Hylenex®: Dissolving Fillers With Hyaluronidase

Most patients at Mabrie Facial Institute are very happy with their filler treatments, and very few require correction. However, we do routinely treat individuals unhappy with filler results from outside injectors in the San Francisco Bay Area by dissolving fillers with hyaluronidase—especially filler in the lips and the under eye (tear trough) area. Our skilled Injectors are highly trained in corrective work, which often involves dissolving fillers with hyaluronidase (Hylenex) and re-treating the area. And keep in mind, dissolving filler isn’t always an all-or-nothing choice. In some cases, our Injectors can carefully dissolve a few millimeters of filler to make a huge difference in your results.

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Dissolving Lip Filler With Hyaluronidase

When it comes to filler, the lips can be one of the most commonly overdone or incorrectly treated areas of the face. This is why most of us are familiar with terms like “duck lips” and “trout pout.”  It’s so common, in fact, that in some circles, the overdone look has almost become the norm.

At MFI, most of the patients we treat prefer a natural lip appearance, but even for patients that may want a more dramatic lip augmentation, there are some important parameters that must be observed when we inject lip filler.

It’s important for most of the filler to be in the red or vermillion portion of the lip. When filler is placed or migrates to the surrounding white portion of the lip, it can look unnatural and give the appearance of duck lips. 

Fortunately, for cases where hyaluronic acid filler is used, if there is too much filler or placed in an unwanted portion of the lips, the results can be reversed by dissolving the filler using a substance called hyaluronidase (Hylenex). 

This patient's former provider overfilled the upper lip and placed filler outside the border, resulting in the elimination of her "cupid’s bow." Over 2 appointments, we dissolved the excess filler, then created the dramatically full yet naturally shaped lips she wanted.

This woman's lips were overfilled at another practice. We injected Hylenex with particular emphasis on the center, edges, and outer white borders. This improved overall definition and contour. Our Injectors later refilled the lips to achieve natural-looking fullness.

This woman's upper lip was overfilled by an outside injector, and the filler extended beyond the lip border, creating the appearance of "duck lips". Hylenex injections restored a more natural projection and border.

Dissolving Under Eye Filler With Hyaluronidase

The skin under the eyes is very thin, and thus filler under the eyes needs to be placed meticulously and conservatively—ideally over the course of at least 2 appointments. Patients come to us with complications from outside injectors, including:

• Too much filler, causing contour irregularities that worsen under eye shadows
• Improperly placed or too much filler causing or exacerbating under eye bags
• Filler placed at an inappropriate depth causing a visible bluish tint called the Tyndall effect
• Lumps, bumps, and asymmetry

We can dissolve hyaluronic acid fillers under the eyes using hyaluronidase injections. Fillers like Sculptra® or RADIESSE®, which are not made from hyaluronic acid, cannot be dissolved.

We placed 2 rounds of Hylenex under this woman's eyes to remove poorly placed filler from another practice that was causing a bluish tint (Tyndall effect). Once fully dissolved, we refilled the area with HA filler over the course of 2 appointments, paying close attention to its placement.

After incorrectly placed under eye fillers only highlighted the areas she wanted to correct, this lovely woman in her 40s turned to MFI to fix it. We dissolved the filler and skillfully achieved the natural, rejuvenated appearance she was hoping for.

Misplaced filler from another provider caused this woman to experience under eye puffiness and a bluish hue (Tyndall effect). We applied 2 rounds of hyaluronidase to remove the previously placed filler, then Restylane was re-added to create a more smooth, natural looking result.

This patient had gray/blue swelling under the eyes (Tyndall effect) from filler placed too superficially under the skin by an outside injector. We dissolved the filler with Hylenex injections, then added filler under the eye in the correct plane.

How Much Does It Cost To Dissolve Under Eye or Lip Filler?

Cost for dissolving filler with hyaluronidase at MFI varies depending on the Injector and how much product is needed. Visit our site’s dedicated pricing page for updated price information on all our procedures. Pricing for hyaluronidase injections does not include any additional filler used after dissolving your old filler.

Qualified borrowers may be eligible for 0% financing for 6 to 12 months through CareCredit and Alphaeon medical financing.

The MFI Advantage

MFI focuses exclusively on injectables, and has set the bar in the art and science of fillers for more than 15 years. Dr. Mabrie, trained as a facial plastic surgeon, has dedicated thousands of hours to carefully selecting and training our talented Injectors in the most innovative, effective, and safe techniques for injectables. There is no other practice in the Bay Area with the level of experience, education, and passion for injectables you'll find at MFI.

Meet Your Injectors

Dr. David Mabrie Kimberly PA-C, Injector

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Concerns: Why Didn’t Fillers (Elsewhere) Work for Me?  

