Restalyne Defyne injected in lips 9 months ago - has it migrated? Will it resolve on its own? (photos)

Question

I was last injected with Restalyne Defyne on 10/7/2021. I now have what looks like filler mitigation. I've attached photos. Is this in fact filler mitigation? If so, does this resolve on its own? Thank you so much

Michael A. Persky, MD · Answer

Hi Marie,
Restylane Defyne is a filler of expression, it is excellent for the areas around the mouth because it spreads and integrates into the surrounding tissue.   It is not a filler that I would reccommend in lips.  Whether to dissolve it with hyaluronidase depends on how much it bothers you.  I would consult with an expert injector if you choose to have it dissolved.  Feel free to contact me for a virtual consult should you have further questions or concerns.  Good luck and be well.  
Michael Persky, MD
Encino, CA

Nick Slenkovich, MD · Answer

Hi, I’m Lauren, the aesthetic injector at Colorado Plastic Surgery Center. I recommend starting with a consultation to evaluate the area and determine whether your filler has migrated. If migration is confirmed, it can typically be dissolved using hyaluronidase.

Anil R. Shah, MD · Answer

Hi Marie117,

I am Sarah, a medical assistant at Aesthetic Skin MD with Dr. Anil Shah in Chicago, and I would love to give you specific advice, but this situation is tough. It is hard to tell if your filler has migrated maybe slightly in the lower lip if anything. I would revisit your original provider to seek their advice. If your filler has migrated, the next step would be to be to get the filler dissolved with hyaluronidase then wait a week or two to get more filler. For any reason if you do not feel comfortable seeing your original provider, our providers specialize and perform these types of injection treatments daily and would be happy to set up a virtual appointment to discuss the matter with you.

Raffy Karamanoukian, MD, FACS · Answer

Filler migration, swelling, and granulomas can cause significant discomfort and cosmetic ramifications. Our office specializes in the use of enzymes and filler reversal techniques without hyaluronidase to help improve the results of botched cosmetic fillers, whether caused by Juvederm, Restylane, or foreign fillers. Our plastic surgery institute provides expertise in filler removal. We begin by examining the facial fillers and assessing the likelihood of fluctuance or liquid volumization. If appropriate, we use Hylenex, or other filler reversal agents to reduce swelling and filler migration. Hylenex can be targeted into the areas of concern using multiple layered injection techniques. If the filler does not completely resolve, then additional concentrations may be employed. The technique has the potential to reduce the filler and may slightly impact normal hyaluronic acid. Treatments are repeated and results can improve immediately and with time.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Nima Shemirani, MD · Answer

Hi @Marie117! This unfortunately does look like filler migration. The filler will break down eventually, but if you are bothered by it, you can go to an expert injector and they can administer Hylenex into the area of migration. Best of luck!

Marc Polacco, MD · Answer

Thank you for your question. It does look like filler migration. If the area feels somewhat firm, that would be the best way to tell. The filler will break down eventually, but if you're concerned about it, a dissolving agent can be used in the region of migration. I hope that's helpful, and I wish you all the best.
-Dr. P

Inessa Fishman, MD · Answer

Filler migration doesn't usually resolve on its own, as hyaluronic acid filler sticks around for a long time in the body, even in highly mobile areas like the lips and mouth.  It may be best to go back to your injector, review your before-treatment photos, and craft a treatment plan based on this information.  Best of luck!

Darryl J. Blinski, MD · Answer

Appears in photos as ? HA filler migration. Best to be seen in person or virtually. But why not return to injecting  MD/NP to have it dissolved with HA filler dissolver???

Restalyne Defyne injected in lips 9 months ago - has it migrated? Will it resolve on its own? (photos)

Answers (8)

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