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

Question

I got my lips last injected a year ago. I've had 0.5 ml injected 3x over the past 5 years. I've never had a problem with migration until now. I'm hesitant about getting them dissolved due to horror stories I've heard but don't know how common it is to have undesired effects. I like the size and shape of the red part of my lips currently but hate the puffiness above my lips. Do you think that will dissolve on its own over the next 6 months or should I just get it dissolved? I had restalyne refine by the way.

Anil R. Shah, MD · Answer

It sounds like you may be seeing some mild filler migration above your upper lip a fairly common issue, especially after multiple small treatments over time.

A few things to know:

Migration usually doesn’t resolve fully on its own once the filler has settled outside the intended area, since hyaluronic acid can integrate with surrounding tissue.

Restylane Refyne typically lasts about 9–12 months, but small amounts can persist longer. If it’s been a year, some softening may still occur naturally, but the “puffiness” is unlikely to disappear completely without treatment.

Hyaluronidase dissolving reactions are generally safe when done by an experienced injector who uses conservative amounts and performs a patch test if you’re concerned about allergies. Severe complications are very rare.

If the shape and size of your actual lips still look good, you might discuss targeted partial dissolving with your injector just addressing the migrated area above the lip line while preserving your current lip volume. An experienced professional can customize this approach safely.

Anna Chacon, MD, FAAD · Answer

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

Camille Cash, MD · Answer

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.

Mats Hagstrom, MD (license on probation) · Answer

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

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

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