Can fillers “migrate”?

Hello! I’m so very grateful for all the questions that you take the time to research and answer for us! Here is one I’m not sure you have covered in debth before: Injectable Filler Migration? I wasn’t REALY sure that there was such a thing but apparently it has happened to me recently after more than 20 happy and satisfied years of getting injectable fillers. ( started with Collagen, then to Restylane, and now Juvederm for several years. ) I had thought my fillers migrated after dental work that was done several days after injections but my Doctor said that was impossible. I recently found an Expert Injector that I love and she said it appears that I have one migration in upper lip and one fold around my nose to chin area on my left side. Could you inform us on the truth about this occurrence please? We trust you! Thank you! E. M.

We get this question also sometimes at our clinic.  If the filler was done at another clinic, and we are being asked for second opinion, it’s difficult.  We don’t know (because we didn’t do the treatment) exactly where the filler was placed. We will often request the records from the other clinic, but sometimes they didn’t keep good records. It’s also possible that it was just placed in a not so great position.  In our clinic, and other good clinics, we keep good “maps” documenting exactly where the filler was placed.  We also keep the lot #’s for each filler used in the note.

The only way to “prove” that a hyaluronic filler has migrated is to do a small biopsy into the area and have the pathologist look it. This is not practical because it would leave a small scar, which none of us would want.

Another way that’s more objective is to test the area with a hyaluronidase (enzyme that uncross links and breaks down HA fillers) injection.  If the area in question is HA filler, then the filler will flatten and the problem will resolve.  If it doesn’t, then you know it wasn’t HA filler there.  This is a quite practical way to resolve the issue. The judgment about how much hyaluronidase  to use would be up to your dermatologist/provider.

Bottom line:

In our experience, it’s a very rare problem. Usually it’s that the filler was placed in a not optimal position in the first place, or the problem is being caused by something else.  It IS a good idea to wait a week before or after filler to have major dental work done.  Teeth cleaning is rarely a problem.

Good luck to you, and I hope this helps,

Dr. Brandith

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