Our Worst Nightmare About Filler Migrations Comes to Life 

By: Nurse Injector Michelle Le – Rejuvenation, Burnaby

“Filler migration” especially for lip fillers, has been a trending topic on various social media platforms such as TikTok and Instagram. With users claiming their face fillers have moved from their original location, it brings up a lot of questions for people looking into cosmetic injections. If you are considering fillers but are concerned about their safety, this blog is for you!

What is Filler Migration? 

Filler migration is a term that refers to when a facial filler is injected into one place but moves to another. However, when this does happen, cosmetics fillers do not migrate from one area of the body to another. In fact, they stay within a few millimetres of the same anatomical regions where it was injected. 

Where Can This Effect Be Seen?

Whilst migration is mainly spoken about in terms of lip fillers, migration can happen anywhere that dermal filler is injected. This includes the under eyes/tear trough, jawline, and cheeks. Let’s talk about the most common migration, lips. If your lip filler has migrated, it will almost always be visually noticeable. This can be presented in many ways, from a puffy upper lip to a lack of a defined border between the lip edge, or above and below the lip border. Essentially it can create lumps or bumps that can prevent your lips from closing properly.

What Causes Filler Migrations? 

Lip filler migration is becoming more and more common. Filler migration can occur due to several reasons, including:

  1. Inappropriate injection technique
  2. Overfilling
  3. Improper placement
  4. Wrong product choice
  5. Muscle activity

Did you know lip filler is injected relatively superficially? Unlike high-density chin, jawline, or cheek filler that is injected onto the bone, low-density lip filler is injected into the soft tissue of the lips. If too much product has been placed, then there’s no more space in the lip for it to go, so it goes upwards beyond the vermillion border into the upper lip and perioral area. This will make the lips start to look heavy and chunky, giving it that “lip filler mustache” or protruding “duck look”. 

The reality is the lip is a muscle. The main muscle involved is called the orbicularis oris. This is a circular muscle that surrounds the mouth and acts as a sphincter to contract and relax the lips and perioral area. The natural, repetitive movement of this muscle in combination with the low density of lip filler is what can cause migration. If you think about it, we use our lips to talk, eat, smile, and so on. Your mouth moves more than any other area of your face and so over time, this recurrent movement of the orbicularis oris and facial expression muscles can pull filler from the lips into the surrounding tissue.

Are Filler Migrations Treatable?

The good news is that face filler migrations are completely treatable. All injectors carry a product called hyaluronidase that dissolves hyaluronic acid fillers. It works by breaking up the bonds that hold the Hyaluronic Acid molecules (the filler) together. Once the filler has been dissolved, we recommend waiting around two weeks until the filler has all been removed and then the lips can be re-filled. Hyaluronidase is also kept on hand for emergencies such as vascular occlusion (a rare but very serious complication that happens when filler blocks a blood vessel). Depending on the degree of migration and the amount of product in place, you can expect at least one session of dissolving for full resolution. 

Taking Care of Your Cosmetic Injections

It is important to remember that some localized swelling is expected after a filler treatment and should resolve on its own. We advise our patients to wait 2 weeks after their initial filler injection to allow time for any swelling to subside and for the filler to settle into the skin. To avoid migration, don’t manipulate the area for at least 1-month post-injection, don’t add more filler too quickly, and make sure you go to a qualified, skilled provider. 

As a Certified Nurse Injector with 7 years of medical aesthetics experience, I prefer natural-looking results that can be built up gradually to get the best results. It is a good idea to do your research and pick the right injector to make sure they know exactly what your aesthetic goals are. If you’re looking for a cosmetic consultation, please do not hesitate to stop by our dermatology clinic in Burnaby. We’re always happy to help!

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