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Does filler migrate as much as TikTok would have us believe?

We asked Etre Vous Expert Dr Ioannis Liakas to set the record straight, and his answer might surprise you

With a staggering 67 million views on TikTok, you’d be forgiven for thinking dermal filler migration is a very normal (though unfortunate) part of any injectable journey. Yet, as many experts will tell you, it’s far from common. In fact, it’s something that shouldn’t be happening nearly as much as social media has led us to believe. Here’s everything you need to know about filler migration, including what to look out for and what to do about it.

What is filler migration? 

First things first, what exactly is filler migration? In short, it’s one of the side effects of injectables and occurs “when the dermal filler spreads or migrates to another region separate from the area in which the injection was placed,” explains Dr Ioannis Liakas, Medical Director at Vie Aesthetics. The most common place for this to happen is the lips and can result in lumps and bumps in areas where you shouldn’t be seeing volume.

Despite how it may sound, when filler migrates, it’s not actually travelling far — but far enough for the results to be less than favourable. “Typically, the lip filler migrates just beyond the border of the lip, which is called the vermillion border; this normally happens in the top lip, but sometimes the bottom lip can be affected too,” Dr Liakas notes. You may be more prone to migration if you have a very thin upper lip or cupid’s bow.

Although lip filler migration isn’t common, the exact rate at which it happens is somewhat of a mystery to experts. This is especially true when regulations surrounding injectables are still so lacking.

Why does filler migrate? 

Filler migrates for a few reasons; understanding these can help you be better informed and empowered to ask questions prior to your appointment and during aftercare.

Improper application technique: 
First and foremost, if your filler has been injected incorrectly, it is more likely to migrate. “Administering lip filler is a form of art and certain techniques are more likely to result in migration than others,” says Dr Liakas. “An injection technique that uses fewer incisions, and thus creating less ‘holes’, will be less likely to result in migration; creating fewer punctures on the border of the lip is always the cleanest and best technique,” he adds. Sometimes, this can mean that the filler hasn’t really migrated, but was simply injected incorrectly.

An overfilled area:
Alongside poor injection technique is overfilling an area. “It is true that when regions of the lips and skin are overfilled with dermal filler, migration can take place,” Dr Liakas says. This overflow of filler can leak into other areas of the face, leading to a result that wasn’t intended.

Dr Liakas explains that a lot of clinics price filler treatments per syringe and sometimes more than one syringe is injected in a single appointment. This can lead to issues if the individual and their starting point isn’t considered, and their treatment plan isn’t adjusted to meet their specific needs. Often the best results come from smaller volumes of filler injected strategically.

The type of filler being used:
Lastly, the type of filler being administered is important when it comes to the likelihood of filler migration. “Practitioners are able to pick from various types of dermal fillers depending on the area they are injecting and the desired outcome from the patient,” Dr Liakas notes. Hyaluronic acid (injectable form; this is not the same as the serum you’re applying topically!) is the most common choice for lips as it provides the most natural-looking result, and it’s easily reversible if necessary. However, Dr Liakas explains that because hyaluronic acid is water-absorbing it can contribute to lip migration.

What to do if your filler migrates? 

Firstly, contact your practitioner and let them know what has happened. Unfortunately, in a lot of instances with those unqualified, you may be disregarded by this practitioner and refused help. If this happens, find a new, reputable practitioner immediately. Don’t be afraid to ask them about their experience with dissolving filler.

There are two things a practitioner can do. The first is dissolving the filler using something called hyaluronidase, which is an enzyme that breaks down hyaluronic acid. “Amazingly, in just a few hours hyaluronidase softens the filler and returns the lips to a more natural shape, projection, and size,” says Dr Liakas. In some cases, if it’s just one area where filler has migrated, it’s possible to just spot treat it.
The other method is to simply leave it. Not all migrated filler needs to be removed because fillers do naturally degrade over time. However, this process is long and can take around 6-24 months.

Although all of these can happen with the most reputable practitioners, it’s not common. Rarely do highly skilled injectors see migration happen (and not nearly as much as TikTok has fooled us into believing) because they are well-versed in anatomy and treat each patient individually. Unfortunately, it’s often used as an excuse for improper technique by practitioners who aren’t trained to the highest standard — or who, scarily, may not have any qualifications at all.

If it does happen under a well-trained practitioner's care then they will be more than happy to see you quickly and rectify the situation. This is why it’s so important to do your research, never falling for cheap deals and quick fixes when it comes to injectables. Trust us, you and your face deserve the best.
Although filler migration shouldn’t be a cause for huge concern, it’s also important to know when you should seek more immediate medical assistance. If you find that your lips are painful, significantly swollen or discoloured, please seek medical help immediately.

Ioannis Liakas, Medical Director

Dr Ioannis Liakas is a shining gem in the aesthetics world. Prior to becoming an industry leading practitioner, he worked...

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