Hx: Patient presented for dissolution of migrated lip filler which she had had injected previously at another clinic.
Tx: On examination the migration was noted to be worse in the top lip. Here the movement of filler had caused the lip to look distorted and asymmetrical, and definition of the lip border had been lost. Although the patient could not recall the type of filler she had been treated with, we suspected it had been highly hydrophilic as the lips had taken on a fluidy, distended and almost translucent appearance. As is common with migration, the bottom lip was not as badly affected as the top lip, so to save the patient money and downtime, the decision was made to dissolve only the filler in the top lip. This was done under a dental block, after spot testing the patient and determining she was not allergic to the dissolving agent. 2 weeks later we reviewed the patient and to improve the proportion of the top lip vs the bottom lip, we added some superficial volume into the lip tissue, taking care not to cross the pink/white border. The patient was advised not to perform any massage of the lips for at least 2 weeks, and in addition to normal post care advice, avoid activities such as smoking, whistling, drinking from a straw, or that involve excessive pursing or pressure onto the lips. At this stage we do not predict any further treatment and look forward to seeing our lovely patient in the future.