Dissolving Filler

Dissolving Filler: The Basics

The majority of lip filler, cheek filler and under-eye filler is hyaluronic acid based product. This includes products like Juvederm, Restylane and Belotero. While we often see amazing results posted on social media, the truth is that not all patients will love the results of their fillers. The good news is that there is a medication that can be injected to dissolve the filler directly.

Hyaluronidase is a medication that breaks down our bodies natural and synthetic hyaluronic acid. I specialize in managing complications and treating poor outcomes of fillers.

filler study JAMA

Why would you want to dissolve filler?

Often times, filler can be placed unevenly by novice injectors. This is a opportunity for an injector to sell you MORE filler when you actually need LESS in a particular area.

Another common reason to want filler dissolved is if filler that is placed superficially and creates lumps and nodules.

Finally, some patients get filler and simply decide it is not for them. Generally, I would recommend going back to your injector to have this done; however if you aren’t comfortable with your injectors’ expertise we can happily help you.

nodule filler

What is hyaluronidase?

Hyaluronidase is the enzyme that is breaks down hyaluronic acid (HA) .  The only other way to break down HA is the magic of time. There is no natural treatment for this! The enzyme works rapidly and you will see results in 1-3 days. There are many brands used: Hylanex, Vitrase and Wydase are examples. While the brand does not matter as much, the things one should know are how much to inject and what depth to inject it at. Finally a big tip: most offices do not use their hyaluronidase that often and it is expensive and has a short expiration period. Always be sure the expiration date is checked prior to using it!

hylenex
How to treat nodules and lumps after filler?

I have performed research studies evaluating all the possible complications of fillers. While lumps can be seen right after treatment, they rarely can appear 1 week to 6 months afterwards. This phenomenon, described as delayed onset nodules, is particularly noted after the injection of the Vycross© line of Juvederm fillers: Voluma ®, Volbella ® and Vollure ®. These nodules can be very difficult to treat but after detailed research I have created a protocol that includes injecting Hyalenex, steroids, antibiotics and 5-flourouracil.

How much does it cost to dissolve filler?

There is a lot of variation in how much hyaluronidase  needs to be injected and how many sessions you need. We charge a $150 consultation for an evaluation and this goes towards your treatment. We then charge by the unit of Hylanex injected and the amount you need will vary. I generally prefer to inject over multiple sessions because there is a such thing as “overinjecting” the Hylanex. If you can bring notes from your injector for product used and location it was placed that is always helpful.

Why would you need emergency filler dissolving?

If filler is accidentally injected into an artery, it can clog the artery. This phenomenon is known as vascular compromise. You immediately will want to have hyaluronidase injected, take some aspirin, apply Nitro paste, and use warm compresses. The key for this treatment is early identification and many new injectors are not always able to diagnose this early on. If you have SEVERE bruising or blistering, you need to seek immediate attention and notify your injector.

filler vascular compromise



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