Dissolving Dermal Fillers: What To Know
Hyaluronidase (Hylenex®) is an enzyme that breaks down the bonds that hold together hyaluronic acid molecules. Treatment involves a series of injections to dissolve/remove unwanted filler. Once these molecules are disturbed, they are then excreted by the body.
Results are immediate and the enzyme continues to work for the next 48 hours. Allergic reactions can occur. If you have a wasp or bee-sting allergy, you can also potentially react to hyaluronidase.
Because the enzyme cannot distinguish between your natural hyaluronic acid and the filler hyaluronic acid, you may lose some of your natural hyaluronic acid during this process. However, your natural hyaluronic acid regenerates within a few weeks – months.
Whether you are reassessing your beauty goals or had a bad experience with filler in the past – dissolving fillers are a great option for people who want to “start over”. While dissolve can be used in most areas of the face, the most common areas treated are the lips and undereye area.
Some common reasons we recommend dissolving for our patients:
Patient Preference: Trends and beauty goals change with time and so do people’s preferences. 2024 trends are shifting focus from volume to definition for a more natural look.
Non-Emergent Medical Issues: Fluid accumulation under the eyes and/or strained expressions can occur due to product choice, depth of placement, technique, and overfilling.
Product Migration: Several causes can result in filler migration: 1) Patient anatomy and function, 2) frequency of injections, 3) Product Choice, 4) Depth of Placement, and 5) injector experience. When injected, the filler will take the “path of least resistance” and settle into the tissues. Over time, this causes filler to shift to surrounding areas.
Emergent Medical Issues: In the case of a vascular occlusion (i.e. filler is injected into a blood vessel), you will want to reverse the filler immediately in the area to prevent further complications.
Ideally, you will want to see the original provider who placed the filler for your dissolving session, however, we understand that some patients may not feel comfortable approaching their previous injector.
After your dissolving session, you can consider doing nothing or refilling with a gentler approach. If you want to add more filler, wait 1-2 weeks between dissolving and refilling to ensure the enzyme is no longer working and that swelling and bruising have resolved.