Dissolving Filler

The natural process of aging contributes to a loss of facial volume and structure that accentuates the appearance of various signs of aging. Decreased facial muscle mass and skin elasticity lead to sagging over time. Dermal fillers help to replace the lost volume leaving the patient with a more youthful, energetic and attractive appearance.

Despite the very high overall success and satisfaction rates of dermal fillers, it occasionally occurs that a patient wants the process reversed. Dissolving filler treatment is the handling for this.

Dissolving filler treatment is an injectable procedure that reverses or undoes the effects of dermal fillers. Hyaluronidase, a substance naturally occurring in the body and which counteracts dermal fillers, is used for dissolving the fillers that may have been placed incorrectly, excessively or unevenly.

Hyaluronidase injections are carefully placed where the dermal filler requires dissolution. The reaction is quick and starts dissolving the fillers immediately, until they are fully metabolized.

Radiesse® is a calcium hydroxylapatite (CaHA) filler that offers robust structural support, but its particulate nature means it cannot be liquefied with the enzymes used for HA-based filler dissolving. When complications arise—such as nodules, surface irregularities, or unintended placement—management generally involves serial saline dilution, massage, and, in stubborn cases, steroid or calcium-chelating injections. Because Radiesse® becomes increasingly firm as collagen builds around the microspheres, early intervention is critical. Delayed treatment may necessitate minor surgical excision; patients should expect a longer course of follow-up compared to hyaluronic acid fillers. Ultrasound guidance is often recommended to safely localize deeper deposits.

Sculptra® (poly-L-lactic acid) stimulates collagen rather than occupying space directly, so that adverse events can appear months after injection. The most common issues include palpable, sometimes visible, papules or nodules, especially in areas with thinner skin. Unlike Radiesse®, these nodules frequently resolve with a combination of vigorous massage and a short course of oral or intralesional corticosteroids; however, persistent granulomas may require laser or surgical intervention. As Sculptra® particles disperse, they can migrate, leading to asymmetry that responds slowly to correction. Choosing an injector skilled in dilute dosing protocols and layered placement substantially lowers the risk of these long-term complications.

If a patient is dissatisfied with or had an adverse reaction to dermal fillers, dissolving filler treatment is the solution. In a few instances, there may be medical or cosmetic complications such as infections or inflammation from excessive, incorrect or uneven application of the dermal fillers. This is an advantage over surgical work, as dermal fillers can be quickly, safely and easily reversed.

When dermal fillers are applied excessively, incorrectly or unevenly, not only can it cause medical complications in the affected area, but the results are unlikely to be very complementary to the patient. Dissolving filler treatment can be beneficial in the following ways:

• Allows patients to have the dermal fillers redone in case of dissatisfied results
• Reduces excessive or prolonged swelling
• Reverses incidences of a vascular compromise or occlusions
• Reduces the infection rate on the treatment area in case it occurs

Candidates for dissolving filler treatments include patients who have recently received dermal fillers and who experienced any of the following conditions:

• Excessive swelling
• Dissatisfying results
• Infections in the treatment site
• Vascular compromise

While the filler itself will be broken down and metabolized within a few minutes, your results from dissolving dermal filler treatment will be visible in about 24 hours, after any swelling has disappeared.

Voted among the 10 Best plastic surgeons by AIPS, and ranked the #1 plastic surgeon in Seattle, our team is also highly credentialed and qualified to bring you the very best in care. Our team is committed to serving every patient’s individual and varied needs and helping them to overcome any condition they feel holds them back from full beauty and confidence.