Can I dissolve filler in distinct spots or does everything dissolve in a seamless way?

Question

I was curious how dissolving filler works. Will it dissolve it in a seamless way or will bumps and chunks of filler remain and look uneven? I got Restylane Lyft in my chin and I think the filler came up too high on the sides so I only wanted to dissolve the sides where I think it looks too bulky.

John L. Burns Jr., MD · Answer

Hyaluronidase is the enzyme that dissolves hyaluronic acid fillers.  It can be administered in very small aliquats to precisely dissolve unwanted hyaluroinc acid filler.

Raffy Karamanoukian, MD, FACS · Answer

Hylauronidase has many advantages and should be considered in patients who are unhappy with their results or in acute cases of overfilling or occlusion. Its often better to reverse filler and restart then to deal with long term edema. 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

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Michael Kulick, MD, DDS · Answer

Good question! Best to go to your original injector who should know where the HA was injected. There is no exact science in terms of predictability as to the impact of the hyaluronidase injected. Hope this helps.

Alix J. Charles, MD · Answer

Thanks for your question.  It may be challenging to inject hyaluronidase and get it to stay so localized within the chin that you dissolve only the filler that you want to dissolve and keep the parts you want to keep. Maybe not impossible, but I think it will be hard to do. You are better off waiting for the filler to reabsorb completely or have it completely dissolved with hyaluronidase, then redo the chin augmentation in a fashion that pleases you. Just my opinion based on what you have said and without any photos to go off of. Best of luck to you.

Liliana Marcu Awan, MD, FAAFP - Account Suspended · Answer

Many rely on dissolving agents after uneven fillers however make sure you go back to the same physician who placed the initial fillers for dissolving the affected area for evenness

F. Victor Rueckl, MD (in memoriam) · Answer

Your injector can put in small amounts of the dissolving agent to be as precise as possible. But it is a liquid and it can spread a bit. Just remember that removing filler is just as much an art as putting it in to begin with, so seek an expert. "This answer has been solicited without seeing this patient and 
cannot be held as true medical advice, but only opinion. Seek in-person 
treatment with a trained medical professional for appropriate care."

Can I dissolve filler in distinct spots or does everything dissolve in a seamless way?

Answers (6)

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