How, When, and Why to Consider It

With more and more people opening up about the work they get done, getting injectables is no longer taboo. However, we've all heard the horror stories of filler that migrates or gives someone a lips akin to a puffer fish.

"There are various reasons why people would want to dissolve their filler," says Dr. Eman Abdallah, founder of Emana Medical in Beverly Hills. "Patients often get put on a filler injection schedule based on the how long we think the filler is advertised to last. However, what we don’t realize is that it can last much longer than we think. In many cases, patients don’t know when to stop, and many injectors don’t know when to just say no. Over time, over-filling lips, cheeks, chin, etc. can lead to asymmetry, bumps, and an unnatural appearance and patients end up want to go back to looking like themselves." 

Additionally, Dr.Edward Chamata, a Houston-based plastic surgeon, says another reason someone may consider getting their filler dissolved is if it caused some sort of complication, such as skin compromise and thus needs to be dissolved urgently so it doesn’t lead to serious complications like skin necrosis (death of the tissue).

It's not common, but if those filler faux-pas occur, know that there are ways to reverse their effects. Below, find everything you need to know about getting them removed — from which ones can be dissolved, which ones can't, what the process of doing so looks like, whether or not it hurts, and when you can get filler again should you choose to.

What types of filler can be dissolved?

Dr. Chamata says the only types of filler that can be dissolved are the ones that are hyaluronic acid-based, such as Juvéderm and Restylane.

"The way the hyaluronic acid is cross-linked at the molecular level dictates how thick or structured it can be, as well as how long it will likely last if injected properly. It also dictates how easily it can be dissolved," explains Dr. Abdallah, adding that thicker, heavily cross-linked filler may require multiple sessions of dissolving.

Non-hyaluronic acid-based ones are those that can't be dissolved. "PMMA filler (Bellafill), calcium hydroxylapatite filler (Radiesse), and poly-L-lactic acid filler (Scultpra) are all examples of fillers that cannot be dissolved.," shares Dr. Chamata.

What are the potential side effects of getting filler dissolved?

There are temporary side effects that can always occur with any type of injectable or in-office treatment, such as bruising, swelling, and discomfort. To minimize the possibilities of bruising or bleeding, Dr. Konstantin Vasyukevich, a board-certified dermatologist in New York City, says to avoid taking blood thinning medications, such as Aspirin, Advil, and Naproxen, prior to your appointment. And for post-care, Dr. Abdallah recommends taking either Arnica pills or applying an Arnica gel to the area to subside bruising and swelling.

When it comes to dissolving filler, Dr. Abdallah says the pain is caused by the enzyme that breaks down the old filler in your skin tissue. However, the amount of pain someone feels will be determined by their pain tolerance and what the treatment area is, as locations such as the lips have more nerves than others.

"Over-dissolving can also break down your body’s naturally occurring hyaluronic acid, so it is important to choose a provider who understands the facial anatomy as well as the physiology of the tissue as a result of the products being used," she urges.