Dissolving filler in nasolabial lines: looks unnatural.

Question

A week ago I had deep dermal filler & nasolabial area now looks unnatural. This is an area I always can tell when someone has had fillers, the lines are not deep enough when I smile, and I think makes the area look strange when fully smiling. It looks fine probably when resting. How difficult is it to slightly dissolve filler in this area, to not loose it all, but reduce the 'stiff' look when smiling, and will the doctor cover the cost? It is not swelling at this stage 1 week in.

Nirmal Nathan, MD · Answer

The medication used to dissolve filler is called hyaluronidase. It is an enzyme that dissolves hyaluronic acid (HA), which is the most common compound used for fillers. Other fillers, depending on what your injector uses, are permanent and cannot be dissolve. Those fillers must be removed surgically.

If your filler was HA (examples include Voluma, Volbella, Juvederm), hyaluronidase generally completely dissolves the filler. You could ask your injector to inject a lower dose but this is generally not how filler is dissolved.

If you have an unnatural look after filler injection, it is either because of technique or poor analysis of your problem. I'd recommend going back to your injector and voicing your concerns. Most experienced injectors will be able to tell you if what your are experiencing is within the range of normal, or if your results are truly an error on their part.

Stephen P. Bracci, MD · Answer

Hi Sharon,
Reducing the amount of filler in this area is not difficult at all, as long as the filler used is a Hyaluronic Acid based filler. To do this, a physician will typically inject a small amount of an enzyme, called hyaluronidase, into the area that was previously treated with HA fillers. By injecting Hyaluronidase into the injection site, it is possible to reduce the amount of filler in this area without fully eliminating all of the filler injected. Keep in mind that it is best to wait at least several weeks to fully assess your results from fillers before you choose this option as you may still be experiencing swelling. 
The fees for dissolving or reducing fillers are individualized by each physician, however, many physicians will not charge to reduce or blend filler products that they themselves have applied. It is always best always to seek a physician who is solely dedicated to cosmetic injectables.

Ravi Jain, MBBS · Answer

I agree that an overfilled NLF can look "done" - especially when there are other signs of ageing on the face which may have contributed to the deepening of the NLF such as cheek descent. So, wait for the filler to settle. If it was hyaluronic acid, then hyaluronidase can be used  - its injected to the same area - but there is a small chance of anaphylaxis (severe allergic reaction) so make sure you see a trained nurse/doctor. If it was not an HA filler, then the solution is much more difficult if possible at all.

Maurice M. Vick, Jr., MD · Answer

One week is too soon to think about treating with Hyaluronidase. You need to wait a month or more for the swelling and tissue reaction to subside. Small injections can be injected later if needed, but may not give a smooth appearance. Hyaluronidase is very expensive so there will likely be a charge. Best Wishes, Maurice Vick MD

Alain Michon, MD · Answer

Thank you for your question. Swelling after dermal filler injections can last up to two weeks. Since you are only one week in after fillers injections, I recommend waiting another week or two. Massaging the area gently can help by smoothing out the filler and improve your look. If it does not improve after two weeks, hyaluronidase can easily be injected to remove some of the filler for a more natural look. Please see an expert in your area. All the best, Dr. Michon

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Dissolving filler in nasolabial lines: looks unnatural.

Answers (5)

Answer: Naso Lab ial Fold Treatment

Answer: Naso Lab ial Fold Treatment

Answer: Too much filler in the nasolabial folds. Is it easy to dissolve ?

Answer: Too much filler in the nasolabial folds. Is it easy to dissolve ?

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Everything you need to know about Dermal Fillers

Our mission is to create a world where every investment in modern beauty is Worth It.