Filler Migration, Explained by a Dermatologist

Has dermal filler migration been trending in the news and on social media for a while now, or is it just my algorithm? I keep seeing stories about fillers drifting from their intended spots, leading to unexpected changes in people’s appearances. Social media, ever-so-kind, has even coined a term for it: The dreaded “#pillowface.” If you’re like me and curious about fillers, it’s crucial to understand how they work. And here’s some good news: filler migration is completely avoidable if done correctly—in the right place, at the right time, and in the right dosage. This issue can arise for several reasons, but don’t worry; we’re here to break it all down for you. Dermatologist Dr. Zeynep Gökalp explains what filler migration is, how to prevent it, and whether it can be fixed.

What exactly is dermal filler migration?

Dr. Gökalp explains that dermal filler migration occurs when fillers move from their intended placement to another area. This can happen due to practitioner errors during injection, such as injecting at the wrong anatomical level, using incorrect techniques, or applying too much pressure during post-procedure massage. Overfilling is another culprit, either by using excessive amounts during the initial treatment or by having too many repeat injections. The wrong product choice can also lead to migration; using fillers with inappropriate density for a specific area or low-quality products can cause problems. Additionally, the body might develop an immune response to the fillers, prompting them to move.

Is dermal filler migration fixable?

Yes, but in some cases it is not. If filler migration occurs, Dr. Gökalp suggests that hyaluronic acid-based fillers can be addressed with hyaluronidase enzyme injections, which quickly dissolve the misplaced filler. However, the situation is more complicated for permanent fillers like acrylamide and silicone, as these fillers cannot be dissolved. In such cases, surgical removal may be attempted, though it is a challenging procedure and complete removal may not be possible.

Should you get dermal fillers regularly?

According to Dr. Gökalp, dermal fillers don’t need to be applied regularly, unlike other anti-aging treatments. Over time, their effects will start to diminish, but they don’t completely disappear within their expected duration either. Regular applications in the same amounts can lead to accumulation, resulting in an overfilled look and an undesirable outcome. Instead, it’s best to inject only the amount that has diminished as needed. This means the intervals between treatments should gradually lengthen, and the quantities should decrease over time. In this case, adopt the “less is more” mentality.