Wait—Do We Need to Worry About Filler Migration Now? Expert Comments
Given the increasing number of patients receiving facial fillers in recent years, it’s no surprise that we’ve also seen an increase in “bad” fillers—horror stories about overcrowding of facial areas or filler migration (which is often and likely to be the same). Like any other topic that goes viral on social media, filler migration has spread to the rest of the internet.
But is it really as common as the 83 million posts on TikTok claim? In short: no. However, filler migration is always a possibility, so we asked board-certified plastic surgeon Jeffrey G. Lind II, MD, and registered nurse Vanessa Coppola, APN-C, FNP-BC, to discuss how to address the issue, recognize it, and resolve it if you experience it. Read on for full details on filler migration.
What is filler migration?
“Filler migration occurs when dermal fillers, commonly used in the lips, cheeks, and other areas of the face, migrate or move away from the intended injection site,” Lind concludes.
While many FDA-approved fillers are based on specially designed gel formulas that won’t move, external factors can get in the way.
How do you know a filler has migrated?
Depending on the severity of filler migration, it may be clearly visible to the naked eye. The most obvious case is usually the lips. “We see this most often in the perioral area, which is the area around the lips,” Coppola said. She explained that filler migrates from the red part of the lips to the surrounding area. “Sometimes you can identify this by the lips protruding from the contour, the red outline of the lip disappearing, and sometimes… filler migrates to the white cast on the skin.”
Detecting filler migration in other areas of the face can be more complicated—as Coppola explained, it’s a delicate art. “For example, in the tear trough area, this can sometimes cause filler to migrate to the surface of the skin and look almost like a Tootsie Roll, which is a discontinuous area of filler under the eye where the lower eyelid meets the cheek,” she explained.
Still, both experts noted that it’s important to schedule an appointment with an experienced healthcare provider to determine if your filler has indeed changed before jumping to conclusions.
What’s the cause?
There are a number of different factors (some natural, some not) that can cause filler migration.
Overfilling: First, experts note that overfilling an area of the face can cause filler material to migrate; generally speaking, technical errors are often the cause of migration issues. To avoid this, you should always work with a certified injector with experience in this field.
Injection Depth Error: Meanwhile, injecting filler material at the wrong depth can cause migration. “Having a very detailed and in-depth understanding of facial anatomy…is necessary to avoid adverse events such as aesthetic migration of filler material,” explains Coppola. “If filler is injected into an area with a lot of muscle activity, it can also cause the filler to migrate to the surface of the skin. We often see this in the tear trough area and on the lips.”
With all of that said, it should also be noted that migration can be caused by something as simple as repetitive muscle movement or overuse of filler. Experts note that repeatedly using filler in the same area over a long period of time can cause problems, as can the type of filler used and a person’s natural anatomical nuances.
How to Treat It?
If you notice filler migration and aren’t sure what to do next, don’t worry. You have a number of options—the first is to do nothing. If migration is neither cosmetically nor physically unpleasant, you can wait. Hyaluronic acid fillers typically dissolve after six months (some even after a year).
For those seeking an immediate solution, the second option is to dissolve the filler. “[Assuming it’s a hyaluronic acid-based filler] the injector can administer the filler with an injectable dissolving drug called hyaluronidase,” Lind explains. “However, this may require multiple sessions.”
It should be noted that dissolving fillers can be an uncomfortable process, depending on your pain tolerance. As someone who has had chin fillers dissolved once, I can personally attest that the feeling is not ideal, and I described it as a sharp, burning sensation. Nonetheless, the quick fix is undoubtedly worth it.
Can it be prevented?
Yes and no. There are some best practices that can help patients achieve the desired filler results. “You should always have an experienced injector perform the injection,” Lind emphasizes. “Injectors should avoid placing too much filler in one location, as it may spill into adjacent areas – the second most likely explanation for “filler migration” is the first being a poorly placed filler by the injector. Injectors must also use the correct filler to get the correct indication.”
Lind also noted that one should not sleep on their stomach for 48 hours after a filler treatment to avoid unwanted migration or distortion.
Notably, both of our experts told us that filler migration is uncommon, regardless of what you may see on social media. Following the above recommendations (along with proper aftercare) should generally result in a positive experience and positive results.
Final Verdict
“Soft tissue fillers are a great tool for facial rejuvenation when performed by an experienced injector,” Lind said. “Filler migration is probably much less common than what is reported on social media. Injection technique, errors in judgement, and technical errors are the most likely causes of what patients report as “filler migration.”
If you want to use fillers but are concerned about migration, our experts offer some advice: Do your homework. In addition to certifications, research the injector before using it. Do you have years of experience? Good reviews? Do you have before- and after-treatment photos of patients that you like? Ask for advice and don’t be afraid to ask questions.
DQH Knowledge drop: In your 20s, your skin cell turnover decreases. (Cell turnover is a key component in keeping your skin youthful.) You know what else slows down? Your collagen production. Starting in your 20s, collagen decreases by about 1 percent per year. Should you want to prevent fine lines and wrinkles, start by eliminating behaviors that contribute to premature aging. “If it’s bad for you, it’s bad for your skin,” says dermatologist Michel Somenek.
“Cigarette smoking reduces blood flow to the skin and causes premature wrinkling and a dull skin texture. Making the repeated pursed motion to inhale can also cause smoker’s lines. Alcohol and recreational drugs are toxins for the skin that damage its cellular structure and DNA,” Somenek tells us. “The faster you eliminate vices while you are young, the better chance your skin and body have to recuperate.” Also, adopting an anti-aging routine in your 20s is key. After all, the best offense is a good defense. We spoke to Somenek and experts Joshua Ross and Audrey Kunin to find out more.
