Dermal filler dissolvers, also known as hyaluronidase, is a specialised enzyme that break down hyaluronic acid-based fillers when you need them removed. In our experience, patients look to dissolve for several reasons, from unwanted side effects to unhappy results, such as overfilled lips. The procedure is quick, taking just minutes to perform, with results visible within 24-48 hours. While it’s generally safe, you’ll need proper medical screening and preparation, including an allergy test. We recommend choosing a provider who understands facial anatomy and has specific experience with dissolver treatments. Let’s explore what’s involved in ensuring your filler dissolution is safe and effective.
Key Takeaways
- Dermal filler dissolvers, primarily hyaluronidase, break down hyaluronic acid-based fillers through enzymatic processes targeting chemical bonds between sugar molecules.
- Results typically appear within 24-48 hours after injection, though complete dissolution may take 2-4 weeks depending on filler volume.
- Common side effects include mild swelling, bruising, and discomfort, with patients needing to avoid exercise and extreme temperatures during recovery.
- Multiple treatment sessions may be necessary, and patients should wait two weeks before receiving new filler injections.
- Only trained practitioners should perform dissolver treatments, as proper technique and anatomical knowledge are crucial for safety.
Understanding Dermal Filler Dissolvers
Dermal filler dissolvers are specialised enzymes, primarily hyaluronidase, that break down hyaluronic acid-based fillers. This naturally occurring enzyme works by cleaving specific bonds within the filler material, reducing its viscosity and allowing your body to reabsorb it. At our clinic, we’ve seen how this process can effectively address various filler-related concerns, from minor adjustments to urgent complications.
When injected, the enzyme disperses through the treatment area, targeting and breaking down the hyaluronic acid filler. While the enzyme itself has a short half-life, it remains active in the tissue for 24-48 hours, gradually dissolving the filler. Our patients often notice visible effects within hours, though complete dissolution may take up to two weeks.
The effectiveness of this dissolving process depends on several factors, including the enzyme dose, type of filler used, and how it’s distributed in your tissue. In our experience, the proximity of the hyaluronidase injection to the filler material significantly impacts the results. This precise procedure requires expertise to ensure optimal outcomes while maintaining your natural appearance.
Types of Fillers That Can Be Dissolved
Not all dermal filler treatments can be reversed with dissolvers. Hyaluronic acid-based fillers, including popular brands like Juvederm, Restylane, Teosyal, and Belotero, are dissolvable using hyaluronidase injections. These injectable treatments represent most of the temporary fillers used in modern cosmetic procedures.
However, some filler materials are non-reversible. These include Sculptra (poly-L-lactic acid), Radiesse (calcium hydroxylapatite), and PMMA-based fillers. These semi-permanent or permanent fillers integrate with your connective tissues and can last 12-24 months or longer. Our clinic primarily uses hyaluronic acid-based fillers precisely because they offer the safety net of being dissolvable if needed.
It’s important to note that even when dissolving previous fillers, you might experience some unevenness or residual effects. In our practice, we’ve seen that sometimes multiple treatments may be necessary for optimal results, especially with concentrated or extensively cross-linked fillers.
How Filler Dissolvers Work
The main ingredient in dermal filler dissolving procedures is hyaluronidase, which specifically targets hyaluronic acid. This enzyme comes in different forms: ovine (sheep-derived), bovine (cow-derived), or human recombinant (such as Hylenex). Each type has its specific applications, though no single variety has proven consistently superior across all scenarios.
The dissolution process is fascinating yet complex. When we inject hyaluronidase, it begins breaking down hyaluronic acid by targeting specific molecular bonds. The effectiveness varies depending on several factors:
- Filler concentration (higher concentrations dissolve more slowly)
- Cross-linking extent (more cross-linked fillers resist dissolution)
- Filler structure (monophasic vs. polyphasic)
Medical Indications for Filler Dissolution
Certain situations require immediate filler reversal. The most urgent is vascular occlusion, where filler blocks a blood vessel. This rare but serious complication requires dissolving the filler within 4 hours to prevent tissue damage. Warning signs include slow capillary refill, dusky or blue-grey skin coloration, pain, and cool skin temperature.
Our clinic also handles less urgent but important indications for dissolution, such as overfilling like in the image above, including:
- Tyndall effect (bluish discoloration, common in tear troughs)
- Filler migration outside the intended area
- Lumps or nodules that develop months after treatment
- Overcorrection or uneven appearance
- Persistent swelling or allergic reactions
- Pre-surgical preparation
Sometimes, patients may require dissolution due to delayed complications or dissatisfaction with their initial treatment. We carefully evaluate each case to determine the most appropriate course of action, considering factors like the type of filler used and the specific concern being addressed.
The Step-by-Step Dissolving Procedure
Your filler dissolving procedure begins with a thorough consultation where we discuss your concerns and assess the treatment area. During this time, we review your medical history and check for any potential adverse reactions to the treatment. Our approach ensures we understand your goals while prioritizing your safety.
The actual procedure follows these steps:
- Application of numbing cream for your comfort
- Skin patch test to check for allergic reactions to hyaluronidase
- Careful injection of hyaluronidase into the filler area
- Gentle massage to help distribute the enzyme
- Initial assessment of immediate effects
- Scheduling of follow-up appointment
The entire treatment typically takes about an hour, though the dissolving process continues working after you leave our clinic. We schedule a follow-up appointment approximately two weeks post-treatment to assess the results and determine if additional sessions are needed.
Potential Risks and Side Effects
When considering dissolving lip filler or other dermal filler treatments, it’s important to understand both immediate and long-term potential risks. Immediate side effects typically include injection-related responses such as redness, swelling, bruising, and tenderness. These effects are usually mild to moderate and resolve within a few days.
