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Dermal filler migration complications following lip augmentation procedures

02 September 2020
Volume 9 · Issue 7

Abstract

Filler migration is a rare complication of dermal filler treatment. Although most research has found that more permanent fillers, such as silicone, are more likely to migrate due to their long-term presence in the body, there have also been reported cases of filler migration from short-term hyaluronic acid-based dermal fillers. As lip augmentation procedures are fast becoming one of the most frequently requested treatments in medical aesthetics, this article looks at the longevity of hyaluronic acid lip dermal fillers, while also aiming to assess the cause of dermal filler post-treatment migration and evaluating how to minimise its risk.

Lips have a significant role in facial aesthetic perception (Yazdanparast et al, 2017).

For this reason, lip enhancement is now one of the most frequently requested treatments in medical aesthetics (Brandt and Cazzaniga, 2008; Kane et al, 2012).

As part of the author's non-surgical facial aesthetics Level 7 postgraduate certification course, numerous lip augmentation procedures were performed on patients who attended clinics. During one clinical examination, one patient who had previously undergone lip dermal filler treatment by another practitioner was assessed. At this appointment, the patient presented with ‘increased lip projection’, extending not only to the vermillion border of her lip, but also beyond this area into the cutaneous ‘white lip’ (Ravichandran and Mann, 2020). According to Sarnoff and Gotkin (2012), the ‘ideal ratio of the upper to lower lip is 1:1.6’. Additionally, they stated that, ‘if a straight line is drawn from the subnasion to the pogonion of the chin, the upper lip should project no more than 3.5 mm anterior to this line, and the lower lip 2.2 mm’. When questioning the patient's treatment history, she reported that she previously had lip fillers placed over a year ago (thought to be Juvederm® Ultra III), to both her vermillion border and body of her upper and lower lip. She went on to say that she felt her lips had changed in appearance over the last year, with the filler ‘migrating upwards’ into her skin, giving them a ‘duck-like’ appearance.

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