Myth vs Fact: The Truth About Dissolving Filler
March 11, 2024
Fillers have a huge fan base thanks to their ability to contour and rejuvenate the face.…
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Mabrie Facial Institute
166 Geary Street
Floor 1300
San Francisco, CA 94108
Phone: (415) 445-9513
Text/SMS: (866) 618-9459
Monday–Friday 8 a.m.–5:30 p.m.
One of the significant benefits of hyaluronic acid (HA) fillers for the face is their
reversibility. An enzyme named hyaluronidase may be used to safely reduce or remove
unwanted HA filler without causing permanent changes to the patient’s own anatomy.
At MFI, we have extensive experience working with both fillers and hyaluronidase. It’s
important to note that dissolving filler doesn’t have to be a complete removal. In some
cases, our skilled injectors can carefully dissolve just a few millimeters of unwanted filler
to make a substantial difference in your results.
Table of Contents
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 essential for most of the filler to be concentrated in the dry, red portion of the lip.
When filler is placed or migrates to the white portion of the lip, it can look unnatural and
create the appearance of “duck lips.” Similarly, if filler is placed in the moist portion of
the lip, it can result in a “trout pout” or fishy appearance.
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).
Dissolving Lip Filler Before and After Results
Dissolving Lip Filler
Dissolving Lip Filler
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.
Dissolving Lip Filler
Dissolving Lip Filler
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.
Dissolving Lip Filler
Dissolving Lip Filler
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 bags or worsening existing 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.
Dissolving Under Eye Filler Before and After Results
Dissolving Under Eye Filler
Dissolving Under Eye Filler
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.
Dissolving Under Eye Filler
Dissolving Under Eye Filler
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.
Dissolving Under Eye Filler
Dissolving Under Eye Filler
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.
Dissolving Under Eye Filler
Dissolving Under Eye Filler
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.
Schedule Me
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.
Schedule MeConcerns & Considerations
Deciding whether to dissolve fillers requires careful consideration. While
hyaluronic acid fillers can be dissolved and replaced at any time, dissatisfaction
with the results can persist for years. Specialists can reliably dissolve fillers, but
the removal and replacement process may involve multiple steps, and initial
results might temporarily appear worse. Patients should be aware of these
aspects of the dissolution process.
Consultation & Planning
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:
- Step 1: Remove/dissolve previous filler
- Step 2: 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
Because we know you have questions about what you should and shouldn’t do after treatment, we created an entire page dedicated to BOTOX and dermal filler aftercare.
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
Can I dissolve my filler?
What is Hylenex?
In the United States, there are currently four approved purified hyaluronidases available. Three of them are derived from animal sources, while the fourth form, Hylenex, is produced in a laboratory using recombinant human DNA. Hylenex has a significantly lower occurrence of allergic reactions compared to animal-derived hyaluronidases.
How does hyaluronidase affect the body’s natural hyaluronic acid?
Hylenex is capable of breaking down both injected hyaluronic acid and the body’s own native hyaluronic acid. However, the body replenishes its native hyaluronic acid within 1 to 2 days. This means that Hylenex is able to remove injected hyaluronic acid without causing a
lasting decrease in the body’s natural hyaluronic acid.
How long does hyaluronidase take to work?
The Hylenex injection rapidly transforms the filler from a gel-like state into a liquid. The body then absorbs this liquid within 1 to 2 hours. When dissolving filler, the average patient typically requires 1 to 2 treatments, with a recommended waiting period of 1 to 2 days between treatments. We usually wait 2 to 5 days before adding more filler.
Should I dissolve my fillers or wait?
If you’re dissatisfied with your results, your original provider should make things right for you. However, if they are unwilling or untrained in revision/correction of dermal fillers, you’ll have to choose whether to wait it out or seek corrective treatment elsewhere.
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.
A Reputation Built on Results
Dr.Mabrie has really good aesthetic judgment. He gave me a holistic suggestion for the entire face....
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