Hyaluronidase Injections Overview
Injectable fillers are most often used to add volume to cheeks, lips, face or any area that has lost volume due to ageing and environmental stressors. Fillers aren’t permanent, and can last anywhere from 3 to 18 months, depending on the type you choose. It’s a commitment.
That said, if you’re not completely happy with your results, you don’t necessarily have to wait it out. You might have the option of dissolving your lip fillers early, depending on the type of filler used. You also may be able to have all the filler dissolved or just some of it, if you want to reduce the volume or even out lumpiness.
Common Reasons for Dissolving Filler
Other than dissatisfaction with the final result and appearance of filler by the patient, some other reasons that filler may want to be dissolved are:
- Treatments done too often or an overfilling that stems from “Filler Blindness,” or the dysmorphia produced by forgetting the original natural fullness of the area.
- Lumps and Bumps in the uneven spreading of the filler under the skin
- Medical Emergencies such as vascular occlusion, when filler inadvertently spreads into a blood vessel.
- Filler migration occurs when the cosmetic filler injected into your face begins to spread from its original position. This can happen due to several reasons, including lack of skills or knowledge in injection techniques, incorrect product use or frequent retreatment at short intervals. Filler migration also happens if too much product is used, resulting in an uneven appearance as it migrates away from where it’s been placed. You’ll most commonly find migration after excessive lip filler.
What type of filler can be dissolved?
Only hyaluronic acid (HA) fillers, like Revanesse® Versa™, Juvederm, Restylane, and Belotero, can be dissolved.
HA is a sugar naturally found in your body, mainly in your connective tissues. Mainly, HA works to keep your skin hydrated, which contributes to plumpness. The HA in Dermal fillers is a synthetic, or lab-made version.
Dermal Fillers made from anything else aren’t reversible — but again, they won’t last forever, regardless. Dermal Fillers degrade over time, which is why you need to get follow-up injections to maintain their look.
How is Filler Dissolved?
Hyaluronidase is a concentrated synthetic form of an enzyme that naturally occurs in your body. When injected, it begins to break down the filler, speeding up the dissolving process that would take place over time. Hyaluronidase had medical uses long before fillers, but healthcare professionals have used it to dissolve HA fillers for almost 20 years. It can dissolve fillers in your lips, cheeks, under your eyes, and any other area — as long as they’re HA fillers.
To dissolve lip fillers, you’ll need to receive injections of hyaluronidase (Hyalase) near the filler. If you decide to have your lip fillers dissolved, you’ll want to start the process by requesting a consultation with Dr. Michael K. Kim to discuss your expectations and your options. It's vital to meet for a consultation before proceeding with this procedure.
The risks and adverse effects of dissolving dermal fillers
- 1. Bruising and/or tenderness
- Small bruises at the injection sites are the most common side effect. These typically fade within a few days.
- 2. Swelling
- You may experience some swelling at the injection points. This is usually minor and resolves within 24 to 48 hours.
- 3. Redness
- The injection site may appear red immediately after the treatment. This is a normal reaction and typically subsides within a few hours.
- 4. Volume loss or skin laxity
- In rare cases, hyaluronidase can dissolve your body’s natural hyaluronic acid along with the filler’s. This can lead to volume loss in areas where you didn’t want it.
- 5. Allergic Reaction
- A small percentage of patients have been found to have an anaphylactic reaction to hyaluronidase which if untreated can have serious consequences. If you have a known allergy to bee or wasp stings then there is a chance that you may be allergy to hyaluronidase and would need to discuss this with Dr. Kim prior to considering filler treatments.
Dermal Filler Dissolving Procedure
If you decide to go ahead with removing fillers, here’s a general idea of what to expect:
- 1. First, Dr. Kim will do a patch test by applying a small amount of hyaluronidase on your arm to check for an allergy or sensitivity. After the patch test, the entire process takes just a few minutes.
- 2. If you don’t have any adverse reactions, they’ll clean your lips and apply numbing cream to the area to minimize discomfort from the needle.
- 3. If you don’t want your fillers completely dissolved, they may first dilute the hyaluronidase so it doesn’t remove all the HA.
- 4. Dr. Kim will inject hyaluronidase into different parts of your lips, with the goal of getting the solution as close to the HA as possible. Sometimes a gentle massage is also employed.
- 5. Once finished, Dr. Kim will clean your lips once more and apply aftercare balm or cream.
How long will it take fillers to dissolve?
Hyaluronidase has an immediate effect. But since everyone’s body chemistry is different, not everyone notices results at the same rate.
Different brands of HA fillers may also degrade at different speeds affecting the dissolving time. Finally, the amount of filler you want dissolved can also factor in. You may need to return for more than one session in order to achieve the results you want.
It is important to remember that a temporary fullness after the procedure is usually expected. This can happen due to a combination of mild swelling from the injections and extra volume from the dissolving fluid.
Most people on average notice results within a few days. Dr. Michael K. Kim will provide detailed instructions on how to care for the treated area, which may include:
- Avoiding excessive heat or cold.
- Refraining from strenuous exercise (24-48 hours)
- Avoiding certain medications that could interfere with the healing process
- Using ice packs to reduce swelling
- Taking paracetamol to manage any discomfort
- Using arnica cream or tablets to reduce bruising
- Staying hydrated
