Dermal filler migration

By Dr. Aaron Stanes

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    What is dermal filler migration?

    Dermal filler migration refers to the movement or shifting of a dermal filler from its intended location after it has been injected into the skin. This can occur when the filler is not injected correctly or when it is not placed in the correct location.

    Dermal fillers are injectable substances that are used to add volume, smooth lines, or enhance the shape of facial features. They are made of various materials, based on naturally occurring substances such as hyaluronic acid, calcium hydroxylapatite, and poly-L-lactic acid. Dermal fillers are commonly used to treat wrinkles, fine lines, and volume loss in the face, but they can also be used to enhance the lips, cheeks, and jawline.

    There are several factors that can contribute to dermal filler migration, including the type of filler used, the technique used to inject the filler, and the individual’s skin structure and anatomy. In some cases, dermal filler migration can be prevented by using a filler that is better suited for the area being treated, using a more appropriate injection technique, or by ensuring that the filler is placed at the correct depth in the skin.

    Dermal filler migration is generally harmless, but can cause various cosmetic complications, including uneven or unnatural-looking results, swelling, and skin discolouration. If you are considering getting a dermal filler treatment, it is important to consult with a qualified healthcare provider to ensure that the procedure is performed safely and effectively.

    What causes dermal filler migration?

    There are several factors that can contribute to dermal filler migration, including:

    1. Injection technique: The technique used to inject the filler can affect its placement in the skin. If the filler is not injected at the correct depth or in the correct location, it may migrate away from its injected location.
    2. Type of filler: Different types of fillers have different rheological properties and may be more or less prone to migration. For example, some fillers are more cohesive, meaning they are less likely to spread or migrate from the injection site.
    3. Skin structure and anatomy: The individual’s skin structure and anatomy may also play a role in dermal filler migration. For example, if the skin is thin or has a lot of movement, the filler may be more likely to migrate. Generally people with softer skin tissue are more prone to migration.
    4. Post-treatment activities: Certain activities, such as those where pressure is applied to the injected area, may increase the risk of dermal filler migration. It is important to follow the post-treatment instructions provided by your healthcare provider to minimise the risk of dermal filler migration.

    How do I prevent dermal filler migration?

    There are several steps that can be taken to minimise the risk of dermal filler migration. Some of these steps include:

    1. Choosing the right filler: Different types of fillers are better suited for certain areas of the face. For example, some fillers are more suitable for treating wrinkles around the mouth, while others are better suited for enhancing the cheeks or lips. It is important that your practitioner chooses a filler that is appropriate for the area being treated.
    2. Receiving treatment from a qualified healthcare provider: It is important to receive treatment from a qualified healthcare provider who has experience injecting dermal fillers. This will help ensure that the filler is placed correctly and that the risk of the dermal filler migrating is minimised.
    3. Following post-treatment instructions: After receiving a dermal filler treatment, it is important to follow the instructions provided by your healthcare provider. This may include avoiding certain activities, such as strenuous exercise or applying pressure directly to the treated area, to minimise the risk of moving the dermal filler.
    4. Monitoring the treated area: It is important to monitor the treated area for any changes or signs of complications, such as worsening swelling or redness. If you notice any unusual changes, it is important to contact your healthcare provider for further evaluation and management.

    How do I know if my dermal filler has migrated?

    There are a few signs that you may notice if your dermal filler has migrated:

    1. Uneven or unnatural-looking results: If the filler has migrated from its intended location, the treated area may appear uneven or unnatural. For example, if the filler was used to enhance the lips and it has migrated, the lips may appear asymmetrical or disproportionate. You may also notice a ‘ledge’ effect, new creases and a loss of definition of the injected area.
    2. Persistent swelling: Dermal filler migration may cause swelling in the area where the filler has migrated too. This is most commonly seen around the eyes due to the delicate nature of the skin.
    3. Skin discolouration: Dermal filler migration may cause the skin to appear discoloured, often seen as a blueish hue. This is known as the Tyndall effect.

    If you notice any of these signs or other unusual changes after receiving a dermal filler treatment, it is important to contact your healthcare provider for further evaluation and treatment. They will be able to determine if the filler has migrated and recommend the appropriate course of action.

    How is dermal filler migration treated?

    Treatment for dermal filler migration depends on the severity of the migration and the specific concerns that you have. Some possible treatment options include:

    1. Massaging the area: In some cases, massaging the treated area may help to redistribute the filler and improve the appearance of the treated area. Your healthcare provider will be able to advise you on whether this is appropriate and the correct technique to use.
    2. Dissolving the filler: In some cases, the filler can be dissolved using a substance called hyaluronidase. This enzyme breaks down the hyaluronic acid in the filler, allowing it to be absorbed by the body.
    3. Surgery: In severe cases, surgery may be necessary to remove the migrated filler. This is generally only required for non-dissolvable dermal fillers, although these types of dermal filler rarely migrate.

    It is important to follow the instructions of your healthcare provider when it comes to treatment for dermal filler migration. They will be able to determine the best course of action based on the specific circumstances of your case.

    In summary, dermal filler migration often occurs due to the incorrect injection of dermal fillers. Using the correct type of dermal filler, the correct quantity and the correct injection technique minimises the risk. While some people are more prone to dermal filler migration than others due to the skin tissue quality, dermal filler migration is generally harmless and more of a cosmetic issue. Fortunately, almost all cases of dermal filler migration are easy to treat, with either massage or filler dissolving. It is important that if you are concerned that your dermal filler has migrated that you get in touch with the practitioner who injected the dermal filler for a formal assessment.

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