What do you recommend for over-filled and migrated nasolabial folds? (Photos)

looks like you have loose skin, filler cannot migrate from folds to that area. you can reverse the area but likely nothing will happen, this needs an early face or neck lift, facetite and in office maintenance with morpheus and threads. at home dermarolling would be great to start prevent wrinkles and tighten skin more.

most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift.  an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done.

For facial slimming a combination of treatments are always needed.  Options include:
1. Buccal fat pad removal to reduce fat on the lower face
2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping.
3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender
4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined

Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma.

 See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option.  Best, Dr. Emer.

Hi there! I’m Lauren, the aesthetic injector here at Colorado Plastic Surgery Center. Filler can also migrate over time. Filler can be dissolved using ultrasound-guided treatments. I would recommend scheduling an appointment with your provider to assess the area and determine the best next steps for you.

Hi @Cool4575. I recommend dissolving the filler with Hyaluronidase. In addition, I recommend Morpheus 8. Morpheus8 is a non-surgical treatment for full body skin resurfacing, skin tightening, and fat reduction of stubborn areas. It uses minimally invasive fractional radiofrequency energy (RF) to penetrate the skin deeper than other microneedling devices, triggering the skin’s natural healing response to promote skin tightening and lifting. Best of luck, Dr. Nima!

Longterm filler problems include migration, edema, and nodularity. 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 and thank you for your question! As you indicated, it is quite rare for hyaluronic acid fillers (other than Voluma) to last this long. You did not mention the exact type of filler you got 2.5 years ago, so the first step is to determine the exact type of filler and ensure it was indeed a hyaluronic acid filler, since that's the only type that can be dissolved with hyaluronidase. Additionally, you need to keep in mind that despite having fillers, the normal aging process continues and you need to exercise great caution in linking your current concerns with filler injected 2.5 years ago. If possible, comparison of serial pictures taken over the past couple of years combined with detailed physical examination by your experienced cosmetic doctor should help. This is very important as you do not want to subject yourself to unnecessary (and potentially harmful) injections unless your doctor can determine that your issues are indeed caused by residual fillers. I hope it helps and good luck!

Thank you for your pictures and questions. I also answered another one of your questions! In regards to the question of the migrated filler, the easiest thing to do is dissolve it and start fresh. If you inject the dissolver and it goes away, then it was residual filler. If it does not change, then it is something else that needs to be evaluated. My guess would be that what you are seeing is aging related changes rather that migrated filler, but that is just a guess. Make sure you see a plastic surgeon who is board certified by the American Board of Plastic Surgery.

All the best!

Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

If the filler used was a hyaluronic acid, then it can be dissolved, even after 2.5 years. I would go back to the same provider and have them take a look to see if it is in fact still there. If it is, then yes, you can still dissolve it!

Nasolabial Folds often form because of loss of volume in the tear trough area and the malar eminence. Adding volume to these areas with dermal fillers will help correct these folds. If you've been filled before in the nasolabial folds and are unhappy with the puffiness, that can be easily corrected with hyaluronidase if the material placed was of hyaluronic acid nature. Good luck with your search from Boston, Dr. Onir

Hello and thank you for your question. Filler migration can occur due to improper placement of the fille causing it to track down. Hyaluronidase can dissolve this filler very quickly in about four hours. Please ensure that this service is provided by an experienced physician.

Yes try jowls HA filler dissolvers in a few sessions @$500/session. Or might recommend mini FL to tighten your jowls. Best to seek only in person consultations with boarded PSs. .