Hyaluronic acid filler treatments are an increasingly popular treatment, but that doesn’t mean everyone who gets them is happy with their results, at least not permanently. That’s why dissolving face fillers is a crucial procedure to have available. This article will teach you everything you need to know about it so that you can analyze your needs and be informed about your treatments and options.
Assessing the Need to Dissolve Old Filler
You need to know the right time to dissolve old fillers to make smart choices about your cosmetic treatment.
Signs of Filler Migration or Overcorrection
Filler migration happens when the product moves away from where it was first injected into nearby areas. This creates unwanted fullness. Here are the signs you might notice:
- Persistent puffiness that spreads beyond the treated area, which you’ll notice weeks after the injection.
- Blurred borders around the lips or other treated features.
- Asymmetry that shows up slowly rather than right after treatment.
- Lumps, bumps, or nodules under your skin.
- Firmness or unnatural texture when you touch the area.
The lips and areas around the mouth show migration more often [1]. Many patients see a “filler mustache” or puffy shelf above their lip line from migrated filler [2]. Research shows filler can stay in tissues for years, and the risk of migration goes up as time passes [3].
When Poor Esthetic Outcomes Require Reversal
Even correctly placed filler might give results that need dissolution. You might need reversal if:
- You see overfilling or “pillow face” where your features look too puffy.
- There’s an unnatural appearance that makes you feel “different but not better” [4].
- You notice tissue stretching from multiple treatments, which can make skin loose over time [4].
- You have a Tyndall effect (bluish discoloration) from filler placed too close to the surface [5].
- You feel psychological dissatisfaction with results that don’t match your goals [4].
Studies show patients who want their filler dissolved mostly worry about swelling (52%), lumpiness (20%), and festoons or malar edema (6%) [3]. Changes can show up months or years later, even if you liked the results at first.
Elective vs. Emergency Filler Dissolution
You can split filler dissolution into two types based on their urgency.
Elective dissolution happens because of cosmetic choice or non-urgent fixes. You might be motivated by:
- Dissatisfaction with the results of a dermal filler treatment.
- A desire to get your natural look back.
- A need to prepare for other procedures.
- Problems with asymmetry, lumps, or migration.
Emergency dissolution needs immediate medical attention. Examples include:
- Vascular occlusion, or filler blocks blood flow, and tissue turns white, then blue-gray [6].
- Bad pain, discoloration, numbness, or tightness where you got treated.
- Risk of tissue death, especially in dangerous spots like the forehead between the eyebrows, the inner corner of your eye, and the nostrils or wings of the nose [7].
What to Know About Hyaluronidase
Hyaluronidase, the enzyme that dissolves face fillers, breaks down hyaluronic acid molecules in your skin. Your body naturally absorbs these broken-down particles. Learning about this process will help you know what to expect from the procedure.
Hyaluronidase Types: Ovine vs. Recombinant
The process of dissolving filler varies with different hyaluronidase formulations.
Ovine-derived hyaluronidase (Vitrase) comes from sheep testicles. This traditional formulation remains a top choice for many practitioners who have used it clinically over many years.
Human recombinant hyaluronidase (Hylenex) is created in laboratories through genetic engineering. Research shows this version might break down hyaluronic acid better than its ovine counterpart [8]. In spite of that, some studies suggest both formulations work equally well in clinical practice [3].
Safety Considerations and Allergy Risk
Safety is your main goal when you think about dissolving face fillers. Allergic reactions to hyaluronidase are rare and happen to less than 0.1% of patients [11]. Learning about these risks is vital if you’re planning this procedure.
Intradermal testing protocols
Your Beauty Vault provider might recommend an intradermal skin test before dissolving your fillers, especially if you have known allergies already. This test includes injecting a small amount of hyaluronidase into your forearm and then watching the injection site for 30 minutes to see if there are any reactions [5].
Some practitioners add a saline control injection with the hyaluronidase test. This helps them distinguish between true allergic responses and normal tissue reactions to the injection [13].
Cross-reactivity with Bee/Wasp Venom
Previous allergic reactions to bee or wasp stings are among the biggest risk factors for hyaluronidase sensitivity. Your past insect sting reactions can tell a lot about potential problems. Consider:
- Large local reactions to stings mean your risk of anaphylaxis from future exposure is more than 5% [5].
- Past anaphylactic reactions to bee or wasp stings raise your risk of anaphylaxis to future stings to at least 60% [5].
Patients with known bee or wasp sting allergies should definitely ask their Beauty Vault provider for an intradermal test before dissolving dermal fillers.
Procedure Protocol and Aftercare Guidelines
A successful facial filler dissolution needs a step-by-step approach from start to finish. Your chances of getting the best results will improve when you follow these guidelines carefully.
Pre-treatment Preparation
Safety and effectiveness depend on proper preparation before dissolving face fillers. Your provider should do a complete consultation to assess your needs and review your medical history.
In the time leading up to the day of the treatment, here’s what you need to do to prepare:
- Stay away from blood-thinning medications and supplements (including aspirin, ibuprofen, fish oil, vitamin E) at least seven days beforehand [18].
- Don’t drink alcohol 24 to 48 hours before the procedure [18].
- Quit smoking several weeks before; it can slow down healing [17].
- Show up with clean skin without makeup in the treatment area [18].
- Make sure your calendar is clear to see your Beauty Vault provider again after two weeks so that they can check your results and decide if you need more sessions [22].
Timeline for re-injection or surgical alternatives
Hyaluronidase stays active for about 24 to 48 hours [29]. New fillers injected during this time would likely dissolve.
