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Dermal fillers have revolutionised the world of medical aesthetic enhancements, giving patients a non-surgical, relatively affordable method to enhance and transform their facial features such as adding volume to the lips and smoothing out the appearance of dimples or bridges in the nose. These treatments, when performed by a knowledgeable and skilled practitioner, deliver beautiful results that can restore lost confidence and boost self esteem.
However, with the use of dermal fillers becoming more commonplace, people have become more knowledgeable about the limitations and potential complications associated with dermal filler procedures - the most widely discussed of which being filler migration.
Dermal Filler migration is an unwanted, but sometimes unavoidable side effect of dermal filler procedure such as lip fillers. It involves the unintentional movement of dermal filler from the areas it was originally intended to enhance to other areas of the face. Filler migration can cause lumps and a puffy or unnatural appearance due to volume appearing where it was never intended to. In fact, even just a few millimetres of filler migration can result in a noticeably unnatural appearance.
For example, migrated lip filler may cause a “shelf” or “duck lip” appearance and migrated cheek filler can lead to puffiness under the eyes or widening of the face in unintended areas. Filler migration can occur immediately after a procedure or show itself gradually over time.
Filler migration occurs due to a mix of technical, product-related, and biological reasons. When filler migration occurs immediately after a procedure has taken place, it is more likely a result of the injector placing the product in the wrong tissue plane, at the wrong depth, or too superficially. Alternatively, when a high volume of filler is injected too quickly, the gel is under excess pressure and naturally pushes into adjacent areas.
Filler migration happening over time can be a result of the filler being used - for example softer fillers or fillers with a high fluid content - or the area where filler is being injected having thinner skin. A combination of these factors leads to gravity, movement, and weak structural support causing filler migration over time - especially if multiple “top ups” have been layered without older filler treatments being properly dissolved. .
Strong pressure or facial massages, sleeping face‑down, or heavy repetitive facial movements - such as excessively chewing gum or drinking from straws regularly - can also disturb a filler before it has integrated with surrounding tissue, while individual factors such as an individuals’s anatomy and immune system can further influence how readily dermal fillers might shift from where they were originally placed.
Most medical organisations agree that true, clinically significant filler migration is rare - especially when dermal filler is administered by a trained professional using the right products and the right amount of product.
Often, when people think their filler has “migrated,” it is actually swelling, normal product spread within the intended skin plane, or simply an overfilling. However, genuine filler migration does occur and can be cosmetically upsetting.
As a practitioner looking to give patients the best possible service, preventing filler migration starts with a thorough patient assessment, taking into account their anatomy, skin quality, and natural movement patterns. You then need to select products based on their specific properties and how well they suit the demands of the treatment area, and always work within the correct injection plane to ensure stability.
It’s also key to prioritise subtle, gradual enhancement over multiple sessions rather than overfilling in a single appointment. Finally, give patients clear, concise aftercare instructions so they can avoid unnecessary pressure or manipulation of the treated area, helping the results stay exactly where they should be.
If migration happens, worry not. There are a number of different remedies that can be enacted to fix the issue.
With hyaluronic acid fillers, treatment is very straightforward and is often just a case of dissolving the product with an enzyme, allowing the tissue to settle, and then, if desired, re‑injecting later with better technique. In some cases where non-hyaluronic acid fillers were used or if the filler has been in place for a long time, correction may be more challenging and could require alternative approaches, including waiting for the product to gradually degrade or surgical removal in rare cases.
Filler migration can sound alarming, but with the right techniques, products, and practitioner expertise, it is far from inevitable. As dermal fillers continue to grow in popularity, understanding the science behind migration empowers both practitioners and patients to make safer, more informed decisions.
Make the clinically proven Dermal Filler choice by exploring our range of dermal fillers today.
