How common is it for lip filler to migrate into the philtrum? Does it reflect poor technique or bad luck?

Question

I'm interested in getting Restalyne lip filler. But I'm concerned about the potential side effect of having the lip filler unintentionally shift into the philtrum. How common is it for lip filler to migrate into the philtrum? Does it reflect poor technique or bad luck?

Michael A. Persky, MD · Answer

Hi Red,Not to worry, properly placed filler in your lip will not migrate into your philtrim, at least in 25 years of lip injection experience I have never seen it in any of my patients.  As with any aesthetic procedure, choosing your treating physician is your most important task.  Good luck and be well.Dr. PEncino, CA

Nelson Lee Novick, MD · Answer

I have been injecting lips and the surrounding areas for over three decades since the early days with the original Zyderm & Zyplast collagen fillers. Nowadays, hyaluronic acid fillers are available to augment the body of the red lips; better define the vermilion borders and to create or enhance the philtrum. Each being a different region typically requires a different filler made for that region. In the case of the red lips I typically choose Juvederm Ultra Plus XC for the body of the lips in my NY practice and Saypha Volume for this purpose in my Israel satellite facility, where a far greater number of regulatory agency approved fillers and volumizers are available. Properly injected into the body of lips, these products stay there until they are eventually metabolized away naturally typically over the course of a year's time. Filler migration into the surrounding areas, including the philtrum would be quite unusual. What I can say is that it is very important to do your due diligence when vetting a potential injector. You would be wise to make certain that you are consulting with a board certified aesthetic physician and that you insist upon seeing his/her personal before and after photos before agreeing to proceed. In a recent survey conducted by the American Society of Dermatologic Surgery of its members,  it was found that "Of all the complications encountered in the past two years, the majority reported that the percentage of complications seen in their practice attributed to medical spas ranged from 61% to 100%." And "the most commonly cited treatments resulting in complications were fillers..."-- with the survey specifically noting "misplacement of product." You might consider having the philtral filler dissolved with hyaluronidase after which your lips may be appropriately treated. Wishing the best of luck.

Daniel Barrett, MD · Answer

Dear redringpop5,
I typically use Juvederm for my lip sculpting. There are two main focuses of lip injections, adding volume and actually sculpting the shape. Both involve injecting the filler in different areas of the lips and patterns.
I would recommend finding a plastic surgeon to perform you lip injections. Most of my patients have results that last at least 6 months.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Dmitriy Schwarzburg, MD · Answer

When injected properly, lip filler should not migrate into the philtrum, unless the injection was in the philtrum itself as part of the treatment goal. Make sure you go to the doctor who personally injects and has done a lot of injections with excellent results.

Camille Cash, MD · Answer

Lip fillers that are properly placed should not migrate.  It is important to select an experienced injector for your treatment.  Be sure to discuss your goals for how you would like your lips enhanced.

Alain Michon, MD · Answer

As with any procedures, risks are possible. Filler migration is fairly uncommon. This can be from many different factors, including your own skin, the type of filler used and tissue integration, technique used etc.,. Hyaluronidase  can be used to correct filler migration or other complications associated with dermal fillers. I recommend seeing an expert. All the best, Dr.Michon

Robert T. Buchanan, MD (retired) · Answer

When properly injected by an expert, there is almost no chance of filler migration. Where the filler is placed depends on the reason for injection and the anatomy of the lips. A lot of this is determined by age. In the young, injection is usually to the body of the lips to simply increase volume evenly. In older individuals, injection is to replace volume that has been lost. This not only includes the body of the lips but the vermillion border and the philtrum. Make sure you see an expert and discuss your desires at length.

How common is it for lip filler to migrate into the philtrum? Does it reflect poor technique or bad luck?

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