Filler migration + the duck lip

After years of using dermal filler to enhance lips, and the practice becoming increasingly mainstream we are beginning to see more and more, the unfortunate phenomenon of ‘filler migration’.

This may appear as loss of the sharp border between the white and pink tissue of the lip due to spread of filler into the tissue around the mouth after original placement in the lip. Because of the increased volume of this ‘perioral’ tissue, lip distortion and asymmetry can occur, and a ‘shelved’ or overly pronounced projection of the lip can result. Most commonly seen in the top lip, this can give the appearance of a duck bill and lend to the unfortunate and often avoided ‘duck lip’ look.

Although the exact mechanism by which filler migration occurs is still being ascertained it is thought to arise from the culmination of a few factors.

  • Overfilled lips – lips that have too much product placed in them (even over a long period of time) are thought to be the leading cause of filler migration, with increased pressure in the lip tissue from copious product resulting in filler being forced out of the lip

  • Lips filled too quickly – migration is also thought to be more likely if lips are filled too quickly i.e. large quantities of filler in a single sitting. Placing lots of product into the lips without giving tissue the time to generate stretch, again may increase tissue tension and the chance of displacement

  • Product with the incorrect properties – product that poorly integrates (or takes a long time to integrate) with tissue and/or excessively soft product is thought to contribute to the phenomenon as the product essentially sits free in the space created via injection and is more prone to distortion

  • Injection techniques – it is thought that techniques that introduce product by penetrating through the white tissue around the lips into the lip body may also contribute to migration as microchannels created by the injection create pathways into the tissue around the mouth through which filler can extrude

  • After care – poor aftercare technique may also exacerbate lip filler migration – activities that increase swelling (and pressure in the lip) such as intense exercise, alcohol, hot showers; firm massage; and or excessive distortion of the lips (smoking, kissing, use of straws) in the immediate period after injection may theoretically contribute to this phenomenon

At Aescend we use high grade filler that integrates quickly with tissue to give natural and soft results. Furthermore we will not inject more than 1 mL at a sitting directly in to the lips, instead requiring our patients to come back for repeated sessions to instead grow volume over time. We are also trained in multiple lip injection techniques and ensure that patients are appropriately educated about aftercare (as well as provided written instructions) prior to leaving the premises.

We also do our best to minimise swelling through technique and product selection, though we do offer a free LED session too with each treatment to help decrease the manifestation of swelling. Ice and advice also available 😉

If filler migration is something you are concerned about, we do free assessment and offer cosmetic dissolution of filler amongst our services. Enquire today!

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