Should you be afraid of lip filler migration?

If there’s one thing that prevents my patients from enjoying the multiple benefits lip fillers offer, it’s the fear of filler migration. I understand why lip filler treatments are under so much scrutiny lately – the number of TikTok videos about lip filler migration or the “filler mustache” demonstrates what can happen in the hands of inexperienced injectors. However, when an expert injector performs the treatment, the risk of filler migration is exceedingly low. 

If you are worried about undergoing lip fillers due to concerns about possible migration, this information should ease your fears and help you make the right decision for yourself.

What is lip filler migration?

Lip filler migration is the process of dermal fillers spreading or migrating to areas beyond the vermillion border (the demarcation between the exposed pink/red margin of the lip and the adjacent normal skin) This process leads to the appearance of over-injected “duck” lips. Additionally, filler migration makes the lips look unnatural with:

  • Bumps and lumps
  • Lack of a defined border
  • Puffy upper lip
  • Misshapen lips
  • Puckering

How often does lip filler migrate?

While social media may make lip filler migration seem like a common occurrence (its hashtag on TikTok has 36M views), it is a rare complication. What these TikTok videos show is that it is not impossible. Too much lip filler migration largely depends on the injection technique, choosing the right dermal filler, and your injector.

What causes migration?

The most common reasons why fillers migrate include:

  • Incorrect Filler Placement – Lip filler migration can occur when injections are placed too close together. When not spaced properly, the filler can cause the lip tissue to be filled too quickly, forcing the product to migrate. In addition, creating multiple punctures on the lip border is like having a garden hose with multiple small holes that cause leakage. When there is a leak, the filler migrates away from the injection site. The number of punctures, depth of filler placement, and type of needles used are necessary for a successful treatment outcome.
  • Poor Injection Technique – Fillers must be injected in a controlled and gradual manner. Injecting it too quickly can create pressure on the treatment area, increasing the chances of migration. Your provider must also have a thorough understanding of facial anatomy to know the right depth of placement since different fillers are designed to be injected at specific depths within the skin.
  • Over-Injecting – Injecting too much filler into the lips stretches them out to accommodate the extra volume. Since the tissue is forcefully stretched and cannot hold all the product, the filler spreads into the neighboring areas and causes the appearance of “duck lips” or a “filler mustache.”
  • Wrong Filler – Not all fillers are created equal, and the wrong product can allow the filler to move beyond the injected area. HA fillers like Restylane® Kysse, Juvederm® Volbella, and RHA fillers are all designed specifically for lip augmentation, and your provider must be able to select the right one based on your needs and goals. Smoother formulations with smaller molecules tend to produce the best results in sensitive areas like the lips.
  • Inflammation – There can be temporary inflammation or swelling at the injection site, which is a natural response when a foreign substance is introduced to the body. The skin tissue reaction causes the filler to move and spread. Inflammation may also be a reaction to the filler and in rare circumstances, an autoimmune response. 

3 signs your lip filler migrated

Lip filler migration is visibly noticeable. It can present in the following ways:

  • A lip that looks rolled – The rolled appearance reduces lip border definition in the upper or lower lip.
  • Puffy lip – Overfilled lips create a “ducky” appearance, and the shadow it casts on the upper lip can make you look like you have a mustache.
  • Induration – Swelling after treatment can cause soft tissue in the treatment area to become thick and hard. Lips appear firm and rubbery, as though they will pop when stuck with a needle. 

Where to treat a migrated lip filler in Charlotte, NC?

Migrated lip filler can be treated with hyaluronidase, an enzyme that breaks down HA gels. Patients who opt to dissolve their filler and undergo additional treatments need to go slow to avoid overfilling again. More importantly, choosing experienced injectors is the best way to ensure an optimal outcome.

As a double board-certified facial plastic surgeon who focuses 100% on cosmetic treatments for the face, I lead Carolina Facial Plastics in Charlotte, NC. My experienced team of certified injectors includes board-certified physician assistants, Heather Bryant PA-C and Amanda Piligian PA-C, and board-certified nurse practitioner, Courtney Whitley FNP-C

All are experts in administering lip fillers, helping our Charlotte, NC patients safely achieve their desired aesthetic goals with results that are beautiful and natural-looking. We use a microcannula instead of a needle to inject the lips in most cases, which ensures a more even distribution of the filler and reduces bruising and swelling after treatment. To learn more about the different types of facial fillers and how they can rejuvenate your appearance, contact Carolina Facial Plastics to schedule a consultation or book your appointment online.

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