In this blog, Dr Adam explains why some patients may wish to remove their dermal fillers

There are several reasons why a patient may want to dissolve their filler. They may have had a cheap poorly placed product several years ago and have since realised that this was a mistake (most commonly lips) or less commonly the result from their current medical practitioner is just not satisfactory. More patients are opting for a more natural look and this also means that previously placed fillers may just not fit in with their new ethos and treatment approach.

So if hyaluronic acid (HA) dermal fillers are used, then the good news is that they can be dissolved.

So there’s a chance I’ll need to have my fillers dissolved??

There is a chance, but it is small. I can count the number of patients I have personally treated in my own clinic that have then required dissolving in the past 5 years for example, on one hand. So I put the risk at less than 1%, and it also depends on your medical history, age, anatomy and the site of injection. Some treatments are naturally higher risk than others.

Sometimes there may be a lump in the lip that doesn’t go with massaging, or that tear trough filler has just caused some swelling that comes and goes. In rare cases, vascular occlusions where the arteries in the face can get blocked the filler needs dissolving as an emergency (thankfully extremely rare when injected by skilled injector).

It is useful and important for patients to know that getting their fillers dissolved is an option, but I have seen patients who have been treated sometimes many years ago, and didn’t realise that their fillers could be removed, and just sort of came to terms with the issue such as under eye swelling.

I rarely have needed to dissolve, but I do know that my patient's feel reassured by the fact that the option is there, and these procedures are not permanent like surgery is.

So is anyone suitable for having their fillers dissolved?

Not exactly. Anyone with a history of anaphylaxis to wasp or bee stings would not be suitable for reversal, or are certainly at much higher risk for having a serious allergic reaction to the dissolving agent. However I ask before any injections whether patients have ever been stung and whether there was a severe reaction, and avoiding injecting dermal fillers in the first place if this is the case.

There is a small risk of allergy in the general public otherwise, but more likely than this is a local reaction including stinging, and some mild/moderate swelling at the site of injection.

So what is the dissolving process?

The dissolving agent used is called Hylauronidase (Hyalase) and this works by breaking down Hyaluronic acid. It is a prescription medicine (like Botox) so if your injector is not a prescriber, then you must have been seen by a prescribing medic prior to injection. So after consultation ensuring that the reversal process is medically appropriate, then current medical practice done by most practitioners is a intra dermal skin test to check for allergic reaction. While not 100% effective, this can detect in some cases, those who are allergic to the Hyalase.

After 20 -30minutes we can then proceed to inject the Hyalase at a dilution and amount judged by your injector - and this is where I would discuss how much experience they have in dissolving / how many cases have they been involved with dissolving. I do see this as very important for the discerning patient as vast inappropriate quantities of the dissolving agent not only can increase the risk of allergic reaction, but also can have an affect on your body’s natural hyaluronic acid. This should rebuild within a few weeks, but drastic, temporary reductions in Hyaluronic acid in the face can be pretty alarming and upsetting for patients.

The vast majority of patients are done within a few minutes, just have to wait around for another 20 minutes in the waiting room, and then are free to leave. Following this there is just a gradual dissolution of the current filler over the next few days. Bruising, pain, swelling, infection are some of the other possible risks.

And if desired, filler can be re-injected 2 weeks later.

And that’s it.

How much experience do you have at Skinphinity?

Over my 5+ years of experience injecting and teaching in this industry, I have dissolved over 50 cases (mostly not my own work!) , and discussed many many other cases with an experienced team of doctors including some industry leading complication experts. I’ve even taught other new injectors how to dissolve and walked them through the process.

What does this mean to you as a patient? Well, you should feel safe in the hands of a trusted, experienced doctor, which you may feel important to your decision when choosing an aesthetics practitioner.

If someone tells you they have never dissolved filler before, they probably haven’t been injecting very long, or haven’t done that many cases.

Got any other concerns?

If you think you may benefit from getting your filler dissolved, this is a medical procedure requiring proper assessment and medical and medication history taking, and a thorough examination. Feel free to contact us for a consultation.

info@skinphinity.com

Written by Dr Adam Cheong

Dr Adam is a fully registered and highly regulated GMC doctor.

GMC Number 7079895

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