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.
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,
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