Filler migration and what to do about it

What to do about filler migration

Tuesday, July 20th 2021

Hyaluronic filler injections are very popular and aesthetic industry is booming post COVID. But unfortunately not all injections are the same and not all injection techniques deliver beautiful results.

One of the most common areas treated by injectors and thought out by patients are the lips. If you look on Instagram there are plenty of beautiful before and after results that promise luscious and plump lips. "Russian" lips pop up frequently on my Instagram feed, they do look beautiful, but unfortunately the "Russian" technique causes the most problems once swelling settles.

This beautiful patient gave me permission to share her before and after results. She came to me to get her lips done. When I examined her, I informed her that we will have to first dissolve the product in her lips which migrated. The old filler which was placed some months prior by another provider migrated above her lip creating a "ledge" and it also was injected into the mucosa-the wet border of the lip causing bumps. This unsightly bumps and bulges are something that happens with "Russian" technique where the injections are performed in perpendicular to the lip columns. The injector has to have good depth perception and control of the needle to avoid injecting the filler beyond the frame of the lips. This technique also carries the highest risk of blood vessel occlusion which can result in necrosis and scarring. The blood vessel that supplies the lip lies right where those bumps are on the mucosal surface, one wrong stick and filler would have been injected into the main artery, compromising it, this patient was truly lucky to avoid it.

Because hyaluronic acid fillers are used for injections I, at High Point Medspa have an enzyme, brand name Hylenex or Hyaluronidase which can dissolve migrated or unwanted hyaluronic acid filler. The injections are quick, but do sting a bit. The improvement is seen within 48 hours, but I suggest to wait up to 2 weeks for the final result.

After the filler was dissolved, I reinjected this patient's lips with a safer technique that avoids injections beyond lip border and she was absolutely happy with her results.

All my new patients who want to come see me at High Point Medspa and who had their lips injected previously somewhere else will be evaluated for filler migration first, prior to injecting more product, because I want all my patients to have the most beautiful lips and that starts with removal of badly placed filler.

The filler injections are offered at High Point Medspa and you can book your Free In-person Consultation through our online booking system.

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