What can I d about lip filler that's migrated over last 2 years? (Photos)

Question

I had lip filler for years and noticed over the last 2 years its migrated. When I go to the person who has been filling it she now just uses botox to flip it. I hate it, don't know what to do.

Raffy Karamanoukian, MD, FACS · Answer

Longterm filler problems include migration, edema, and nodularity. Filler migration and permanence is a very common problem because there are many different types of HA fillers on the market and each is specified for a specific part of the face. Use of highly cohesive fillers on thin skin may cause swelling and nodularity. If patients have filler migration or nodules, we recommend a combination approach of filler reversal with enzymes Hylenex and Hyaluronidase in different strengths to dissolve the filler. We may also need to add Kenalog to the mix in order to reduce fibrous tissue. If the filler does not dissolve, it either means the filler is not HA material or we need more enzyme. The HA reversal can be combined with other lasers and skin treatments at the same time, and it usually (usually) does not affect adjacent tissue.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your question and posting your photo. The filler can simply be dissolved and the lips refilled appropriately. Make an appointment with an oculofacial surgeon for proper guidance. Good luck,

Nelson Lee Novick, MD · Answer

If the unwanted filler is a hyaluronic acid-based (HA) filler, then hyaluronidase can be used to dissolved the unwanted filler after which you would be wise to consult with a board certified, cosmetic dermatologist to discuss retreating your lips. These days, with a number of fillers available specifically for use in and around the lips achieving natural, more youthful lips with the appropriate proportions between the upper and lower ones is certainly achievable. The proper choice of filler and the appropriate injection technique are extremely important for minimizing unsatisfactory results and filler migration. Hope this helps. Best of luck.

Terry Loong, MBBS, MRCS - Account Suspended · Answer

Hi Nikgab11, 
Sorry to hear you no longer like the look of your lips. The lip dermal filler which have migrated can still be dissolved with hyalase. It would be helpful to have pictures of your lips before any dermal filler treatment was done so we can gauge how much and where to use the hyalase. Once the swelling from treatment has settled, you can then review it to see if you're happy with the end result or seek another practitioner who has a different approach to lip treatment. Hope this helps. 
Dr Terry

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