Unfortunately, many providers try to do too much with fillers all at once. This can result in overfilling, and filler that spreads out or pools in the wrong areas. We have all seen people with that “puffed up” look that can happen when fillers aren’t carefully layered in stages. 

At MFI, we take our time over the course of at least 2 appointments, carefully sculpting your contours and allowing plenty of time for swelling to subside in between treatments. This, combined with our extensive training and experience, enables us to create ideal contours, smooth transitions, and balanced results that look amazing but not obvious. 

Dissolving Fillers

Consultation and Planning for Your Corrective Injections

Pre-Treatment Considerations

Corrective work, especially when dissolving filler, is a process that can involve dissolving over multiple appointments and re-treating, if desired.  It’s important that patients be informed and prepared before deciding on treatment.  A few things to consider: 

Multiple Visits – Depending on the treatment area and extent of correction required, be prepared for a minimum of 2 to 3 visits.

Your results could look worse before looking better – Treatment areas could temporarily appear more sunken after dissolving filler.

Consider the timing – Since swelling is common after filler treatment, it’s best to wait at least 2 weeks before deciding whether you want your fillers dissolved.

Your Filler Dissolving Procedure

Some individuals come to us specifically because they are interested in dissolving fillers received elsewhere. In other cases, our skilled Injectors observe poorly placed or problematic filler as part of our Illumination 360° process of examining your face from every angle in extremely bright light. In either case, we will carefully mark your face to indicate where to inject the Hylenex.

Dissolving the filler involves a quick injection into the offending filler, which will break down and subside right away. This involves a little discomfort, but we offer a variety of options to keep you comfortable. The appointment takes 30 to 60 minutes, and we typically schedule a second appointment to evaluate your results and re-treat with filler.

Your Lips or Under Eyes Require 2-3 Treatments

When trying to correct bad filler results and give you the results you originally sought, there are two steps involved:

• Remove/dissolve previous filler
• Re-treat with filler in the appropriate amount and placement

Each of these steps can take up to 2 treatments, so you may require 2, 3, or 4 visits.

Examples of 2+ Treatment Process for Lips

Examples of 2+ Treatment Process for Under Eyes

Preparing for Your Procedure

For the best experience, follow these tips in advance of your appointment:

• A few days before your appointment, restrict blood thinners such as anti-inflammatories, fish oil, and alcohol. Limiting these will reduce your risk of bruising from injections.
• DO NOT discontinue prescribed, medically necessary, medications.
• Eat and drink a normal breakfast or lunch prior to your appointment; low blood sugar can make patients lightheaded during treatment.

Recovery & Aftercare

You may experience redness, bruising, and swelling after your corrective injections. These should go away within a day or two. Other side effects may occur, and we’ll be sure to discuss these with you before your treatment.

Swelling

• Some patients may experience swelling after Hylenex injections
• This may cause temporary asymmetry, lumps, or bumps
• Will gradually resolve to reveal your final results over the first 24 hours

Bruising

• Bruising is normal but uncommon, and should resolve in a few days

Redness & Discomfort

• Often minimal and lasting just a few days
• Your treated areas may be tender to the touch

Downtime

• No downtime required
• May return to work immediately after treatment
• May resume normal exercise the next day

Safety

One of the reasons we have Hylenex at our disposal is as a safety precaution. One of the rare risks involved with dermal fillers is a complication called vascular occlusion. This is when an artery or vein is blocked by filler, restricting blood flow to the tissues in the area. This can quickly lead to tissue necrosis (death) if it isn’t recognized and treated quickly. This risk is somewhat higher in non surgical rhinoplasty, or when an injector is not extremely familiar with the vascular anatomy of the treatment area.

At Mabrie Facial Institute, we have the experience and training to generally avoid complications like vascular occlusion. However, that experience and training also enable us to look for and identify signs of vascular occlusion and immediately dissolve the filler with Hylenex if there is any risk.

Dissolving Filler FAQs 

The MFI Advantage

MFI focuses exclusively on injectables, and has set the bar in the art and science of fillers for more than 15 years. Dr. Mabrie, trained as a facial plastic surgeon, has dedicated thousands of hours to carefully selecting and training our talented Injectors in the most innovative, effective, and safe techniques for injectables. There is no other practice in the Bay Area with the level of experience, education, and passion for injectables you'll find at MFI.

Meet Your Injectors

Dr. David Mabrie Kimberly PA-C, Injector

Schedule Me

We’d Love To See You

If you’re ready to talk to an expert about correcting fillers from another injector, request a consultation online or call us at (415) 445-9513 to schedule your appointment. If you’ll be visiting us from outside the area, you’re in good company, and our Fly in for Your Procedure page was created just for you to help make planning your trip as smooth as possible.

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