I read that injectables can be extracted from the skin if you don't like the results. How is this possible? Laverné from Indianapolis, IN
How Do I Get Rid of Wrinkle Filler if I Don't Like the Results?
Doctor Answers (11)
Extraction of fillers
There are several options to remove fillers:
1. Hyaluronic acid fillers (Juvederm,Restylane for example) can be dissolved with hyaluronidase
2. Fillers that are more permanent like collagen fillers usually resolve with time but if they may need to be excised
3. Permanent fillers will have to be excised
4. Some fillers such as sculptra respond to steroid injections.
Of note, fillers near the lower eyelid can sometimes be removed without a scar through an approach through the inside of the eye.
Anytime a patient has an adverse outcome from a filler, I would first give it some time before performing surgery.
Reversal of Injection Procedures
One of the reasons we lean toward hyaluronic acid fillers such as Restylane, Juvederm and Perlane is because they are easily reversed with Hyaluronidase. This product dissolves and degrades the Restylane, Juvederm or Perlane so as to reverse the results of the initial injection. It's a great insurance policy when choosing a practitioner. Make sure yours has it at his/her disposal.
Removing an undesireable result from filler injections may be possible
Most patients find the immediate results of soft tissue filler treatments very satisfying. If an undesirable result occurs, your treatment provider should be able to discuss and carry out all of the treatment options.
Removing the effects of a "filler" treatment can be difficult. This is why any filler treatment needs to be done carefully, conservatively and only by very experienced and Board Certified Specialists. Hyaluronic Acid based dermal fillers have the additional safety of being partially or completely reversed with time or with the injection of a commercially available enzyme known as Hyaluronidase.
Even in very experienced hands, any filler treatment could result in unwanted results or a complication. The management of these undesirable results should be discussed before you have a treatment. Other techniques for reducing unwanted results are occasionally needed and are known to experienced and qualified specialists.
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Removal of dermal fillers
Not all dermal fillers can be removed easily. Hyaluronidase is very good at removing hyaluronc acid dermal fillers.
Hyaluronidase for filler dislikes
If you are unhappy with some aspect of a hyaluronic filler (such as Restylane or Juvederm), there are several options - 1) wait to see if what you dislike improves or reduces, 2) your physician can try to extract the unwanted filler material with pressure on the skin after a tiny poke or incision is made - this works well if the material is placed to close to the skin surface where it can easily be extracted, and 3) an injection of a small amount of hyaluronidase can dissolve the unwanted filler.
Reversal of undesirable facial filler injections
The key is to choose a reputable, experienced board-certified aesthetic physicians for your facial filler injection. Vast majority of the time, in the right hands, aesthetic filler injections are instantly gratifying and do not require reversal. For first timers, it may be desirable to utilize hyaluronic acid fillers such as Restylane or Juvederm, so that in the very unlikely scenario that you are not happy with the cosmetic outcome of the filler injection, there may be an option for complete reversal with hyaluronidase.
Hyaluronidase for Hyaluronic Acid Fillers
The beauty about hyaluronic acid fillers is that they are reversible via injection of an enzyme known as hyaluronidase. However, in my hands, the need for use of this reversing agent has been very rare. In general, satisfaction from fillers is very high with two exceptions: too little injected or too much injected. The one anatomic area to be very careful with is injection around the eyes. The filler to be used, if at all, is a hyaluronic acid filler (Juvederm, Restylane). Radiesse, which is made from calcium hydroxylapatite is a fantastic filler in the nasolabial folds, but not recommended around the eyes.
Hyaluronidase--A Safety Valve for Hyaluronic Acid-Containing Fillers
Nonsurgical rejuvenation of the eyes, cheeks, lower face and neck have become very popular in-office procedures in the past few years. Hyaluronic acid-containing injectable agents, such as Restylane, Perlane, Juvederm Ultra and Juvederm Ultra Plus are now used routinely not only for filling, but for volumizing, shaping and contouring of the eyebrows, the region under the eyes, smile lines, "marionette" lines and jowls. These procedures take only minutes to perform and often engender a "Wow!" reaction when patients look in the mirror immediately after treatment.
On rare occasions, particularly around the eyes, where the skin is especially thin (even in youth) and around the mouth, due to the anatomy of that area, small bumps or other irregularities may occur following the injection of any of these materials.
In these uncommon instances, enter the cavalry: hyaluronidase. Hyaluronidase is an enzyme that dissolves hyaluronic acid. Injected in minute droplet quantities, the hyaluronic acid fillers and volumizers can usually be dissolved away completely in one to three days. The enzyme seems to preferentially melt the injected hyaluronic acid rather than the native variety. All this makes a great "safety valve," and I routinely inform patients who are anxious first timers to fillers and volumizers that we have this treatment available "just in case" they feel they need it, which fortunately seldom occurs. The fact is that I store it in my office fridge just to reassure patients and have seldom ever have needed to use it.
Hyaluroinic acid fillers, Hyaluronidase and correction
Hyaluronidase is a naturally occuring enzyme produced by bacteria that digest the hyaluronic acid normally present in the skin., It can also be used to digest the hyaluronic fillers (Restylane, Prevelle Silk, Hyalform, Perlane, etc) that are injected into the skin.
Removing Facial Injectable Filler
Most facial injectable fillers today are temporary and designed to only last a few months to a year. Many cosmetic patients are happy with the aesthetic results of these non-surgical treatments for facial wrinkles.
Some patients are unsatisfied with the cosmetic results and would like to reverse the treatment. Removal of filler material is difficult at best, and impossible for some fillers. Some fillers are potentially more easily reversible, such as the hyaluronic acid fillers. Your cosmetic surgeon may inject hyaluronidase to speed up the natural breakdown of hyaluronic acid. Hyaluronidase dissolves the filler with results generally within a day.
Speak to a specialist to determine the appropriate treatment options for you. Best of luck.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.