More significant concerns include allergic reactions. These may present as prolonged redness, swelling around the face or mouth, itching, or skin bumps. In our experience, proper pre-treatment screening and careful technique minimise these risks significantly.
Long-term considerations include possible volume loss or skin laxity, as hyaluronidase can affect your natural hyaluronic acid as well. Some patients may experience what’s known as Post-Hyaluronidase Syndrome, which can include facial hollowing or changes in skin quality. Our practitioners carefully balance the amount of dissolving agent used to minimise these effects while achieving your desired results.
Recovery and Results
Understanding the timeline for filler dissolution helps set realistic expectations. While you may notice changes within minutes of the hyaluronidase injection, the most noticeable effects typically appear within 24-48 hours. In fact, studies have shown that hyaluronidase reduces the volume of HA fillers with a 64.1% decrease within the first hour and up to 81.7% after 24 hours (Bravo et al., 2024). Initial swelling usually subsides within 48-84 hours, giving you a clearer picture of the results.
The complete dissolving process can take up to two weeks, particularly with concentrated fillers or larger volumes. During this time, the enzyme continues breaking down hyaluronic acid while your body naturally processes the dissolved material. Our patients appreciate knowing that patience is key – rushing to judgment before the two-week mark may lead to unnecessary additional treatments.
Some cases may require multiple sessions, especially if you have a significant amount of filler to dissolve. We carefully evaluate your progress during your follow-up appointment before recommending any additional treatments or new filler injections.
Essential Aftercare Instructions
Proper aftercare significantly impacts your recovery and results. Here are our clinic’s detailed guidelines for post-dissolution care:
Immediate Care (First 24 Hours):
- Avoid touching or rubbing the treated area
- Apply cool compresses for 10 minutes every hour
- Skip makeup application for at least 12 hours
- Take antihistamine if recommended (typically 10mg loratadine)
- Use paracetamol for any discomfort
First Week:
- Avoid blood-thinning medications unless medically necessary
- Skip facial treatments, including facials and chemical peels
- Sleep slightly elevated to minimise swelling
- Stay well-hydrated
- Avoid smoking, vaping, or using straws
Two-Week Recovery Period:
- Protect the area from direct sun exposure
- Avoid strenuous exercise for the first 48 hours
- Pause active skincare products (like retinol) for 24 hours
- Attend your scheduled follow-up appointment
- Wait at least 14 days before considering new filler treatments
These guidelines help ensure optimal results while minimising potential complications. Our team remains available throughout your recovery to address any concerns and ensure your comfort during the healing process.
Choosing a Qualified Provider
Choosing a qualified provider is the best way to ensure a safe and effective filler dissolution treatment. When you’re looking for someone to perform this delicate procedure, its best to choose a qualified aesthetic practitioner with extensive experience with both dermal fillers and hyaluronidase administration.
Having fixed our fair share of issues caused by other clinics, we’ve seen how proper provider selection directly impacts treatment outcomes and safety.
Here are some important steps we recommend when selecting your provider:
- Verify credentials and certifications, ensuring they’re trained to prepare and administer hyaluronidase.
- Review their specific experience in filler dissolution and track record of addressing complications.
- Schedule a consultation to discuss your concerns and evaluate their communication style.
- Examine before-and-after photos of their previous dissolution procedures.
Practitioners performing these cosmetic treatments should be properly qualified, have medical backgrounds, and be registered with their appropriate medical body.
Why is this important? Because hyaluronidase is a prescription-only medication, which means non-medical professionals like beauticians can’t legally perform this procedure. Our practitioners not only hold the necessary prescribing licenses but also maintain comprehensive indemnity insurance and regularly update their training in facial anatomy and complication management. Our clinic lead, Alisha, is also an educator for a global aesthetic training company and has co-authored clinic handbooks on anatomy and advanced injection techniques, knowledge which she brings back to the clinic.
Remember, while dissolving fillers is generally straightforward, it’s still a medical procedure requiring careful consideration and professional expertise. At our clinic, we’re committed to providing safe, effective treatments while ensuring you’re fully informed and comfortable throughout the process.
Frequently Asked Questions
Can Dermal Filler Dissolvers Remove Permanent or Non-Hyaluronic Acid Fillers?
No, you can’t remove permanent or non-hyaluronic acid fillers with dermal dissolvers like poly-L-lactic acid. These dissolvers only work on hyaluronic acid-based fillers. You’ll need to explore other options for non-HA or permanent fillers.
How Much Does a Dermal Filler Dissolving Treatment Typically Cost?
The exact cost depends on the amount of filler, your provider’s expertise, and your location. Treatments may require multiple sessions, so it’s difficult to provide an average cost. Feel free to get in touch with us for a free personalised quote.
Will Dissolving Fillers Affect Future Filler Treatments in the Same Area?
No, dissolving your fillers won’t negatively impact future treatments. You’ll need to wait at least two weeks before getting new fillers, but once the area’s healed, you can safely receive fresh injections.
Can Pregnant or Breastfeeding Women Safely Undergo Filler Dissolving Treatments?
You shouldn’t get filler dissolving treatments while pregnant or breastfeeding. There’s no research proving it’s safe, and most practitioners won’t perform the procedure during these times to protect you and your baby.
How Long Should You Wait After Getting Fillers Before Dissolving Them?
You should wait at least 14 days before dissolving fillers for cosmetic reasons. This allows swelling to subside and fillers to settle. However, if there’s a medical complication, immediate dissolution might be necessary.
