40 years old, previous lip filler 3 years ago. Left side of mouth is weird - lip filler migration? (Photo)

Question

Im 40 years old. I’ve had quite a bit of lip filler over the years, but none for the past 3 years. I had HIFU on my lower face & jawline 6 months ago .I know my lips are overfilled, as I have a shelf. But that deep smile line & sharp upturned lip corner only appeared in the past month. It looks so weird. The right side of my mouth looks normal. What can I do about it?? The HIFU successfully reduced jawline fat & tightened my jawline. Could it be related to that deep crease and weird smile line? I just want the left side of my mouth / smile to be the same as the right side.

Yasemin Aydinli, MD · Answer

Thank you for sharing your story &mdash; this is a very understandable concern. What you are describing sounds multifactorial. Old lip filler can persist far longer than advertised, and when it migrates above the lip border it creates the "shelf" you mention. At the same time, HIFU treatments reduce fat and tighten tissue, and when the lower face deflates or tightens slightly unevenly, pre-existing asymmetries that were previously camouflaged can suddenly become visible. The timing you describe &mdash; a new crease and upturned corner appearing months after HIFU &mdash; fits this pattern.
My usual recommendation in this situation is to start by simplifying the picture: have the residual lip filler dissolved with hyaluronidase. This removes the migrated product, eliminates the shelf, and lets us see your true baseline anatomy. Dissolving is quick, low-risk, and often improves the perioral contours by itself. Once the tissues have settled for a few weeks, the remaining asymmetry can be assessed accurately and treated precisely &mdash; whether that means a small, conservative refill placed correctly within the lip, a drop of filler to support the corner of the mouth, or a tiny amount of neuromodulator if a depressor muscle is pulling that corner down.
I would advise against adding more filler on top of the current situation, as that tends to compound the problem. An in-person assessment (including watching your smile dynamically) would allow a precise diagnosis, but the dissolve-first approach is almost always the right opening move here.

40 years old, previous lip filler 3 years ago. Left side of mouth is weird - lip filler migration? (Photo)

Answers (1)

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