Defined lips, a lifted nose bridge, and smoothed under eyes: Facial fillers can do it all, but they can’t necessarily be undone with the same ease. Once associated with dramatically plumped lips and jutting cheekbones, fillers like Restylane and Radiesse are just as often used for subtle tweakments and reshaping — available immediately without going under the knife. But when it comes to dissolving these facial fillers, the process gets a little more murky.
Most patients that choose to have their dermal fillers dissolved want a better version of what they already have. Dr. Rahi Sarbaziha, M.D., an integrative aesthetics doctor based in Beverly Hills, says this is the biggest catalyst behind a recent increase in filler dissolution requests.
“Older types of fillers used in the past are not as advanced and natural-looking as the newer generation,” she says. “As people become more aware of the improved options available, they may choose to dissolve older fillers and opt for newer, more natural-looking alternatives.” Other patients simply want to avoid going overboard. According to Dr. Sarbaziha, injecting the same area repeatedly over several years can cause the material to accumulate and cause an unnaturally puffy look. To start fresh, some opt to have it dissolved first.
Then there’s the classic case of filler gone wrong, or a final result you dislike. “As patients are falling for trends on social media and less experienced injectors are offering services, we’ve seen an uptick in patients seeking fixes to their filler problems,” says Dr. David Shafer, M.D., F.A.C.S., a double board-certified plastic surgeon at New York City’s Shafer Clinic.
Consider this your reminder to find an experienced injector you trust, but sometimes you just need an undo option. After all, isn’t the beauty of opting for fillers that they’re temporary? Whatever the reason behind your decision, here’s what you need to know before you get your facial fillers dissolved.
Which Facial Fillers Can Be Dissolved?
You may have heard before that any hyaluronic acid-based filler can be dissolved. This is accurate. “Our natural body white blood cells secrete hyaluronidase, which is part of our immune response that causes filler to dissolve,” says Dr. Ava Shamban, M.D., a board-certified dermatologist based in Los Angeles and founder of Ava MD and SKINFIVE clinics. To accelerate this process, injectors use a concentrated form of hyaluronidase, which catalyzes the breakdown of any HA filler and dissolves it ahead of schedule. The easiest way to check if your filler is HA-based is simply to ask, but popular ones include Restylane and the RHA family (RHA 2, 3, 4, and Redensity), Juvéderm, and Belotero.
That leaves non-HA based fillers, which are usually made of calcium hydroxylapatite, poly-L-lactic acid, or polymethyl methacrylate. Popular choices include Radiesse, Sculptra, and Bellafill, none of which can be dissolved using hyaluronidase. Dermatologists and surgeons still recommend these fillers for certain results, but if an issue arises, potential solves aren’t as simple. They “can be manipulated to some extent after injection, but complete dissolution is challenging,” says Dr. Sarbaziha. According to Dr. Shafer, the likelihood of melting non-HA based filler is “close to 0%.”
What’s The Process Of Dissolving Facial Fillers?
No matter what kind of dermal filler you have, the first step is to book a consultation with an experienced injector so that they can evaluate the condition of your fillers. From there, Dr. Sarbaziha says the process can take “anywhere from one to 10 sessions to dissolve hyaluronic acid fillers,” depending on your specific case.
Timing is also important. If you’re unhappy with HA-based fillers, experts recommend getting them dissolved as soon as possible. “Melting [the filler] immediately or the days following the injections is the most successful,” says Dr. Shafer. Filler lumps that occur weeks or months after your initial appointment are usually caused by a tissue reaction. In these cases, Dr. Shafer uses a “cocktail injection” of hyaluronidase, 5-FU, and kenalog. You’ll still be able to dissolve your fillers, but it may take several treatments “depending on the severity.”
As for the rest of the process, it’s fairly similar to your initial injection. Once your fillers have been injected with hyaluronidase, you’ll get a quick facial massage to help it move through your tissues. While all HA-based fillers can be dissolved, some take more time than others. If this is the case, you’ll schedule follow ups for additional injections. Dr. Shafer recommends a slow and steady approach. “Just as injecting filler should be done conservatively, so should melting,” he says. “Plan on more than one session.”
And if you’re working with Radiesse or another non-HA based filler? Experts say there are two possible fixes. The first is to add rather than melt away. “It may actually be better to place more filler to ‘fix’ issues with a skilled provider,” says Dr. Shamban. Or, you can opt to have the particles surgically broken up and removed if you don’t want to wait for them to dissolve naturally.
Are There Side Effects Involved With Dissolving Facial Fillers?
The most common side effects of dissolving your facial fillers are the same as getting them in the first place: swelling and bruising. Neither should last more than a few days, and your skin should completely return to its original state within two weeks, says Dr. Sarbaziha.
Your facial structure might also look different, especially if you’re used to seeing yourself with filler enhancements — but you’re essentially just going back to where you started. “The melting will not affect your natural tissue,” says Dr. Shafer. If you feel like your skin looks deflated, it’s due to displacing hyaluronic acid in an area that previously had more volume. Don’t worry: This is temporary. “A patient’s natural hyaluronic acid will improve in a short period of time,” says Dr. Shamban. To further tighten your skin, you can book sessions of Sofwave, radiofrequency microneedling, or a CO2 laser treatment.
What Should Your Watch Out For After Dissolving Your Facial Filler?
If you plan on going back for more facial fillers, Dr. Shamban advises waiting two to three weeks before your next appointment. Otherwise, aftercare is simple. Dermatologists usually tell you to avoid massaging your face after fillers, but when you get them dissolved, the opposite is true. “Gentle massaging helps distribute the dissolved filler evenly and aids in its absorption,” says Dr. Sarbaziha. You can enhance this effect by using a warm compress. To combat swelling and bruising, take anti-inflammatory supplements like arnica, bromelain, and turmeric.
The only remaining step is to wait for your skin to go back to normal. During this time, Dr. Shamban’s prescription will serve you well: “Ice, arnica, and a good dose of patience.”