Filler Migration Is Real—But Here's What You Can Do About It
A quick peek at TikTok can make it seem like everyone is getting filler...and filler migration. Filler migration, aka when your face filler actually drifts from where it was initially injected, can be a major departure from the look you were going for, whether you received lip injections, chin filler, or some other kind of injectable. When the actual filler moves, it can leave skin looking lumpy or swollen—in places where you don't *actually* need or want it.
The good news? It's super-rare, with the incidence rate being around 1%, according to studies. But you might be hearing more about it since "the number of patients getting injected with filler is rising," says Omer Ibrahim, MD, a board-certified dermatologist in Chicago. IL. And although filler migration is not ideal, it's possible to treat if you do end up with it post-injection. We talked to experts to get the deets.
What is filler migration?
For the uninitiated, "filler migration really refers to when the filler expands or physically moves away from the intended area into which it was injected," says Dr. Ibrahim. For example, you get filler injected into your lips, but the skin around the lips starts to look a little plump or lumpy, too.
But filler can only migrate so far. In fact, "filler cannot move more than a few millimeters—so an injection in the cheeks, for example, won’t end up on the jawline or in your body systemically in any way," he says.
If you're not sure whether you have filler migration, we gotchu: Filler migration looks like pronounced fullness that's adjacent to the area you intended to plump—and it sticks around for days after your injection. "Swelling is temporary, whereas filler migration does not resolve," says Melanie Palm, MD, a board-certified dermatologist in San Diego, CA. In the lip area, for instance—where migration is common—you'll see an abnormal fullness that goes beyond the line where your lips and skin meet.
What causes filler migration?
There are a few reasons you might experience filler migration. The first is if the filler is placed incorrectly within your skin. "This can result from crossing two anatomic regions—with the filler migrating back through the area of initial skin puncture—or from placing product in the wrong tissue plane," says Dr. Palm.
Overfilling is another biggie; it can exaggerate the look of filler migration, according to Dr. Palm. That goes whether you got too much filler in one sitting or over the course of several injections. After all, "everyone’s anatomy has limits, bound by ligaments and bony landmarks," says Dr. Ibrahim. In other words, the filler literally just doesn't fit where your injector placed it.
Speaking of injectors—the person wielding the needle can make a ~big~ difference here. Having an experienced injector is a big deal for your overall safety—since they can handle complications that can come up—but they can also minimize the risk of filler migration. If the person injecting your filler doesn't totally know what they're doing, they can place it in the wrong plane, place too much in a single area, or even use the wrong type of filler for where you're getting it, according to Dr. Ibrahim. (For instance, you need more flexible fillers for areas of frequent movement, like your lips.)
And, of course, if you're not using an FDA-approved filler, you can also increase the risk of filler migration. These black-market fillers can even—brace yourself—lead to disfigurement. "Some fillers, like acrylamide and silicone, can stay in the skin 'forever' and actually cause inflammatory reactions that can be disfiguring," says Dr. Ibrahim, who adds that they can also end up in your lymph nodes. Um, we'll pass.
Finally (whew!) certain areas of the face are more prone to filler migration than other, which leads us to...
Where is filler migration most often seen?
While filler migration can happen anywhere, it's most common in the lips and tear troughs, aka under-eye filler. "These areas are under high pressure," says Dr. Ibrahim. Translation: They're small, contained areas with limited space that are under transparent stress from constant movement, like talking and smiling. That can push filler around, causing it to migrate. Here, what causes filler migration in each area:
Lip filler migration
Lips are one of the major areas where you can experience migration—for a few reasons. "It often presents as a lack of definition around the border of the lips, resulting in the unwanted 'duck lips' look that some people get," says Dr. Palm. "This occurs because filler migrates beyond the lip border into the white upper lip, or ergotrid."
Plus, she says, the skin around the upper lip is thinner than other areas of the face, so when this happens, it tends to be more noticeable. And finally, "patients are more inclined to fill their lips over other areas of their face," says Dr. Palm. So, filler migration just tends to be more common here just because lip filler is so popular.
Eye filler migration
In the eye region, filler can migrate even if you do everything right. "Repeated movement of the muscle surrounding the eye may contribute to correctly placed deep filler migrating through the muscle and causing a bluish cast or swelling in the tear-trough region," says Dr. Palm.
Cheek filler migration
Migration can also happen with cheek filler. "There are case studies of filler migrating from the temple to the cheek region if placed at a certain tissue depth because of a potential communication path between the temple and cheek regions," says Dr. Palm. If that doesn't convince you to seek out an injector who knows what they're doing, we don't know what will.
How to fix filler migration
While hyaluronic acid-based fillers dissolve over time, they kinda do so at their own pace—so it's better to address filler migration ASAP rather than try to wait it out. The fastest way is with hyaluronidase, an injectable enzyme that dissolves the filler. "This requires typically a series of sessions to dissolve the filler with hyaluronidase, followed by a week wash-out period, and then reintroduction of properly placed filler," says Dr. Palm. (Keep in mind, however, that some fillers are easier to dissolve than others, depending on their technology and structure, she says—so your protocol might look a little different.)
Otherwise, that's pretty much it. And, for the future, try not to overdo it in the first place. "We as humans undergo 'perception drift' all the time—where we fix a flaw and are satisfied with the outcome, but down the line feel that another flaw needs to be fixed or that we are back at baseline and need to redo the procedure," says Dr. Ibrahim. "It is important to not fall into this cycle, as this can lead to overfilling, filler unevenness, and migration past the injection site."
Meet the experts:
Omer Ibrahim, MD, is a board-certified dermatologist at Chicago Cosmetic Surgery and Dermatology in Chicago, IL. His research interests include hair loss and laser resurfacing.
Melanie Palm, MD, is a board-certified dermatologist at Art of Skin, MD in San Diego, CA. Her expertise is in cosmetic dermatology, including injectables and lasers.
Why trust Cosmopolitan?
Deanna Pai is the interim deputy beauty editor at Cosmopolitan with more than 12 years of experience covering skincare, makeup, and beyond. She’s an authority in all skincare categories, but is an expert when it comes to aesthetics. When she's not testing skincare formulas, she's chatting up top dermatologists and plastic surgeons to learn about everything new and innovative.
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