Filler migration is a very “hot” topic that is gaining popularity, especially thanks to videos shared on TikTok and other social media platforms. But can this extremely rare complication affect anyone?
As of today, there are over 24 million views of the hashtag #fillermigration on TikTok. Filler migration occurs when a product injected into the skin, such as a hyaluronic filler in the lip area, shifts from its original place, resulting in unnatural distortions of the facial features. A deeper review of the available video content on the topic will lead you to clips showing exactly how the migrated fillers appear. However, if you take the time to go through the entire list of results, you will also come across videos that illustrate the breakdown of the migrated fillers and discuss the incorrect injection techniques that lead to such outcomes.
Such an experiment might leave anyone with the mistaken impression that filler migration occurs very frequently and is a widespread problem. Experts in the field share that despite the perception created by social media, filler migration is a complication that occurs relatively rarely. It is a fact that it does happen and is written about, so in this article, we will attempt to answer the question “why?”
Nowadays, the demand for filler injection services exceeds the supply because the age threshold for the beginning of their use has significantly decreased, and the number of patients is many times higher compared to ten years ago. Concurrently, there is an emergence of more and more inexperienced specialists on the market offering injection procedures. This is why today, filler migration has transformed from a very rare complication into a current topic widely discussed on social media.
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What is Filler Migration?
By definition, filler migration is the process whereby the dermal fillers shift or migrate to areas different from where they were injected. The dermal fillers are minimally invasive injections that can contain hyaluronic acid, calcium hydroxyapatite, or other ingredients that reduce the facial wrinkles and smoothen the skin. Filler migration is most commonly observed in the lip area, the prominent part of the cheeks, and around the tear duct, but it can occur in any other place where a filler has been placed.
Theoretically, any type of filler can migrate. To prevent this risk, non-surgical injection procedures must be performed by specialists who have a detailed understanding of the body anatomy.
A number of scientific studies are currently underway to investigate whether the fillers actually migrate, i.e., move within the tissues. There have been recorded cases where silicone particles from injected fillers or detached pieces from implants do migrate through tissues, including via the lymphatic flow, reaching more distant locations. Such complications occur much less frequently with hyaluronic acid.
If a lump appears near or around the injection site, it may be the result of various factors, including an incorrect injection technique, such as injecting too superficially or too quickly, which can lead to the product entering the wrong plane of tissue, into the lymphatic system, or into a blood vessel. This is usually visible immediately after the procedure or within a few days. In other cases, the properties of the filler or the appearance of the tissue may change gradually over time. This can be related to a partial breakdown of the filler or a more superficial migration due to muscle contractions, which is most often observed around the lips and in the area under the eyes. The affected area may swell and deform gradually, even years after the initial filler placement.
Why Do the Fillers Migrate?
One widely accepted explanation found in various sources and comments from professionals regarding filler migration relates to the qualifications and skills of the specialist who has performed the procedure. Not only is the injection technique crucial, but also their good judgment regarding the particular filler and the exact quantity to be used. Overfilling the area with an injection product can predispose to a subsequent migration. This most often occurs with the so-called “Russian lip technique”. We recommend that you always seek highly qualified aesthetic dermatologists or plastic surgeons for filler placements.
How to Recognise if Your Filler Has Migrated?
Before delving too deeply into analysing your face, keep in mind that the clearest and most easily recognisable sign that your filler has migrated is the presence of an unnatural bulging and fullness in a specific area. With lip fillers, for example, the upper contour and border of the upper lip become less defined, creating a depression at that spot. The mouth may take on what is known as the “duck lip” appearance. With under-eye fillers, the migration manifests as the formation of lumps under the lower eyelid and/or in the upper part of the cheeks below the eyes.
The leading dermatologists note that the swelling and the unnatural bulging in the injection areas may not necessarily indicate a filler migration, but could rather be a consequence of the chosen type of product used. For this reason, if you notice something to be seemingly off, it is extremely important to consult your dermatologist first.
How Quickly Does the Filler Migration Develop?
The approximate timeframe for the appearance of filler migration largely depends on the cause that has provoked it. If it has been triggered by an overfill of the injection area with an excessive amount of product, the migration may manifest immediately. When the filler has been injected using an incorrect technique, or when the injection sessions in the same area have been too frequent, the filler migration may become apparent after months or even years.
What to Do in the Case of a Migrated Filler?
Increasingly in the dermatologists’ practices, instead of placing the fillers in new areas, they are required to dissolve the areas where the filler has already migrated. The dissolution of the fillers is a process whereby hyaluronidase — a naturally occurring enzyme in our body — is injected into the affected area to absorb hyaluronic acid.
When the decision to dissolve a migrated filler has been made, it is crucial for the hyaluronidase to be placed in the correct location; otherwise, some long-term issues may arise. The enzyme must be injected precisely where the filler has migrated, as otherwise, it may cause a deficit in the volume of the body’s own natural hyaluronic acid. It is important to note that there are circumstances in which the filler migration cannot be corrected. These cases include the placement of liquid silicone gel. Liquid silicone gets encapsulated and can lead to the formation of nodules and granulomas that are often impossible to remove or correct.
If you proceed with the dissolution of the fillers, it is not uncommon to experience a swelling in the treated area. It is very important to trust a specialist with extensive experience for this procedure — someone you can rely on, who can answer all your questions, and who makes you feel calm and confident in the chosen treatment plan. Although the studies examining the fillers and their longevity in our bodies continue, the initial results suggest that residues and traces of the fillers can remain in our bodies for years, especially in the cases of initial overfilling with the product.
If you suspect that your fillers have migrated or want to learn more about all potential complications, we advise you to consult a dermatologist.