Filler migration above lip after dissolving. Is it residual migration or scar tissue? (Photo)

Question

I've been thru 2 rounds of dissolve to address migration on top lip, including completely dissolving lips. I want to refill but still see it, especially when I press my lips together. Could it be scar tissue & more dissolving will not help? I have concerns about continuing to dissolve as I believe it's eaten some of my natural tissue & am reading stories on here about people with permanent damage from dissolving, but am worried if I refill the migration will come right back & be more obvious.

Raffy Karamanoukian, MD, FACS · Answer

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

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Filler migration above lip after dissolving. Is it residual migration or scar tissue? (Photo)

Answers (1)