Perioral mounds - could this be from filler migration? (Photos)

Question

Three years ago, I had lip and nasolabial filler injections approximately three or four times. About a year ago, I began noticing progressive bumps or fullness in the cheek and perioral mound area, which seem to be getting worse over time. When I touch the area, it feels like a thicker layer — possibly fat or migrated filler — but I am not sure. My questions are: could this be due to filler migration, and what are the possible treatment options to reduce or eliminate these perioral mounds? I am 40 Years old.

Homeira Izadi, MD · Answer

Hi dear,These are very common finding when we start losing collagen and the fat comes to this area due to gravity. Most likely these are your own fat migrating from top to the bottom but in order to make sure it is fat ( which you can remove by injecting Kybella) you can have an ultrasound that easily differentiates between these two conditions. If it is the old filler as long as it was a hyaluronic acid filler, you can easily remove it with hylenex enzyme. Another option is Fotona facelift to tighten and minimize those bumps.

Ebru Soylemez, MD · Answer

Yes, your symptoms may be related to previous dermal filler treatments, especially when they appear years after injection.
The most important first step is an ultrasound evaluation. Ultrasound allows us to determine whether filler material is still present, its exact location, and whether the fullness is due to residual filler, migration, or tissue-related changes.
If hyaluronic acid (HA) filler is identified, dissolving it with hyaluronidase is the safest and most appropriate first step. This can help reduce unwanted volume and restore a more natural contour.
Any further filler treatment should only be considered after proper correction and full assessment of the area.

Anna Chacon, MD, FAAD · Answer

Hi, thank you for sharing your history and your concerns so clearly. What you’re describing — progressive fullness or bumps in the cheek and perioral area years after filler injections — can sometimes be related to filler migration, especially if multiple treatments were done over time. However, other possibilities include natural changes in fat distribution, subtle swelling from previous procedures, or even fibrous tissue forming in response to filler.

Filler migration typically occurs gradually and can create areas of lumpiness or uneven fullness. It’s not uncommon for it to appear months to years after the injections, particularly in areas that have been treated multiple times.

Regarding treatment options, several approaches can help reduce or smooth these mounds, depending on the underlying cause:

Hyaluronidase injections (if the filler is hyaluronic acid) can dissolve migrated or excess filler.

Manual massage or gentle remodeling techniques can sometimes redistribute filler, though results vary.

Non-invasive treatments like energy-based devices may help improve tissue texture or mild fullness due to fat.

In some cases, targeted surgical or minimally invasive procedures are considered if the fullness is due to fat or fibrous tissue rather than filler.

Because the cause can be a mix of factors, identifying whether it’s migrated filler versus natural tissue changes is key to choosing the most effective treatment.

It’s understandable to feel frustrated when changes appear years after treatment. Knowing the exact cause really helps in deciding which approach will give you the smoothest, most natural-looking outcome.

Perioral mounds - could this be from filler migration? (Photos)

Answers (3)

More Dermal Fillers Questions

Filler or Botox for undereyes - can I expect good results? (Photo)

What type of filler/collagen stimulator should I get and where is it to be applied? (Photos)

Lichen Planus on my body - are facial fillers safe?

Reaction to hyaluronidase - is there anything else that can be used to dissolve filler?

52, male, premature aging. Filler/other options for fat loss/aged skin? HARMONY CA? (Photo)

Male, 23 - Marionette lines only on one side. How can I fix this? (Photos)

WE SEND PRETTY
EMAILS