Keep reading for the best anti-aging products for your 20s, according to skincare professionals.
Sunscreen
“We all know that the sun is the number one cause of skin aging and starting the prevention in your 20s is very important,” Ross says. “The majority of your sun damage won’t start to appear until you’re in your 30s, so don’t wait until you see it surface or you’ll be behind the curve. Stay ahead of it with a good-quality zinc-based sunscreen worn daily.”
Farmacy Green Defense Daily Mineral Sunscreen
An invisible sunscreen with SPF 30, plus botanical extracts meant to protect skin with tons of antioxidants. Bonus: It’s clean and fine to use under makeup.
Bareminerals Complexion Rescue™ Tinted Moisturizer Broad Spectrum SPF 30
Although we recommend you use your SPF and moisturizer separately, we also understand moments when you don’t have time or energy for that extra step. For those times, this bareMinerals moisturizer is a great thing to have on hand.
Vitamin C Serum
“A great introduction to anti-aging is to start with a vitamin C serum in your morning skincare routine,” Ross says. “It’s a powerful antioxidant that will neutralize free radicals and brighten the skin.” He adds that it’s a great way to counteract the effects of the sun’s harmful rays, which, as previously mentioned, are among the biggest causes of premature aging.
Drunk Elephant C-Firma™ Vitamin C Day Serum
The Drunk Elephant C-Firma is a lightweight serum that promises to give skin a glow by combining the brightening powers of vitamin C with ferulic acid, l-ascorbic acid, and vitamin E. The included sodium hyaluronate is meant to replace hydration loss, so you shouldn’t have to deal with any irritation.
Sunday Riley C.E.O. Rapid Flash Brightening Serum
This potent serum is jam-packed with vitamin C (15 percent, to be exact), which means it’s a potential superstar at both brightening skin and dousing it in antioxidants.
Peptides
Using peptides on your skin has many benefits, says Somenek. “The skin barrier is what defends the body against pollution, UV rays, bacteria, and toxins. It can be damaged by several everyday factors. Using topical peptides aids in building a stronger barrier,” he says. “Peptides comprise elastic fibers, which are a type of protein. These fibers help to make skin appear taut and firm. Peptides can also help repair damaged skin, relieve inflammation, and even out skin tone. Some peptides can kill acne-causing bacteria that is common in 20-somethings.”
Kunin agrees, saying, “Peptides are an excellent entry point for supporting collagen.” She recommends looking for face and eye treatments that contain these collagen-boosting powerhouses.
Charlotte Tilbury Magic Eye Rescue Cream
This Charlotte Tilbury super-emollient eye cream has a base of coconut oil and shea butter (read: it’s incredibly hydrating). Botanicals plus peptides are meant to help reduce dark circles and boost collagen, respectively.
This creamy moisturizer serves up potent collagen-boosting peptides and pycnogenol, and antioxidant-rich vitamin C. “Instead of sitting on top of the skin, peptides penetrate the outer layer so they go deep. The ‘signals’ they send tell the cells to produce elastin and collagen, which are needed for youthful-looking skin,” explains Somenek.
At-Home Peel Pads
Remember that skin cell turnover fiasco we talked about earlier? One way to help support it is by exfoliating. “Exfoliation is important to help keep skin fresh and luminous,” Kunin says. She recommends using at-home peel pads as an easy and effective way to exfoliate.
“The goal in your 20s is to fight the slowing pace of cell turnover. It is wise to use products that gently exfoliate, yet still remove oil and other impurities. Products that have Alpha Hydroxy Acids (AHA) or Beta Hydroxy Acids (BHA) are a good choice.”
According to Somenek, you should only exfoliate two to three times a week. “People of all ages are guilty of over-exfoliating and that can be too much of a good thing,” he says.
Dermadoctor Kakadu C Intensive Vitamin C Peel Pad
A few swipes of this Derma Doctor powerful peel pad promise to leave your skin glowing and smooth, thanks to the seven (yes, seven) types of chemical exfoliants, including AHA and BHA. It also contains vitamin C via Kakadu plum extract for added brightening and antioxidant protection.
KEY INGREDIENTS Kakadu plum extract is sourced from the Kakadu plum, a fruit grown in northern Australia. It contains vitamin C, which restores the skin’s natural barrier, increases collagen production, and soothes irritation.
Dr. Dennis Gross Skincare Alpha Beta® Universal Daily Peel Pads
These are the gold standard of peel pads, with a cult following and over 900 five-star reviews on Sephora. They’re easy to use and contain a blend of anti-aging exfoliating acids.
Emollient Night Cream
“In your 20s, you need to start upping the hydration in your skincare routine. You may have been cautious of over-moisturizing because of acne in your teens, but as you enter your 20s, your skin transitions and becomes drier,” Ross says. “I recommend an emollient night cream added into your evening skincare regimen.”
“Twenty-somethings need to make sure that they are not using creams that will clog their pores and cause excess oil production,” says Somenek. Opt for non-comedogenic products.
Cerave Skin Renewing Night Cream
One great choice is the CeraVe Skin Renewing Night Cream, which is a non-comedogenic night cream that leaves skin soft and glowy. It combines the moisturizing powers of ceramides and hyaluronic acid.
RoC Retinol Correxion Max Hydration Creme
“The best night cream ingredients contain retinol, benzoyl peroxide, and/or salicylic acid or hyaluronic acid. The goal is to moisturize, yet remove excess oil,” says Somenek. This Roc Retinol Correxion cream fits the bill as it contains both hyaluronic acid and retinol so it promises to moisturize while also being non-comedogenic.
