Lip filler creating weird bulge below lip - Is it scar tissue? More migrated filler? Inflammation? (Photos)

Hi! Thank you for sharing your concern so thoroughly and including photos—it really helps to understand what’s going on.

From your description, a few things could be contributing to the bulge below your lip:

Scar Tissue / Fibrosis:
Repeated filler injections, dissolving, and re-injections can sometimes lead to scar tissue forming under the skin.

This can create a firm or irregular area that doesn’t fully resolve even after the filler is dissolved.

Residual or Migrated Filler:
Even small amounts of filler that remain after dissolving can sometimes migrate slightly or settle in an unusual way, especially in areas of frequent movement like the lips.

Inflammation / Swelling:
Chronic low-grade inflammation from repeated injections or minor reactions can contribute to persistent lumps or unevenness.

Given that this has happened consistently over many years and doesn’t fully resolve after dissolving, scar tissue or fibrosis is a likely component, sometimes combined with residual filler.

This is a tricky area because the lips are very mobile, and repeated injections can change the tissue architecture over time. It may not be possible to completely “reset” the tissue, but careful assessment by an experienced injector can help soften the area or redistribute filler more evenly if desired.

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. It sounds like you're experiencing a persistent issue with filler migration or possible scar tissue formation. Over time, repeated lip filler injections can sometimes lead to changes in the underlying tissue, either from filler migration (where the product moves from its intended placement) or the formation of fibrous tissue from the repeated injections, which might cause that bulge below your lip. It could also be a combination of both, as filler placed too close to the muscle or not injected evenly can migrate or cause an uneven result. Inflammation from the filler or an allergic reaction could also contribute to the problem, though less likely if it happens every time.

what we can observe, it looks like there is a noticeable line or bulge just below the lower lip border. This appearance is actually quite common in patients who have had repeated lip filler treatments over the years. In many cases, this happens because older filler may not have fully dissolved, even if it seems like it has. With each new session, small amounts of filler can migrate or accumulate in the same area, creating a subtle bulge or firmness under the lip. Sometimes mild fibrosis can also form after multiple injections or dissolving sessions, which contributes to the appearance. The good news is that this is usually manageable. A proper assessment can help determine whether the issue is: residual filler, migrated product, fibrosis, or mild inflammation. Based on this, your practitioner can plan the most suitable approach whether that’s gentle dissolving, waiting for the tissue to settle, adjusting the technique for future fillers, or combining the treatment with small doses of Botox to reduce pressure from surrounding muscles