Your tissues need two to four weeks to recover fully after filler dissolution before getting new injections [26]. This waiting period lets hyaluronidase clear out completely. It also provides a clearer view of your natural facial contours and reduces the risk of complications. Keep this in mind if you want to have new fillers by a certain date so that you can schedule the dissolution accordingly.
Expected Outcomes and Long-Term Considerations
Your body reacts uniquely to filler dissolution procedures. A clear understanding of the recovery process and results will help set the right expectations. Clinical experiences show certain patterns, though effects vary from person to person.
Face After Dissolving Fillers: Volume Loss and Skin Laxity
You’ll likely notice immediate facial volume changes after dissolving fillers. Your face might look temporarily hollow or deflated as the filler and your natural hyaluronic acid break down [3]. Your skin will bounce back gradually as it regains elasticity and hydration.
People who’ve used fillers long-term often see bigger changes. Research links post-dissolution facial changes to how long and how much filler someone has used. Patients who kept fillers for 60 months saw more hollowing than those who had them for 24 months [25]. The same goes for quantity; people who used larger amounts noticed more hollowing than those who used less [25].
Need to Dissolve Your Dermal Fillers? Come to the Beauty Vault!
If you’re displeased with your treatments, reversing them is the first step toward achieving the look you truly desire. Now that you have the information you need to proceed, it’s time to partner with a team that cares as much about your goals as you do and has the skill to back it up. That’s exactly what we offer at the Beauty Vault in West Hollywood. Book an appointment now by calling us at (323) 800-6770 or filling out a contact form.
FAQs
Q1. Is it necessary to dissolve old fillers? Dissolving old fillers may be necessary if you experience issues such as overfilling, migration, or unnatural appearance. Consider dissolution if you notice puffiness, asymmetry, or lumps in the treated areas. However, the decision should be made in consultation with a qualified healthcare professional.
Q2. Can fillers be dissolved after several years? Yes, fillers can be dissolved even after several years. While your body naturally breaks down hyaluronic acid fillers over time, some may persist longer, especially in areas like under the eyes. Hyaluronidase can be used to dissolve these long-lasting fillers if necessary.
Q3. How should you prepare for filler dissolution? To prepare for filler dissolution, avoid blood-thinning medications and supplements like aspirin and fish oil for at least a week before the procedure. Refrain from alcohol consumption for 24 to 48 hours prior, and arrive with clean, makeup-free skin in the treatment area. Your Beauty Vault provider will give you specific instructions based on your individual case.
Q4. What can you expect after dissolving facial fillers? After dissolving fillers, you may experience temporary volume loss and a slightly hollow appearance as both the filler and some naturally occurring hyaluronic acid break down. You might also notice swelling, bruising, and tenderness at injection sites. These effects typically resolve within a few days to weeks.
Q5. How long should I wait before getting new fillers after dissolution? It’s recommended to wait at least two to four weeks after dissolving fillers before considering re-injection. This waiting period allows your tissues to recover fully, ensures complete dissipation of the dissolving enzyme, and provides an opportunity to assess your natural facial contours accurately.
References
[1] – https://www.iebotox.com/blog/filler-migration
[2] – https://www.truejewelcosmeticcenter.com/education/do-you-know-the-signs-of-filler-migration/
[3] – https://www.hubmeded.com/blog/dissolving-filler-before-and-after-realistic-results
[4] – https://empireondemand.com/blogs/posts/too-much-cheek-filler-signs-risks-safe-reversal-options
[5] – https://pmc.ncbi.nlm.nih.gov/articles/PMC8570661/
[6] – https://www.spamedica.com/blog/face-fillers-gone-wrong/
[7] – https://pmc.ncbi.nlm.nih.gov/articles/PMC4728901/
[9] – https://pmc.ncbi.nlm.nih.gov/articles/PMC11733830/
[10] – https://www.revive.md/blog/how-to-dissolve-fillers-in-the-lips-face
[11] – https://www.aaaai.org/allergist-resources/ask-the-expert/answers/old-ask-the-experts/hyaluronidase
[12] – https://www.anesth-pain-med.org/upload/pdf/Apm009-03-05.pdf
[14] – https://www.sciencedirect.com/science/article/abs/pii/S0091674909013190
[16] – https://www.epain.org/journal/view.html?doi=10.3344/kjp.2015.28.2.153
[17] – https://my.clevelandclinic.org/health/treatments/dissolving-lip-filler
[19] – https://amyberishaaesthetics.com/education/how-long-does-hylenex-take-to-work-a-timeline-guide/
[20] – https://www.enhance-me-training.com/wp-content/uploads/2023/02/ELECTIVE-Dissolving-Protocol.pdf
[21] – https://www.dermatologist-nyc.com/blog/what-are-the-dos-and-donts-after-hyaluronidase-42556/
[23] – https://azulbeauty.com/filler-dissolution-when-its-time-to-dissolve-and-start-over/
[24] – https://www.karwalaesthetics.com/filler-dissolving
[25] – https://pmc.ncbi.nlm.nih.gov/articles/PMC11037726/
[26] – https://www.danielezra.co.uk/media/blog/understanding-wrinkly-lips-after-dissolving
[27] – https://www.aestheticmdr.com/so-youve-dissolved-filler/
[28] – https://www.plasticsurgery.org/news/articles/risks-and-rewards-what-to-know-about-dissolving-filler
[29] –https://www.austinfaceandbody.com/non-surgical/injectables/filler-correction-reversal/
