One side of lips won’t hold filler - what are my options? (Photo)

Question

Fore the past year every time I get my lips filled, regardless of which filler I use or how they inject it one side, almost completely dissolves or migrates. Any advice?

Anna Chacon, MD, FAAD · Answer

It can definitely be frustrating when one side of your lips seems to behave differently, especially if you've tried different fillers and different injection techniques with the same result.

From what you've described, there are a few possible explanations.

One of the most common is natural facial asymmetry. Almost everyone has differences between the right and left sides of the face. One side of the mouth may be more active when you talk, smile, or chew, which can cause filler to break down or shift more quickly over time.

Another possibility is that what appears to be the filler "dissolving" is actually migration or movement. If the tissue on one side is looser or has a different anatomy, the filler may spread rather than stay where it was originally placed, making that side appear to lose volume even though the product is still present.

Scar tissue from a previous procedure, trauma, or even repeated filler treatments can also affect how filler integrates into the tissue. In some cases, old filler that hasn't completely dissolved can alter the way new filler settles.

Looking at your photo, there does appear to be some asymmetry, but it's difficult to determine from a single image whether the issue is true volume loss, migration, or simply differences in your natural lip anatomy.

If migration has occurred repeatedly, adding more filler isn't always the best solution. Sometimes it's more effective to dissolve any misplaced filler first and then start fresh with a conservative approach. In other cases, using a different injection plane, placing smaller amounts over multiple sessions, or selecting a filler with different structural properties can produce a more balanced result.

The encouraging part is that this is usually a treatable problem, but the solution isn't necessarily more filler. Understanding why one side behaves differently is the key to achieving a more even, natural-looking result.

Yasemin Aydinli, MD · Answer

When one side repeatedly "loses" filler regardless of product or injector, the usual culprits are stronger muscle activity on that side, faster local metabolism, or migration due to previous filler layers. Reasonable options: dissolve everything with hyaluronidase, allow 4–6 weeks reset, then re-inject with a firmer, more cohesive HA product in small aliquots; a tiny dose of botulinum toxin to the overactive side can also reduce displacement forces.

One side of lips won’t hold filler - what are my options? (Photo)

Answers (2)

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