Fillers can swell and migrate unpredictably, especially when a filler with a high-edema quotient is used in thin areas. Our office uses disciplined approaches to help patients with acute or chronic issues related to hyaluronic acid fillers. We begin by assessing for any tissue compromise and advocate early treatment to avoid complications with vascular occlusion. In chronic issues, it is important to gradually break up and dissolve filler so there is no further migration of loose filler substrate. Conservative staged dilution may also help avoid volume loss. If the filler is not dissolving, we may consider stronger concentrations or surgery.
