Lip Filler Part 1: Why Do My Lips Look Smaller After Getting Fillers?

Lip Filler Migration

During lip filler consultations, I often hear the following:

‘I definitely got lip fillers, but as time passes, my lips actually look smaller.’

Or, ‘The area above my upper lip has become bulging.’

In many of these cases, the main cause is lip filler migration.

What is Lip Filler Migration?

Lip filler migration

refers to the phenomenon where the filler moves from its original injection site to another area.

Especially around the upper lip, you might notice:

✔ The skin above the lip becoming puffy

✔ The philtrum appearing longer

✔ A feeling that the lips are rolling inward

This phenomenon is commonly referred to as:

👉 ‘moustache shadow’

👉 ‘duck lip’

Why Does This Happen?

(Based on Medical Literature)

The lips are the most active part of the face.

Talking / Smiling / Eating

Throughout all these activities, the lip muscles are constantly moving.

As a result, the filler can be pushed upward.

Main Causes Explained in Medical Literature

1️⃣ Excessive Filler Volume

If the amount of filler exceeds what the lip tissue can accommodate,

➡ it can spread or migrate to surrounding tissues.

2️⃣ Incorrect Injection Layer

The lips consist of several layers for filler injection, such as:

✔ vermilion border

✔ lip body

✔ subcutaneous layer

If injected into a layer that is too shallow,

➡ the filler can be pushed upward toward the skin above the lip.

3️⃣ Repeated Filler Procedures

Repeatedly getting fillers can stretch the tissue,

➡ making it difficult for the filler to stay in its original position.

4️⃣ Influence of Lip Muscles

The lips are surrounded by a strong muscle called the orbicularis oris muscle.

Due to the movement of this muscle,

➡ the filler can be pushed upward

➡ or spread sideways.

This is Why It Happens

When lip filler migrates to the upper skin,

✔ the area above the lip looks thicker,

✔ the lips themselves actually look smaller, and

✔ the philtrum can appear longer.

In fact, medical literature explains that

➡ when migration occurs from the pink lip to the white roll,

the lips can appear to roll inward.

In other words, the filler is still there, but because its position has changed, the lips look smaller.

Treatment Options in These Cases

If you have lip filler migration, there are two main treatment methods.

1️⃣ Hyaluronidase

This method involves dissolving the filler to correct its position.

It is especially the most effective method for:

✔ filler injected too deeply or too shallowly

✔ old filler

2️⃣ Partial Filler Correction

Depending on the case, we might:

✔ dissolve only the migrated filler (while it is impossible to target it 100%, the goal is to dissolve only the migrated area as much as possible)

✔ and then redesign the necessary areas.

Recently in Europe, topical hyaluronidase like Topilase is being used

to correct shallow migration (according to literature). However, it has not yet been officially approved or distributed in Korea, so no clinics use it here yet.

The Most Important Thing About Lip Fillers

Lip filler is not a procedure where simply injecting a lot of volume is important.

Rather, what matters is a designed procedure that considers:

✔ the appropriate amount

✔ the correct layer

✔ facial proportions

✔ lip movement

Therefore, for lip fillers,

👉 ‘designing naturally rather than injecting a lot’ is far more important.