Is this lip filler migration? (Photos)

Question

I’ve been getting lip fillers since May 2021, we started with a half syringe of versa, then 6 months later we did a full syringe of versa and it was PERFECT, they looked so even and natural! Another 6 months later we did less than half of versa in my lips. This was 3 months ago. I’ve noticed my lips now look different then they did before but I can’t tell if this migration or not. My injector is extremely reputable and this hasn’t happened before

Jonathan Kulbersh, MD · Answer

Hello, and thank you for providing images along with your question. Your puffy upper lip and lack of defined vermilion border appear to be symptoms of lip filler migration. You can either wait for the filler to break down or dissolve the excess with hyaluronidase. Whichever you decide, it is still important to revisit your provider to inform them about the migration. You may need to decrease the filler you need or try a new filler for your next treatment.

It is essential to seek treatments from expert injectors that have the knowledge and experience to produce the best results. They know the best products to use, how much to use, and have the training to perform the most advanced injection techniques to ensure the best possible outcome.

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

Nima Shemirani, MD · Answer

Hi @BeautyisPain96! This appears to be filler migration. This can be dissolved with Hylenex. I recommending dissolving and starting with a fresh canvas. Restylane Kysse works great for the lips. Hope this was helpful!

Michael A. Persky, MD · Answer

HiB,

Yes, you have some migration of filler from your red lip up into your white lip.  See your injector for treatment to dissolve the misplaced filler.  Good luck and be well.

Michael Persky, MD
Encino, CA

Eric M. Joseph, MD · Answer

Your results may be more consistent with overcorrection rather than upward migration. You can discuss with your doctor options moving forward, such as observation, vs. dissolving enzyme, vs. dilute steroid injection. I hope this is helpful. Dr Joseph

Mona Khurana, MD · Answer

Hi BeautyisPain96
Yes, indeed, I think you are absolutely right about this being filler migration. Certainly this can happen to just about anyone, even in the hands of an experienced injector. I think this is a capacity issue. Your lips have only so much volume they can take before the filler starts to move or migrate out side of the lip line.This is easy to fix with small volumes of hyaluronidase (the enzyme that dissolves filler). I usually try to approach this with a minimal amount of the dissolving fluid on the outer margins of the migrated product. This way, we can try to maintain your beautiful lip shape and improve the appearance of the migration.
Thanks Dr. Mona Khurana

Darryl J. Blinski, MD · Answer

Yes. Nicely posted series of photos btw. I would inject HA dissolver into areas of migration in few low dose sessions. Best to virtual consult with....

Is this lip filler migration? (Photos)

Answers (7)

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