These are questions I get asked regularly, and 60% of the time the answer is yes your dermal filler has migrated, and no your lip filler outcome is not normal.
Unfortunately in the industry today, some dermal fillers used, whether this be due to cost for the injector, hence larger profit margins and or publicity of the brand, are known to cause some issues over months or years post treatment. The ability for the dermal filler to migrate is determined by the attributes the product has, the abilities the injector possesses and the amount of dermal filler used. Dermal fillers vary between brands and products within each brand.
The most common fillers today are products that contain substances similar to Hyaluronic acid. Hyaluronic acid (HA) is a natural substance found in the body.
HA dermal fillers consist of long chains of hyaluronic acid. Most dermal filler products will consist of HA cross-linked with a chemical such as 1,4-butanedioldiglycidyl ether (BDDE) for Restylane, Belotero and Juvéderm, divinyl sulfone (DVX) for Hylaform, 1,2,7,8-diepoxyoctane (DEO) for Puragen, and suspended in a physiological or phosphate-buffered solution.18 The product is then processed as a homogeneous gel or a suspension of particles in gel carriers.
The way in which HA fillers are manufactured/ produced has given rise to differences in properties in fillers. For example variability between the degree of cross-linkage, particle size and concentration within each product. These properties are vital in determining the clinical performance of the filler.
So when you look at the properties each product has, it can become apparent which products are more likely to cause migration later on.
What is migration?
Migration can mean a number of things in the aesthetic industry. When we refer to migration and lip fillers, this can present a number of ways, from a puffy upper lip, to the lack of a defined border between the lip edge and above and/or below the lip border.
Can I get more lip filler if I have migration?
In theory yes, however you may not get the desired look you are after. At L1P we advise a consultation so Dr Ranjbar can determine the extent of the migration. In some instances it would be advisable to either dissolve fully or try to pinpoint where to dissolve.
Will migrated filler go away on its own?
In theory yes, but due to the dermal filler being in the wrong compartment this may take several months to years to degrade enough to enable visualisation of a clear lip border again.
View our article on a clients journey in needing to dissolving her lips and the problems she has faced with her lip Fillers.
Yeom J, Bhang SH, Kim B-S, Seo MS, Hwang EJ, Cho IH, et al. Effect of cross-linking reagents for hyaluronic acid hydrogel dermal fillers on tissue augmentation and regeneration. Bioconjug Chem. (2010) Feb;21(2):240–7.