Dissolve Dermal Fillers

When and How to dissolve poorly injected Dermal Fillers?

Dissolve Filler

As minimally invasive aesthetic procedures such as BOTOX and dermal fillers become more common, we are also seeing more poorly done jobs with undesirable outcomes.

With advancements in technology, dermal fillers available in 2020 generally last for a year or more. This means that if dermal fillers are not properly injected, it may look like a sore thumb for more than a year!

What are the common cases of fillers needing dissolving?

At SL Aesthetic Clinic, we typically see under eye ‘lumps’ or ‘sausages’ that have stayed on for years after an initial tear trough filler treatment. These patients were invariably affected but felt helpless at the same time, believing that one day the fillers will go away.

However, as fillers degrade only if there is sufficient naturally-occurring hyaluronidase (the enzyme that digests hyaluronic acid, which are the main component of fillers), and in certain areas without this enzyme, fillers can persist for years.

How do you know if you had a poorly done filler treatment?

Filler treatments aim to create natural, harmonious aesthetic outcomes which should conform to a publicly-accepted standard of beauty. Generally, when one can tell that you have had fillers done, the filler injected is probably sticking out like a sore thumb. Some common problem areas include:

  • Overfilled cheeks (pillow-face look)
  • Nose bridges which are too high or too broad (Avatar nose)
  • Chins which are too sharp and long (witch’s chin)
  • Under eye lumps and sausages
  • Overly-filled lips (duck lips)
A scary face

How can fillers be dissolved?

The most commonly used dermal fillers (such as those under Juvederm, Restylane and Teosyal brands) are gels made up of cross-linked hyaluronic acid. A medication called Hyaluronidase can be injected into the filler to dissolve the target filler, much like how the filler is injected in the first place. There will be some temporary swelling of the filler which should not last more than a couple of hours before it starts to be dissolved.

Can all fillers be dissolved?

Hyaluronidase is a very specific enzyme that can only dissolve hyaluronic acid-based fillers. It does not work on other types of fillers such as Sculptra, Ellanse or Radiesse.

How soon can fillers be re-injected?

Studies have shown that the filler-dissolving effect of hyaluronidase lasts only for 3 to 6 hours after injection. Hence, fillers can theoretically be re-injected to achieve a more desirable outcome after 6 hours. However, in practice, we generally advise our patients to wait for 2 to 3 days before re-treatment with dermal fillers for the same area.

Who is suitable or unsuitable for dermal filler dissolving?

Dermal filler dissolving is suitable for any healthy adult looking to dissolve only hyaluronic-acid based dermal fillers.

Dissolving dermal fillers may be unsuitable for the following circumstances:

  • Previous content or material of filler is not hyaluronic-acid based or of unknown origin.
  • Hypersensitivity or allergy to any component of hyaluronidase/hyalase.
  • History of allergic reaction to wasp or bee stings.

Pre-Treatment Instructions

Always inform your doctor of all medications, including supplements you may be taking as well as your medical history, including anti-inflammatory drugs such as ibuprofen and aspirin, anti-histamines, Vitamin C. We advise patients to stop taking these non-prescribed medications where possible in advance of treatment.

Expectations & After-Care

  • The entry points used for dermal filler dissolving usually closes within a day with little or no scabbing.
  • There can be some bruising, swelling and tenderness over the treated areas for a few days, make up can be used to conceal the areas of bruising.
  • Use a gentle cleanser during the recovery period.
  • Always use sunscreen and avoid unnecessary sun exposure to reduce the risk of post-inflammatory hyperpigmentation.

If you think that you have had a dermal filler injected with a suboptimal outcome, do consult our Aesthetic Physicians who will advise if you are a suitable candidate for dissolving the filler and benefit from re-treatment.

[05 May 2021] Written by Dr. Wei Xiang

Dr Ko Wei Xiang

Dr Wei Xiang – The Artist
MBBS, Singapore; MRCS, Edinburgh

Dr Wei Xiang has been heavily involved in the arts throughout his life. During his formative school years, he studied fine arts under the prestigious Art Elective Programme, where he developed his artistic talent and creative expression across various media, including painting, charcoal, digital media and photography.

After graduating from the Yong Loo Lin School of Medicine in 2014, Wei Xiang pursued postgraduate surgical training in a residency programme, where he honed his surgical skills over the years. His artistic side remained strong, and he constantly yearned to express a greater aesthetic element in his work. In 2019, he left his surgical career in search of his calling.

A fateful encounter with Dr Kelvin Chua brought Wei Xiang into the world of Aesthetic Medicine. It was in Aesthetic Medicine where Wei Xiang found his “ikigai” of sorts. Under Kelvin’s mentorship, Wei Xiang grew steadily and became adept at a wide range of aesthetic procedures including Botox, fillers, lasers, HIFU, Thermage, Ultherapy and PicoCare Laser. His keen eye for beauty, coupled with his steady hands, allows him to bring out the best in his patients.

Wei Xiang occasionally still creates artwork in his free time, when he is not spending time with his wife and daughter, or jamming and making music.

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