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  • How Can You Remove FIller if the Patient Isn't 100% Happy?
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If any hyaluronic acid filler has to be undone, so that would include Restylane, Perlane, Juvederm, Belotero, Voluma, there's an enzyme called hyaluronidase, and that's an enzyme that disintegrates hyaluronic acid. It dissolves it. So if for example, there's a lump of product somewhere and it doesn't go away with massage, and it just makes the face look uneven, and it needs to be erased, there have been situations where I've seen people have their tear troughs filled with Juvederm, for example, and Juvederm lasts quite a while in that area. It created a bulge and then they came in for a consultation for how to deal with this. I just inject a little bit of this enzyme and it dissolves it. Those are actually situations where I felt like a hero because I could really change something that someone thought was permanent, and that they were stuck with. So it's a good tool to have in our toolbox.

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This is non-animal derived, so with collagen and products and some non-hyaluronic acid products in the past there'd be some animal derived origins and therefore we'd have to skin test to see if they were allergies or hypersensitivities to it. With this, because it's derived from normal tissue and it's just cross-linked in a way that makes it stable, if we just put normal hyaluronic acid that was engineered in a lab and bio-identical to the hyaluronic acid of skin, and we just injected it, it wouldn't last because it's not cohesive. It's not bound together. It's not cross-linked into a gel and so it would just dissipate. So it's made in a bio-identical way, and cross-linked in a way that allows it to hold and integrate into the tissue. Whether it's the dermal plane or sub-dermal plane.

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How Can You Remove FIller if the Patient Isn't 100% Happy?

Dr. Daniel Levy explains the process of dissolving a filler with another injection and explains in detail how the chemicals work.