Background: Lip augmentation with injectable materials is a popular aesthetic procedure. When complications occur, patients often ignore which material was implanted, thus making subsequent treatments diffi cult. This study aims to present the diagnosis and management of dermal fi ller complications in the perioral region. Study design: The Medical charts of 26 patients with fi ller complications in the oral region were reviewed. All patients were submitted to High Frequency Ultrasound, often complemented by Magnetic Resonance Imaging (MRI) and White Blood Cell Scintigraphy, to evaluate fi ller characteristics and complication types. Antibiotic, corticosteroid or surgical treatment was therefore planned. Results: Imaging always identifi ed dermal fi llers in the oral region, distinguishing among infections, fi brosis, granulomatous infl ammation and product migration. Nine patients received surgery, ten received medical treatments, six received both, and one refused treatment. Eighty percent of the patients presented an improvement after three- year follow-up. Conclusions: Complications of oral region fi llers are similar in clinical presentation but differ in etiology, therefore necessitating different clinical approaches. Imaging techniques add useful information for treatment planning.