Why Lip Filler Migration Can Cause the Dreaded "Duck Lips"

Kylie Jenner is a popular reality television star and social media influencer who is known for her signature full lips. In 2015, Jenner revealed that she had gotten lip fillers to achieve her plump pout, sparking a widespread trend of young people getting lip fillers to emulate her look. Jenner has faced criticism for promoting a potentially dangerous trend, as lip fillers can carry risks and complications, including migration and the "duck lips" appearance. 

This trend is characterized by the desire for fuller, more voluptuous lips that resemble the style Jenner popularized. The look typically involves enhancing both the volume and shape of the lips to create a pronounced and well-defined appearance. The specific aesthetic is a well-balanced and symmetrical enhancement that maintains the natural curvature of the lips while providing a noticeable increase in size, particularly in the lip body.

Many young girls continue to seek the “Kylie Jenner’s lips look” when they are looking to get lip filler done. However, lips can become over-filled and develop a "ducky" appearance when too much dermal filler is injected or when the filler is not administered properly. This exaggerated look is often not the intended outcome of lip augmentation and can occur due to various reasons:

Excessive Filler Volume

One of the primary causes of over-filled lips is the injection of too much filler material. Everyone's facial structure is different, and there is a limit to how much volume the lips can naturally accommodate. When the amount of filler exceeds this limit, the lips can protrude outward in an unnatural manner, creating a "ducky" appearance.

Incorrect Injection Technique

The technique and placement of filler injections play a crucial role in the final appearance of the lips. If the filler is injected too superficially or not evenly distributed, it can lead to an uneven surface and the characteristic protrusion associated with "duck lips." Additionally, improper technique may cause the filler to migrate beyond the lip border (vermillion border), exacerbating the ducky look.

Inappropriate Filler Choice

Different types of fillers have varying levels of viscosity and cohesiveness. Using a filler that is too thick or not suitable for the delicate lip area can result in an overfilled appearance. It's important to use products that are specifically designed for lip enhancement and that can create a smooth, natural-looking result.

The choice of lip filler depends greatly on your anatomy, your desires, and your goals. Here are some example products that are commonly used by aesthetic injectors for smooth, natural-looking results.

  1. Juvéderm Ultra and Ultra Plus: These are used to add volume to thin and fading lips. Juvéderm Ultra is slightly softer and feels a bit more natural to touch.
  2. Juvéderm Volbella: This is used to improve lip definition, create a “Cupid’s Bow” at the top of the lips, and minimally adds volume throughout. Results can last up to five years.
  3. Juvéderm Vollure: The least robust filler in the Juvéderm family, meaning it takes up the least amount of space beneath the skin. This makes it ideal for adding volume and sitting smoothly beneath the skin, providing a natural and subtle look.
  4. Restylane Refyne and Defyne: These are also effective lip fillers. Generally used to add volume and fullness to the skin to correct moderate to severe facial wrinkles and folds.
  5. Revanesse Versa: A popular lip filler.

Lack of Anatomical Consideration

The natural anatomy of the lips must be taken into account when injecting fillers. Overlooking the individual's unique lip shape and structure can lead to disproportionate augmentation and a ducky appearance. The goal should be to enhance the lips while respecting their natural contours and symmetry.

Cumulative Effect

Repeated filler injections without allowing previous fillers to fully dissipate can lead to a buildup of material in the lips. Over time, this can contribute to an over-filled look as the cumulative volume of filler becomes too great for the natural lip tissue to support.

Patient Expectations and Trends

Some patients may request a very full, pronounced look, influenced by trends or celebrity images. If their expectations are not managed properly, and they insist on adding more volume than is appropriate, the result can be over-filled lips with a ducky appearance.

Lip filler migration and dissolving is a topic that has gained a lot of attention in recent years, as more and more people are turning to lip fillers to achieve fuller, more defined lips. While lip fillers can be a great way to enhance your natural features and improve your overall appearance, it's important to understand the potential risks and complications that can arise from lip filler treatments, including migration and dissolving.

What are “Duck Lips”?

The "duck lips" appearance is a term used to describe lips that have been overfilled with filler, resulting in a pouty, exaggerated look. This can happen if the filler is injected too close to the surface of the skin, or if too much filler is used in the treatment. The duck lips appearance can be unflattering and can even make it difficult to speak or eat normally.

Also a visual sign of lip migration is when there is a plump upper lip and a lack of a definite boundary between the lip edge and the upper or lower region of the lip border.

