Injectables · Correction
What filler migration looks like — and what fixes it
A large share of our injectable work is now correcting other clinics. Here is how to tell swelling and weight gain from four years of product.
Dr. Ryan Ramos · April 8, 2026
People arrive convinced they have gained weight in their face. Often what they have is ten syringes of hyaluronic acid that never went anywhere.
The myth of the twelve-month filler
Fillers are marketed with a duration — nine months, twelve, eighteen. That figure describes when the visible effect of a correctly-placed syringe fades, not when the product has gone. MRI studies have found intact filler years after placement, well past the marketing number.
If you have topped up every twelve months for five years on the assumption that the previous round had cleared, you may be carrying considerably more than you think.
What migration looks like
- Lips: a shelf above the vermillion border, a top lip that reads full even at rest, a moustache-like shadow in profile.
- Under-eyes: puffiness that is worse in the morning and does not respond to sleep, sometimes with a faint bluish cast — the Tyndall effect, from product placed too superficially.
- Cheeks: a flat, wide look rather than a lifted one. Weight in the mid-face rather than height.
- General: a face that photographs heavier than it feels, and looks worse in overhead light than in a mirror.
The under-eye version is the one most often mistaken for tiredness, and it is the one most often treated by adding more.
Why we scan before dissolving
We put an ultrasound probe on the area before touching it with hyaluronidase. Two reasons.
First, product is frequently not where the notes say it is. Filler migrates along tissue planes, and it turns up in places nobody injected.
Second, targeting matters. Flooding a whole region with hyaluronidase dissolves your own hyaluronic acid alongside the filler. That replenishes in a few weeks, but the difference between targeted and untargeted dissolving is the difference between fixing a problem and starting from zero.
You see the same screen we do, before and after.
Then what?
Wait. If you want volume rebuilt, we do it after a settling period — not the same day. A face that has just had four years of product removed is not the face you will have in six weeks, and injecting into it means guessing.
On judgement
Nobody gets a lecture here about where they had it done. A meaningful share of this work is correcting other clinics, and the person in the chair is almost never the one who made the decision that caused it.
Ultrasound-guided dissolving starts at $550 a session, and most cases resolve in one or two.
