1 session and above
Permanent
Minimal downtime
30 mins
Dermal fillers are primarily made of hyaluronic acid (HA), a naturally occurring substance in the skin that adds volume and hydration. When a filler needs to be dissolved -whether due to lumps, asymmetry, migration, or medical concerns- hyalase (hyaluronidase) is the enzyme used to safely break it down.
Hyalase works by chemically breaking the bonds in hyaluronic acid, turning the filler into a substance that the body can naturally absorb. This process allows for safe and controlled dissolution, whether the goal is partial correction or complete removal.
While persistent lumps are one of the more common reasons, there are several other situations where patients may seek to dissolve fillers or skinboosters:
Previous treatments may have added too much volume or created uneven results, leaving patients feeling that their face no longer looks natural. Dissolving the filler allows us to rebalance the features and start fresh with a more tailored plan.
Filler can sometimes shift from the intended area, causing lumps, irregular contours, or uneven appearances. Hyaluronidase can help restore proper positioning or remove the migrated material entirely.
Some patients experience adverse reactions such as acne breakouts, irritation, or swelling after treatment. This is more common in patients who had procedures overseas, where treatments may not have been properly tailored to their skin type or anatomy. Dissolving the filler allows the skin to recover safely and prevents prolonged complications.
In rare cases, fillers can lead to complications such as vascular occlusion, where blood flow is compromised. Prompt dissolution with hyaluronidase is essential to prevent long-term tissue damage.
Some patients choose to dissolve fillers because they want to experiment with different products, techniques, or treatment areas. Dissolving gives them the freedom to adjust their aesthetic plan without committing to previous filler placements.
Hyaluronidase/filler removal can be done for various types of fillers, including cheek fillers, lip fillers, chin fillers, tear trough fillers.
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:
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.
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.
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The most commonly used dermal fillers 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.
Hyaluronidase is a very specific enzyme that can only dissolve hyaluronic acid-based fillers. It does not work on non-dissolvable fillers.
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.
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:
Hyaluronidase is an enzyme that occurs naturally, particularly a soluble protein stimulant that breaks down hyaluronic acid (HA). HA is considered as the foundation of many dermal fillers and is a sugar polymer that is found throughout the human body.
When hyaluronidase is injected into the HA or the area surrounding it, the enzyme severs the chemical bonds that hold the HA molecules together. The gel-like structure of the HA filler is then broken down into tiny residues that are absorbed and released as waste by the body naturally.
Hyaluronidase gets the job done quickly, but does not remain in your tissues for a long time as it has a very biological short half-life. The enzyme can only live for about two minutes and is usually metabolised and removed from the body within 24 to 48 hours after its injection.
While the enzyme is no longer in your body, its effect stays as the process of dissolving HA begins and continues for a bit of time. The complete breakdown of the dermal filler usually happens in three to seven days.
Only dermal fillers that are made from hyaluronic acid (HA) can be dissolved by Hyaluronidase. This type of filler is a popular choice due to its biocompatibility and reversible characteristics. It is often used to enhance the cheeks, lips, under-eye and other parts of the face.
It is important to know and remember that hyaluronidase cannot dissolve dermal fillers that are not made from hyaluronic acid. Examples of these fillers are those made of calcium hydroxyapatite, poly-l-lactic acid, fat transferred tissue, and synthetic fillers that are permanent (e.g. silicone). Undoing the results of these materials requires a different approach or they may not be reversed at all.
This is a common question that many patients ask about Hyaluronidase. The timing for using the product depends on its goal:
This is another top and valid concern that many patients have when considering HA filler treatments and Hyaluronidase. The quick answer is yes, but the damaging effects are temporary and involve the treatment area only. Hyaluronidase does not destroy collagen directly.
Due to its natural characteristic of breaking down hyaluronic acid, Hyaluronidase will affect the hyaluronic acid produced by the body organically and the synthetic filler injected in the target area. You can expect to see tissue dehydration and lesser volume where hyaluronidase has been injected until your body naturally creates and replenishes HA over time.
Similar to any aesthetic treatments, hyaluronidase may lead to side effects. However, these are mild and should resolve within a few days. The side effects of hyaluronidase include:
Side effects that are less common, but will need urgent medical attention are:
You can see immediate “deflation” in the treated area. However, the final result will show within three to seven days after swelling, which is a side effect of the treatment, has resolved and the skin has totally recovered.
If you are planning to get another filler treatment, it is recommended to wait for at least 14 days to make sure that the process of dissolving HA is complete and the tissue is stable.
In general, yes, but it is not a treatment that you may want to excessively repeat. While hyaluronidase can be used several times, using it in the same area can flood the tissue with enzymes that can cause extended inflammation and lead to the delay of the natural healing process of the skin.
Even if there is no “strict” limit on how many times it can be used, Hyaluronidase should only be done following these standards:
In Singapore, any aesthetic doctor can dissolve HA fillers using Hyaluronidase provided that they are qualified as the enzyme is a prescription-only medication. A trained doctor is needed for this procedure as they need to know where exactly the product should be injected and the dosage needed to dissolve the intended amount of HA filler. For safety, a qualified doctor should be administering Hyaluronidase to handle a medical emergency in case allergic reactions occur.
You can feel a pricking sensation as the enzyme is injected into your skin. Pain can be managed with the use of a local anaesthetic (lidocaine).
The recommended number of Hyaluronidase treatment is between one to three sessions to achieve optimum results.
It is recommended to wait for at least 14 days before getting a new filler treatment.
Hyaluronidase is best used to address complications or unwanted results from HA dermal fillers, such as “filler fatigue,” lumps, migrations, and Tyndall effect.
If you are not satisfied with the results of your HA filler treatment, you can visit our clinic to get a consultation with an aesthetic specialist who can help guide you through the undoing magic of Hyaluronidase.
We offer treatment plans and fees tailored to your skin condition and goals.
