I had cheek, nasal folds and lip filler and now have a pillow face. If I get them dissolved, will I look how I did before?

Thank you for the interesting question. I have seen major problems with overinjection of facial fillers. This is a growing problem, especially with non-specialists and those who are greedy and inject despite knowing it is not in the patient’s best interest. Hyaluronidase may help. It can dissolve HA fillers, so first make sure that is what you had injected. Some more chronic swelling can occur with excessive filler injections. We call this facial appearance one with “filler fatigue.” I suspect it is due to disruption in the normal lymphatic flow in certain portions of the face. This can be very difficult to treat.   if you suspect you have some permanent swelling, it is essential that you seek out a fully-trained plastic surgeon and not some random injector to deal with this major problem.

Longterm filler problems include migration, edema, and nodularity. Filler migration and permanence is a very common problem because there are many different types of HA fillers on the market and each is specified for a specific part of the face. Use of highly cohesive fillers on thin skin may cause swelling and nodularity. If patients have filler migration or nodules, we recommend a combination approach of filler reversal with enzymes Hylenex and Hyaluronidase in different strengths to dissolve the filler. We may also need to add Kenalog to the mix in order to reduce fibrous tissue. If the filler does not dissolve, it either means the filler is not HA material or we need more enzyme. The HA reversal can be combined with other lasers and skin treatments at the same time, and it usually (usually) does not affect adjacent tissue.

Best,
Dr. Karamanoukian
Realself100 Surgeon