Understanding Filler Migration

Dermal fillers offer a popular non-surgical solution for restoring volume, enhancing facial features, and smoothing out lines. While these procedures are safe and effective in experienced hands, one possible side effect is filler migration, a phenomenon that is often misunderstood due to misinformation online and on social media. It refers to the appearance to filler adjacent to its intended location. While most assume that this is due to the injected material moving from its original placement, there can be a number of other factors that lead to its appearance. Contrary to information posted on social media, filler cannot migrate to distant sites. Contrary to information posted on social media, filler migration to distant sites is extremely rare.

Why Does Filler Migration Happen?

There are several factors that can contribute to filler migration:

• Injection technique: Poor placement or injecting in an incorrect plane can increase the risk. The two most common examples that we see in our office is lip filler placed in the wet mucosa of the upper lip – usually with performing the “Russian technique” and then when correcting the tear trough (under eyes) with cannulas in which the filler is placed in the wrong plane. This creates ‘floating filler’ that is difficult to correct.
• Overfilling: If too much product is used than an area can accommodate, this can create pressure that causes the filler to move to an area of lesser resistance. When it comes to delicate areas, such as the lips, we often prefer to stage the syringe in which smaller amounts of the filler are placed at each visit to prevent this. 
• High-movement areas: Regions like the lips or around the mouth are more prone to migration due to constant motion.
• Incorrect product choice: Not all fillers are suitable for all areas; using the wrong type increases migration risk. For example, fillers with higher hyaluronic acid (HA) concentration should be avoided in certain areas.
• Post-treatment behavior: Excessive touching, massaging, or sleeping on the face soon after treatment may push filler out of place.
• Product specific: Fillers that are more hydrophilic tend to have more noticeable migration, due to the swelling effects of hydration.

Can Filler Migration Be Prevented?

While it’s not always possible to completely prevent migration, the risk can be minimized by:

• Choosing an experienced and qualified injector.
• Using only high-quality, approved filler products for the correct and/or intended area of the face.
• Following all post-treatment care instructions carefully.
• Avoiding overcorrection or layering too much product at once.
• Allowing proper time between treatments to assess results.
• Precise placement of filler. Use of the more precise needle technique rather than the cannula technique (especially in the tear trough).

How Is Filler Migration Corrected?

If filler migration occurs, several corrective options are available:

• Hyaluronidase: If a hyaluronic acid-based filler was used, an enzyme called hyaluronidase can be injected to dissolve the misplaced product.
• Manual manipulation: In early cases, a trained professional may be able to gently massage and redistribute the filler. 
• Time: In some situations, the body may naturally metabolize the filler over time.

Reinjection or touch-up: Once the area is stabilized, additional filler may be used to restore balance or symmetry.

When to Seek Help from an Experienced Injector at GreeneMD

If you notice unusual swelling, lumps, asymmetry, or changes in the treated area, consult with a qualified injector promptly. Early intervention often leads to better outcomes.