

Fillers, if injected properly, do not migrate.   Some residual filler can remain well beyond the expected duration but this would not cause jowling. Best wishes.

Leonard Grossman, MD · Answer

When a plastic surgeon uses a proper filler and a proper injection technique, the filler should not migrate under any conditions. The only place where this does not apply is in the lower eyelid area where there's absolutely no or very little soft tissue to accommodate the filler and the orbicularis oculi muscle tends to push the implant towards the area of least pressure which is close to the nose. This is the reason why fillers should be done by plastic surgeons and people who know the facial anatomy very well and not in a salons or by doctors who have absolutely no connection to the aesthetics and facial region. I hope this helps and good luck from New York City plastic surgery

Do fillers migrate but never fully go away?

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