Normal vs over filled duck lips

Lip filler migration is a potential complication of lip filler treatments, where the filler substance moves from the intended injection site to another area of the face. When the lips are done over many years. It is best to have it dissolve and start fresh to prevent the “duck lips” appearance.

Key Signs of Lip Filler Migration

To identify the signs of lip filler migration, you should look for any changes in the shape or appearance of your lips after your treatment.

Some common signs of lip filler migration include:

Unevenness or Asymmetry in the Lips

After receiving lip fillers, you might expect your lips to have a symmetrical and balanced appearance. However, if you start to see that your lips look uneven or asymmetrical, it could be a sign that the filler has moved. This might manifest as one side of your lips appearing larger or differently shaped compared to the other, or your upper and lower lips may no longer have the same proportionality they had immediately following the injection.

Lumps or Bumps in the Lip Tissue

You may feel or see lumps or bumps in your lips or even inside your mouth if the filler has migrated. These irregularities are pockets where the filler has clumped together instead of being smoothly integrated with your lip tissue. They can create an uneven texture that is both visible and palpable. If you notice these lumps or bumps, they could be an indication that the filler has not stayed in place.

A "Duck Lips" Appearance

One of the more noticeable signs of filler migration is when your lips take on a very pouty and exaggerated look, often described as "duck lips." This occurs when the filler spreads beyond the edges of your lips, particularly causing your upper lip to protrude in an unnatural manner. The intended result of lip fillers is usually a subtle enhancement, so a pronounced "duck lips" effect suggests that the filler may not be confined to the desired areas.

Changes in the Sensation of the Lips

Should you experience any numbness, tingling, or a change in the normal sensation of your lips, this could be indicative of filler migration. These sensory changes might be due to the pressure exerted by the displaced filler on the nerves in your lips, or they could be a side effect of the injection technique. It's important to keep track of any such changes, as they can affect not just how your lips feel but also their function, potentially impacting your ability to speak, eat, or express yourself.

How To Fix Duck Lips

If you've experienced lip filler migration, the first step is to consult with a qualified medical professional. They will be able to assess the extent of the migration and recommend a treatment plan to address the issue. In some cases, the filler can be dissolved using a special enzyme called hyaluronidase, which breaks down the filler substance and allows it to be safely absorbed by the body.

The dissolving process typically involves a series of injections with the enzyme, and it can take several treatments to fully dissolve the filler. It's important to note that dissolving lip filler is a delicate process and should only be performed by a qualified medical professional.

If you're dealing with the appearance of "duck lips" after receiving lip fillers, an aesthetic injector can employ several methods to correct this issue. Here's what you might expect during the process of fixing "duck lips":

1. Assessment:

Firstly, your injector will assess your lips to determine the extent of the filler migration and the best approach for correction. They will examine the shape, volume, and symmetry of your lips, as well as the specific areas where the filler has migrated.

2. Dissolving the Filler:

If the "duck lips" are due to an excess of filler or migration, your injector may opt to use an enzyme called hyaluronidase. This enzyme is effective in breaking down hyaluronic acid-based fillers, which are commonly used in lip augmentation. Your injector will carefully inject hyaluronidase into the areas where the filler needs to be dissolved. You may feel a slight pinch or discomfort during the injection, similar to what you felt when you received the fillers.

3. Massage:

After the hyaluronidase is injected, your injector might gently massage your lips to help distribute the enzyme evenly and encourage the breakdown of the filler. This can help reshape the lips and reduce the exaggerated poutiness.

4. Monitoring the Results:

The effects of hyaluronidase can be seen relatively quickly, sometimes within 24 to 48 hours. Your injector will monitor the results and may require you to come back for a follow-up visit to ensure that your lips are returning to a more natural shape and that the "duck lips" appearance is being resolved.

5. Re-injection (if necessary):

Once the unwanted filler has been dissolved and your lips have settled, you and your injector might discuss the possibility of re-injecting filler, but with a more conservative approach. If you decide to proceed, your injector will use careful techniques to add volume to your lips while avoiding the previous issues that led to the "duck lips."

6. Aftercare:

Your injector will provide you with aftercare instructions to ensure proper healing and maintenance of your lip shape. This may include avoiding certain activities, applying ice to reduce swelling, and staying hydrated.

Remember to always have lip filler procedures and corrections performed by a qualified and experienced aesthetic injector to minimize the risk of complications and ensure the best possible outcome.

Overall, lip filler migration and dissolving is a serious issue that can have significant consequences if not properly addressed. By understanding the potential risks and complications, and taking the necessary precautions, you can help ensure that your lip filler treatments are safe and effective.

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Nancy Park, RN, BSN
Certified Aesthetic Nurse