Dermal fillers are one of the most popular aesthetic treatments. They define, reshape and add volume across the face, from the lips and cheeks to the jaw and under-eyes. Done well, they’re a quick and effective way to refresh your features. But what happens if there’s a problem, or you’re simply not happy with the results? Thankfully, hyaluronic acid fillers aren’t permanent. If needed, an enzyme called hyaluronidase can dissolve them. In this article, we go through the main reasons you might want to dissolve dermal fillers, how it’s done and what to expect.
Please note, we are an online skin clinic so we do not offer dermal fillers, injectables or filler dissolving. We have written this because we believe people deserve clear, honest information before they commit to anything.
Why Would You Dissolve Dermal Fillers?
Whilst most people are happy with their fillers, there are times when it’s best or even necessary to dissolve them. This is also why it’s so important to only ever have hyaluronic acid fillers, which can be reversed. The main reasons are:
- Medical reasons: Fillers carry risks. Immediate complications such as vascular occlusion or an allergic reaction are emergencies and usually mean the filler has to come out straight away. Delayed problems like infection or hard lumps, known as granulomas, can also need dissolving. These are rare but serious, so only ever see an experienced medical injector who keeps hyaluronidase to hand.
- You’re unhappy with the results: This is the most common reason, and any reputable injector will offer it. Usually the area looks overfilled, uneven or simply not what you pictured.
- A change of heart: Less commonly, you may no longer want the enhancement even though nothing is wrong with it. You can either wait for hyaluronic acid filler to fade naturally or have it dissolved. It’s your face, so a change of heart is perfectly valid.
- Your practitioner recommends it: Sometimes an injector advises dissolving before any further treatment. This is usually because of overfilling, migration or lumps that have built up over time. Starting from a clean base gives a far better result, and many will not re-treat until problem filler is gone.
It’s worth remembering that filler takes time to settle. In the first 4 to 6 weeks there can be some swelling and asymmetry. The area may look bigger or less even than the final result. Often a simple review with massage, and sometimes icing in the early days, is enough to even things out. For this reason most injectors suggest waiting at least a month before dissolving, though ultimately the choice is yours. If only one area is uneven or lumpy, your practitioner may spot dissolve just that part rather than removing everything.
There’s one more situation worth knowing about. If you’re due to have facial surgery, your surgeon may ask you to dissolve filler beforehand. It counts as a foreign material that can get in the way of the procedure or your recovery.
Which Dermal Fillers Can You Dissolve?
Hyaluronidase only dissolves hyaluronic acid fillers, which is exactly why they’re the safest choice and the ones we’d always recommend. They’re also the most widely used and include popular brands such as Juvederm, Restylane, Teosyal and Belotero.
There are some reputable and popular non-hyaluronic acid fillers that hyaluronidase can’t break them down. These include poly-L-lactic acid, calcium hydroxylapatite or PMMA which breakdown slowly over tiime by themselves but you can’t dissolve them immediately. These include Radiesse, Sculptra and Bellafill. If there’s a problem with one of these, you have to wait for the body to break it down naturally. Lumps or complications can sometimes need surgery to put right. It’s one more reason to stick to hyaluronic acid filler in the face.
How are Dermal Fillers Dissolved?
Hyaluronidase is an enzyme that breaks down hyaluronic acid, and it can dissolve filler for any of the reasons above. The process is quick and usually takes less than an hour. Your injector numbs the area with cream first. They then inject hyaluronidase, using the amount and concentration needed to break down that particular filler.
The effect isn’t instant. There’s usually swelling straight after, along with some mild discomfort and bruising that settle within a day or two. It can then take a few days up to a week to see the final result, as hyaluronidase works over about 72 hours. It’s also impossible to predict the exact amount needed or to limit it precisely to one spot. So some asymmetry can remain after a spot treatment. Removing filler completely sometimes takes more than one session, depending on how much filler you had and which product it was.
Is Hyaluronidase Safe?
Hyaluronidase is generally very safe with few side effects. The main concern is an allergic reaction. This is why your injector should do a patch test before using it for the first time, unless it’s an emergency. In a genuine emergency such as vascular occlusion, treatment guidelines advise acting straight away rather than waiting to skin test, because rapid hyaluronidase can prevent lasting tissue damage. Some people get temporary redness, swelling or bruising at the injection site. It can also break down a little of your skin’s own hyaluronic acid. This is temporary though, and your body replaces it within 6 to 8 weeks.
When & Where to Get Fillers Dissolved
If you’re having any problems or are unhappy, contact your practitioner first. They can assess whether it’s an emergency that needs dissolving immediately, or whether it’s early swelling that will settle. Lumps and unevenness often respond to gentle massage in the first few days. Because swelling distorts the result, your injector will advise whether to wait or go ahead.
A trained medical professional should always carry out dissolving, ideally the one who treated you. They know exactly which product went where. If your filler was done by a non-medic, they won’t be able to dissolve it or manage any complication. In that case you’ll need to find an aesthetic doctor or other medical provider who offers dissolving. If you’re worried about infection, allergy or vascular occlusion and can’t reach your injector, see your own doctor or go straight to A&E.
Are There Alternatives to Dissolving?
Not every lump or bit of unevenness needs dissolving. Sometimes gentle massage is enough to smooth or reposition the filler. If you have no complications and simply want rid of it, you can also wait. Hyaluronic acid filler breaks down on its own over time. There’s also Topilase, a newer topical option designed to dissolve filler without injections. It’s early days though, and it needs more study before we know how well it works.
When it comes to dissolving, prevention really is better than cure. You can avoid most of the reasons people end up here by choosing an experienced medical injector. A good one will be honest about what suits you and what filler can realistically achieve. Good technique, quality products and a sound knowledge of the anatomy all lower the risks. Above all, only ever have hyaluronic acid dermal fillers in your face. If there’s a problem or you change your mind, then you can dissolve them.
At City Skin Clinic, we are passionate about personalised skincare. Our doctors design bespoke skincare treatments tailored to your skin and goals using ingredients such as tretinoin and azelaic acid where appropriate. We treat acne, hyperpigmentation and skin ageing. To access our services book a video consultation or complete our online consultation form. Your journey towards great skin and hair starts here.
This article is intended for general informational purposes only and is not a substitute for medical advice, diagnosis or treatment. Always consult a qualified medical provider for any medical concerns or questions you might have.
