Filler in smile lines gone wrong. How can I fix this? (Photo)

Hi @XrayMe93. You can dissolve the unwanted filler with Hyaluronidase. I recommend seeking treatments from expert injectors who have the skill and experience to precisely inject fillers into treatment areas and avoid risks and complications. Best of luck, Dr. Nima!

Filler migration and permanence is a very common problem because there are many different types of HA fillers on the market and each is specified for a specific part of the face. Use of highly cohesive fillers on thin skin may cause swelling and nodularity. If patients have filler migration or nodules, we recommend a combination approach of filler reversal with enzymes Hylenex and Hyaluronidase in different strengths to dissolve the filler. We may also need to add Kenalog to the mix in order to reduce fibrous tissue. If the filler does not dissolve, it either means the filler is not HA material or we need more enzyme. The HA reversal can be combined with other lasers and skin treatments at the same time, and it usually (usually) does not affect adjacent tissue.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Hi, from your photos, it looks like you have developed some creases that Are engraved into the skin where your natural dimples are. The best way to address this is to inject a diluted hyaluronic acid filler very superficially into the creases. I have found that the best products to use are: Restylane, Versa or Belotero. The trick is to use the version of these products that do not have lidocaine premixed in them. I like to mix in my own lidocaine to thin the product out so that it does not leave a bump. It's a pretty simple fix if done correctly.