New vein or migrated filler? (Photo)

Question

wonder what to do? For past months i havr this new bulge that looks like it may be a vein? injector doesnt seem to think dissolving the filler will help. Any advise to get rid of this? Filler has been there for almost 2 years. Thanks!

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your photos — I completely understand your concern, especially since changes like this can be frustrating after several months or years of filler.

Based on your description, the raised area could be due to one of a few possibilities:

Prominent vein or vascular visibility: Over time, filler can compress nearby tissue, making superficial veins more noticeable, especially in thinner skin areas like around the mouth.

Filler migration or encapsulation: Occasionally, filler that’s been in place for over a year can shift slightly, forming a small lump or ridge. Even though it may look bluish like a vein, it can sometimes be residual product.

Localized swelling or fibrosis: Long-standing filler can sometimes cause mild tissue thickening or firmness that becomes more visible with changes in lighting or facial movement.

If your injector doesn’t believe dissolving with hyaluronidase will help, that’s likely because it’s not behaving like typical migrated filler. However, a few gentle, non-invasive options might help:

Vascular laser (like Excel V or Nd:YAG) to reduce visible veins.

Radiofrequency microneedling or Gentle massage to improve local texture and lymphatic flow.

Ultrasound evaluation (e.g., with a Clarius device) can help determine whether there’s filler present or just a vein — this is often the most accurate way to guide treatment.

If it turns out to be migrated filler, a small, precisely placed dose of hyaluronidase can still be used to dissolve it safely. If it’s a true vein, laser treatment or even leaving it alone (if not bothersome) may be best.

You’re doing the right thing by asking before jumping into dissolving — a careful evaluation with imaging or a second opinion from an experienced injector would help decide the safest next step.

Falguni Patel, MD, FACOG · Answer

Hi Stephanie, 
An in-person consult would be needed here to give you an exact answer, however I have seen this before with lip fillers. Sometimes the tissue above the lip is a little thin or weak and the filler can disperse into that space and give that appearance. It may be worth dissolving to see if it makes a difference or removes that lump. If you decide to refill your lip, I recommend using a filler that is softer and natural and build your volume up slowly over time.

John Michael Thomassen, MD · Answer

This may be a line from filler injected close to the dermis or in the dermis.  Gentle massage on the lip daily should improve this line.  If not you can try dissolving with hyaluronidase.

Camille Cash, MD · Answer

If you had your filler treatment almost two years ago it would be unusual for filler to migrate at this time.  If there is filler present you can consider dissolving it with hyaluronidase which will help if the remaining filler is causing the superficial vein to be more noticeable.

New vein or migrated filler? (Photo)

Answers (4)

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