Hyaluronic acid (HA) based fillers are those which are most commonly used. One of the significant advantages of a HA-based filler, is the potential for removal or dissolution of the filler, should the result be less than satisfactory. A substance called hyaluronidase (trade name Hyalase) is used to break down the filler, causing it to dissolve almost instantly, in most cases. Hyaluronidase is a prescription medication, which means that it can only be administered by a doctor or a nurse under the direct supervision of a doctor. Dentists are also qualified to administer this treatment.
Filler removal or dissolution is most commonly done where the cosmetic result is not what was desired, or someone simply decides that they no longer wish to have the effects of the filler. Much more rarely, dissolution of the filler is required to be administered urgently owing to an adverse reaction during the course of the initial treatment, to manage potentially serious complications. It is for this reason that it is safest to have any filler procedure done by a professional who is qualified to inject hyaluronidase, in the unlikely event that this is required.
Type of anaesthetic
None/ local anaesthetic
Length of procedure
Patch test 10 minutes
Filler removal 10-30 minutes
1 day to 2 weeks (depends on area)
Onset of action
Immediate to 48 hours
Duration of effect
Interval to further filler treatment
Consultation, patch test & treatment
There is a small risk of a serious allergic reaction to hyaluronidase. Therefore, the first step, following consultation, is to perform a patch test, to assess for evidence of allergy to the medication. A tiny amount of the medication is injected under the skin of the forearm. You will then be asked to remain in the office for a period of a couple of hours, after which the injected area will be check and assessed for signs of allergy. During this waiting time, it is necessary to remain within the office, for your safety.
The next step is for the hyaluronidase to be injected directly into the filler. Depending on the site and area affected, a series of injections may be required. Numbing cream will usually be applied prior to this step, to minimise any discomfort. Following injection, the area will be massaged, to aid the dissolution of the filler. Frequently, the filler will dissolve almost immediately, although with certain products, the complete effect may take a day or two to become apparent. We advise that you attend for a follow-up appointment at approximately a week following the initial appointment, in order that the outcome of the procedure can be assessed and further treatment administered if required. A second patch test is not usually required for a second treatment.
What can I expect after treatment?
Following treatment, there may be some redness, swelling, or bruising of the area. The extent of this will depend on the individual and the treatment required. The lips and under-eye area are most prone to swelling. There may be some itchiness or redness, which may take a few days to resolve.
Can I have filler again?
Further filler injections are usually possible: these are best deferred until all swelling from the dissolution procedure has resolved.
Is it possible to have “only some” of my filler dissolved?
While it is possible to limit the area of hyaluronidase to just one area (e.g. treatment of lips but not cheeks), it is not possible to remove only some of the filler from a particular area. Hyaluronidase treatment is typically “all or none”, so it is not possible, for example, to remove half of the filler from your lips. You should work on the assumption that you will be “back to square one” following treatment.
Are hyaluronidase injections always required to correct filler?
No. In some cases additional filler may be the solution – e.g. to add symmetry or balance to a previous treatment. The appropriate options will be discussed with you at the time of your consultation.
Do you dissolve fillers done by other practitioners?
Yes, we are in a position to offer corrective procedures for filler injections performed by other practitioners. We do require, however, some details of the product that was originally injected. Not all fillers are HA-based, and attempting to dissolve a non-HA based filler with hyaluronidase is bound to fail. At an absolute minimum, we require to know the name of the product used. If you are unsure what was used, please contact your original practitioner to find out what was used in your original treatment prior to attending for your appointment. If you have a copy of the notes from the original treatment, please bring them with you to your appointment, as they may contain useful information.
Will health insurance cover this procedure?
Dissolution of fillers is not covered by medical insurance.