Is my lip filler unevenly distributed, and what can be done to make it more evenly distributed? (Photo)

Question

I have had lip filler with 0.8 ml, primarily in my upper lip to make it fuller and remove my natural aging wrinkles. I still find it unevenly distributed, especially at the top, and my aging wrinkles are very visible. My provider says I just need to give it time to integrate, but I don't think it has improved. Would you consider this a good result yourselves, and what are the options for making it look nicer? Should it be dissolved, or can more lip filler be added to make it more even?

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your concern so clearly. After 0.8 mL of filler placed primarily in the upper lip, it is understandable that you are paying close attention to symmetry and texture, especially since your goals were more upper-lip fullness and softening of vertical aging lines.

From your photo and description, I do think there appears to be some mild unevenness in the upper lip, particularly along the upper border (vermillion border) where one side looks slightly fuller or more projected than the other. I would describe it as subtle asymmetry rather than a severe or obviously misplaced filler result.

About the “Integration” Explanation

Your provider is correct that lip filler can look uneven during the first 1–2 weeks because of swelling, firmness, and temporary water retention. However, if it has been several weeks or longer and you feel that the appearance has not improved, then it is reasonable to reassess rather than simply continue waiting indefinitely.

Why Your Vertical Lip Lines May Still Be Visible

This is a very common source of disappointment. Filling the body of the upper lip does not always erase vertical perioral lines (“smoker’s lines” or aging wrinkles). Those lines often require additional superficial treatment, such as:

very small amounts of microdroplet hyaluronic acid filler placed directly into the lines,
skin resurfacing (laser, RF microneedling, or chemical peels),
or neuromodulator treatment if muscle movement is contributing.

So the fact that the wrinkles are still visible does not necessarily mean the entire lip filler treatment failed.

Should More Filler Be Added?

Possibly—but only if the existing filler is first carefully evaluated.

If the unevenness is due to slightly insufficient volume on one side, a tiny touch-up amount (often 0.1–0.3 mL) can sometimes improve balance beautifully.

If the unevenness is caused by filler sitting too superficially, forming a ridge, or being concentrated in one area, adding more filler can actually make the asymmetry more noticeable.

Should It Be Dissolved?

Based on what you’ve described, I would not immediately jump to dissolving the entire 0.8 mL unless:

the filler feels lumpy or firm,
the border looks distorted or overfilled,
or you are unhappy with the overall shape and projection, not just the symmetry.

In many cases like yours, the best approach is selective correction rather than complete reversal.

My Honest Impression

If I were assessing this as a colleague reviewing a result, I would say:

The lips do not look dramatically overfilled.
There is mild upper-lip asymmetry, especially along the top border.
The remaining vertical lip lines are understandable given the amount and placement of filler.
I would be more inclined toward a conservative refinement or targeted touch-up than full dissolution, assuming the filler has had adequate time to settle.
A Helpful Way to Think About It

Your result does not strike me as a “bad filler result” or a true filler disaster. It looks more like a partially successful treatment that did not fully achieve your goals, particularly regarding symmetry and wrinkle softening.

The safest path is usually:

Confirm that the filler is fully settled (generally at least 2–4 weeks after treatment).
Determine whether the unevenness is from volume deficiency or product placement.
Consider either a very small balancing touch-up or selective dissolving of the fuller area, rather than dissolving everything and starting over.

I completely understand why you are questioning the result, especially when the wrinkles you wanted treated remain visible. Your concerns are valid, and the good news is that the degree of unevenness you’re describing is often quite amenable to subtle correction without having to undo the entire treatment.

Irena Karanetz, MD · Answer

Hello,
 
And thank you for the question.

You can try massaging the areas to help soften the lips.
 
If that does not help, it is possible to dissolve some small "bumps" that you feel with Hyaluronidase which is an in-office injection.
 
I hope this helps.
Best regards, Dr. Karanetz
 
Dr. Irena Karanetz
Fellowship-Trained
Board Certified Plastic Surgeon

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin. This is a great question. I highly recommend scheduling an in-person consultation in order to better assess your areas of concern and discuss an appropriate treatment plan to help achieve your aesthetic goals. Our office phone number is: (312) 944-0117. I hope this helps and best of luck!

Bao Ngoc N. Tran, MD · Answer

The filler is placed too close to the vermillion border and too superficial. I think it tends to exaggerate the upper lip wrinkles. I would recommend a deeper injection further away from the vermillion border. I personally do not inject near the oral commisure (corner of the mouth) as it’s not an anatomic injection (our lips do not have much volume at the corner). I recommend dissolving and starting over

Is my lip filler unevenly distributed, and what can be done to make it more evenly distributed? (Photo)

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