A good hyaluronic acid (HA) lip filler treatment can be beautifully subtle and impactful, however lately I’ve been having more nuanced conversations around this service.  These treatments have been remarkably popular over the last years, and being a relatively new trend, we are learning more about how HA filler behaves over time.  Having been doing this for years, I have noticed that for some who have engaged in regular and repetitive treatments over several years, it's time to start fresh, 

When we apply filler over filler and repeat, the product can migrate from the lips into the surrounding tissue.  As our body breaks down the hyaluronic acid over time, water is drawn to the area blurring the lip borders.  This can lead to a less-defined lip border with a bulging of the skin above, almost resembling a ‘white mustache.’  Once the border has been insulted, it’s time to halt lip-filling treatments and talk about embarking on the dissolving journey.  

Why does filler migrate? 

• Overfilling the lips!  When the lips are filled to their capacity the product can move from the excess pressure. 

• Too frequent of treatments.  The trauma of the treatment can potentially insult the borders allowing filler to go beyond them 

• Wrong product choice.  Some of these more hydrophilic, or water loving, products can give a puffy look as the product breaks down and draws in water over time.

• Poor injection technique. Placement of the product outside of the lip can happen, particularly with an injector of lesser experience.  The Russian lip technique is infamous for leading to migrations when not done correctly. 

The good news is that there is an accessible, safe, and relatively immediate solution here as we can dissolve this HA filler with an enzyme named hyaluronidase.  I like to compare this process to getting your nails done.  The first thing the nail technician does is remove the previous manicure before applying a new one.  If you have engaged in regular lip fills for the last 2-3 years, it may be worth consideration to start fresh by dissolving past products; and especially if we are observing signs of migration. 

These days when you come to me for a lip fill, I focus on the consultation and examination to ensure that we set ourselves up for beautiful results. This process has been leading to more informed decisions that honor the integrity of the lips and lead to new treatments with optimal results. But before we can get there we have to touch base about the previous treatments and if migration is noted, we either pause before injecting more or embark on the journey of dissolving.

There is often anxiety attached to dissolving with hyaluronidase for fear of an allergic reaction, however the incidence for this is extremely small (1).  In a filler dissolve appointment, we begin with numbing for comfort, and then we inject the enzyme into the lips similar to how we inject filler. Hyaluronidase has an immediate effect and it continues to work over a couple of days. Just as with other injections, there is a possibility for bruising and swelling.

We grow to adore and identify with the lips that we invest in; so, no wonder it feels difficult both emotionally and financially to consider dissolving previous treatments. We may feel like we are wasting the treatments, but it’s the right maintenance in order to preserve natural, beautiful lips with integrity of shape and fullness in this moment and for future treatments. 

While it is ultimately up to you to choose to dissolve before filling again, it is my recommendation to do so if you are experiencing migration of previous filler. I practice to deliver results that are naturally enhancing and beautiful to look at, and sometimes this involves starting from fresh. 

I offer complimentary consultations for new AND existing clients so feel free to schedule any time. 

Thanks for reading,
Heather