Dissolving Filler: The Basics

filler complicationsThe majority of lip filler, cheek filler, and under-eye filler is the hyaluronic acid-based product. This includes products like JuvedermRestylane, 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.

Why Would You Want To Dissolve Filler?

why dissolve fillersOftentimes, a filler can be placed unevenly by novice injectors. This is an 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 the filler 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.

What Is Hyaluronidase?

Hyaluronidase is the enzyme that 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!

How To Treat Nodules And Lumps After Filler?

While lumps can be seen right after treatment, they rarely can appear 1 week to 6 months afterward. 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-fluorouracil.

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. After a thorough consultation, we will determine the extent of how much Hylanex you may need. Depending on the severity of migration or lumps, I charge either per units or per vial. I generally prefer to inject over multiple sessions because there is such thing as “over injecting” the Hylanex. If you can bring notes from your injector for the product used and the location it was placed that is always helpful.

Cost per unit: $10/U 

Cost per vial: $850/vial 

Lip dissolving package: Package includes fully dissolving migration + 1 syringe of lip filler $1500 flat fee 

Why Would You Need Emergency Filler Dissolving?

reasons for filler dissolvingIf 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.

VIDEO: Botched Filler: How to Get it Dissolved (tips, secrets and technique)

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