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.

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.

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.

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.

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.

We can offer appointments for dissolution of filler done by other practices, only where we have received a detailed written referral from the original injector, outlining the nature and extent of the treatment they have performed, product used, etc.. Provided this referral contains adequate information, we will then be in a position to schedule an appointment for you.

Dissolution of fillers is not covered by medical insurance.