How long will .5ml of Restylane Contour take to dissolve if injected to the cheeks?

Question

31 year old, pushed into getting cheek filler by med spa, already have very full cheeks and didn't need filler at all. I was told it would help with my under eye hollows which was what I went in for. I did it thinking I could get it removed. I got it more than a month ago and hate how round my face looks now, it did not help my under eye hollows. My eyes look smaller, and smile lines worse. I am definitely done swelling, too afraid to dissolve from the horror stories. How long?

Anna Chacon, MD, FAAD · Answer

I'm sorry to hear about your experience. The duration for Restylane Contour (a hyaluronic acid-based filler) to dissolve naturally can vary depending on several factors, including the individual's metabolism, the amount of filler used, and the specific area where it was injected. However, here are some general guidelines:

1. **Natural Dissolution Timeline**: Hyaluronic acid fillers like Restylane generally last between 6 to 12 months. In some cases, they may last longer, up to 18 months. Since you have a small amount (0.5 ml) and considering your age and metabolism, you might expect it to gradually diminish over 6 to 12 months.

2. **Metabolic Factors**: Younger individuals with a faster metabolism might notice the filler dissolving more quickly. Your body's natural hyaluronidase enzymes will gradually break down the filler over time.

3. **Area of Injection**: Fillers in areas with more movement, such as the lips, tend to dissolve faster than those in less dynamic areas like the cheeks. Since your filler is in the cheeks, it might take closer to the longer end of the dissolution spectrum.

Options and Considerations if You Want to Accelerate the Process

If you're very uncomfortable with the filler and do not want to wait for it to dissolve naturally, you might consider the following:

1. **Hyaluronidase Injections**: This enzyme can be injected to dissolve hyaluronic acid fillers quickly. While you mentioned being afraid of dissolving due to horror stories, it's important to know that when performed by an experienced and skilled practitioner, hyaluronidase can be safe and effective. Discuss your concerns and potential risks thoroughly with a board-certified dermatologist or plastic surgeon.

2. **Consultation with a Specialist**: Seek a second opinion from a qualified professional who specializes in fillers and facial anatomy. They can provide personalized advice and may help address your concerns more effectively.

3. **Patience and Monitoring**: If you prefer not to undergo any further procedures, monitoring the filler over the next few months might be the best approach. Sometimes, the appearance can change slightly as the filler integrates more naturally with your tissue.

Psychological and Emotional Considerations

It's also important to address the emotional impact this situation has had on you:
- **Support System**: Talk to friends, family, or a counselor about how you're feeling. Emotional support can be very helpful.
- **Perspective**: Remember that the change is temporary, and your natural look will gradually return.

Given your concerns, I strongly recommend consulting with a board-certified dermatologist or plastic surgeon who can provide you with a professional evaluation and discuss all your options, including the risks and benefits of hyaluronidase injections. They can also help you manage expectations and guide you through the process safely.

James M. Economides, MD, FACS · Answer

I understand your frustration with this situation. Cheek filler, especially when not needed, can create a rounder appearance and sometimes make the under-eye area look worse due to changes in facial contours. Since you’re concerned about dissolving based on horror stories, here's what you should know:

1. Filler Duration:
Hyaluronic Acid Fillers (such as Juvederm or Restylane) typically last between 6-18 months, depending on the specific product, your metabolism, and how much was injected. Over time, your body will naturally break down the filler, and the effects should diminish.
If you want to avoid dissolving the filler with hyaluronidase, the filler will gradually reduce on its own over the next several months.
2. Swelling vs. Final Result:
While it’s been over a month, some subtle swelling may still be present. It usually takes around 4-6 weeks for fillers to fully settle, but since you mentioned you're definitely done with swelling, it's likely that what you're seeing now is the final result.
3. Concerns About Dissolving:
Dissolving with Hyaluronidase: Many people worry about dissolving filler due to concerns about potential side effects. However, if performed by a skilled injector, dissolving can be done in a controlled and targeted way to reverse the filler without complications.
If you feel your face looks overfilled, dissolving a small amount of the filler in the cheeks might restore the balance without making drastic changes.
4. Your Options:
Wait It Out: If you're too anxious about dissolving, you can wait for the filler to gradually break down over the next several months.
Consult an Experienced Injector: If you want to consider dissolving but are worried, seek a second opinion from a highly skilled injector who can assess whether a small, localized dissolving treatment might help without affecting the rest of your face.
Alternative Treatments: If under-eye hollows remain a concern, after the cheek filler has settled or dissolved, you might consider specific tear trough filler to address this area more directly.

How long will .5ml of Restylane Contour take to dissolve if injected to the cheeks?

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