Why does my lip filler keep migrating & is there anything to prevent it happening?

Question

I’ve had my lip filler dissolved 6 times now (ouch!) and been to 5 different cosmetic injectors for filler, all with different techniques, but every single time - my top lip filler migrates into a mustache. Is there ANYTHING I can do to prevent this from continually happening?

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. Experiencing persistent migration of lip filler into the mustache area, despite multiple attempts with different injectors and techniques, can be frustrating and challenging. Several factors may contribute to this issue. First, the anatomical structure of your lip and surrounding tissue may make it more prone to filler migration. If the filler is placed too superficially or too close to the lip border, it might migrate into adjacent areas, such as the mustache region. Additionally, variations in injector technique and the type of filler used can impact how well the filler integrates and stays in place. To address this problem, I recommend using a thicker, more cohesive filler specifically designed for the lips, which is less likely to migrate. Proper injection technique, including careful placement and avoiding overfilling, can also help. Additionally, I suggest using cannulas rather than needles for a more controlled placement. If migration continues to be an issue, exploring alternative treatments such as lip augmentation with structural fat grafting might be beneficial, as it could offer a more stable and long-term solution. I hope this helps and best of luck!

Anna Chacon, MD, FAAD · Answer

Lip filler migration can indeed be a challenging and frustrating issue. Here are some insights and tips that might help:

Injector Expertise: The skill and experience of the injector play a crucial role in preventing filler migration. Seek out a highly qualified and experienced injector who specializes in lip fillers and has a deep understanding of facial anatomy.

Type of Filler: Different fillers have different properties. Some are more prone to migration than others. Discuss with your injector about using a filler that is less likely to migrate, such as those with a firmer consistency.

Technique and Placement: Proper technique and precise placement of the filler are essential. The filler should be placed in the correct anatomical plane and not too superficially. Ensure your injector uses a technique that minimizes the risk of migration.

Volume of Filler: Overfilling can increase the risk of migration. Sometimes, using a smaller amount of filler might reduce this risk. Gradual enhancement over multiple sessions might be a better approach.

Post-Treatment Care: Following post-treatment care instructions is vital. Avoid excessive movement, pressure, or manipulation of the lips immediately after the procedure. This can help the filler to set properly and reduce the risk of migration.

Individual Anatomy: Your unique anatomy might contribute to the migration of the filler. Discuss any anatomical considerations with your injector to tailor the treatment plan to your specific needs.

Alternative Treatments: If filler migration continues to be a problem despite all precautions, you might want to consider alternative treatments for lip enhancement, such as a lip lift or fat grafting. These options might offer different benefits and risks.

For a comprehensive evaluation and personalized advice, I recommend consulting with a board-certified dermatologist or plastic surgeon who can assess your situation and suggest the best course of action.

Best regards,

Mats Hagstrom, MD (license on probation) · Answer

Personally, I do not believe that fillers migrate.
I’ve been injecting fillers since the 1990s and have never seen a case of fillers migrating.
The concept of fillers migrating is in my opinion at poor excuse for poorly done work.
Individuals with thin upper lips need to have conservative treatments to not look natural.
Without seeing pictures, we can’t begin to make an assessment.
Provider selection is by far the most important variable.
Consider more conservative volumes in the future. You can always increase the amount on the next treatment. 
Best,
Mats Hagstrom MD

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