How long after having your lip filler dissolved do you have to wait to be able to get filler put back in them?

Question

I have had my lips injected 3 times and have started to notice the area above my top lip is starting to go a bit puffy. I’d like to get it all dissolved and start again if possible but how long will the process take? Can I get it dissolved and redone in the same day?

Raffy Karamanoukian, MD, FACS · Answer

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

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Imaan Joshi, BSc, MBBS, FRACGP · Answer

The hyaluronidase works for 6-8 hours and studies have shown it is no longer in the system after this time. 
In saying that, the bruising and swelling that may invariably occur with dissolving, especially sensitive areas such as lips, may mean that it will take days if not weeks for your lips to settle to their pre-filler size and shape and to give you the best chances of having a good outcome when ready to refill. 
My advice tends to be to wait around 2 weeks and not to be in a hurry as residual swelling in the lips may distort anatomy, however slightly, and may lead to potential complications and problems when refilling. 
Lastly, find a trusted qualified injector and stick to them through the process instead of going from injector to injector who may not know exactly what was done, when and with what product.

Steven F. Weiner, MD · Answer

Most of the dissolving when using hyaluronidase takes place in the first 15-30 minutes. It can continue to work for 3 days. After 3 days, there is no active enzyme and further injections can be performed.

Center for Aesthetics and Plastic Surgery - Grand Rapids · Answer

Hello there! I would recommend having the "puffy" area reversed, wait a few days to let everything settle and heal, and then follow this with lip filler if desired. There is a risk of the reversal agent affecting the injected filler if you have them done on the same day. Cheers! Sarah RN BSN

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

Dissolving agents begin to work immediately and are pretty much done after 48 hours. I do not recommend redoing fillers until at least day 3 and usually ask patients to wait a week just in case there's any mild swelling or anything. So we can really have a clean slate. Depending on how much filler you have also you may need more than one round of dissolving agent. I like to inject smaller amounts a few times rather than bolus large amounts in. This allows better control and more precise removal of the filler. Removing filler is just as much an art as putting it in. "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."

How long after having your lip filler dissolved do you have to wait to be able to get filler put back in them?

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