I like the size and shape but hate the puffiness above my lips. Should I dissolve migration or wait it out? (Photos)

Thank you for your thoughtful and detailed question. It’s completely valid to feel conflicted when considering whether to dissolve migrated lip filler, especially since you’ve had a good experience overall until now.

Based on your description:

You’ve had small amounts of 0.5 mL filler injected 3x over 5 years

Your last session was a year ago

You’ve developed puffiness above the upper lip, but the actual lip shape and size remain to your liking

You used Restylane Refyne, a hyaluronic acid (HA) filler

If you wish to dissolve the migrated filler you will want to select an experienced injector. If you wait for six months chances are the filler will start to break down and resolve your concern. Restylane Refyne typically lasts for about 12 months so you should start to see gradual improvement soon.

Fillers do not migrate.
I’ve been injecting HA fillers since they came on the market.
I’ve never seen fillers migrate.
In your case, your upper lip was simply over treated and you should’ve had your lower lip treated as well.
To get a more natural look, I generally recommend patients keep the fullness ratio of the upper and lower lips the same.
I generally never treat the upper lip without treating the lower lip. having an upper lip that’s fuller than a lower lip looks very unnatural.
If it was up to me, I would probably add some filler to your lower lip, then simply wait for the filler to dissolve.
mats Hagstrom MD