Filler Dissolving
What Is It?
Filler dissolving means breaking down hyaluronic acid filler with an enzyme called hyaluronidase. We inject the enzyme where the filler is. It cuts the structural chains of the filler and speeds up its breakdown in the tissue. To me, the fact that a result you don’t like can be undone is the most important advantage of hyaluronic acid fillers.
There is one distinction here, though. This enzyme only dissolves hyaluronic acid. Calcium hydroxyapatite, poly-L-lactic acid and fillers described as permanent can’t be reversed this way; they are a separate matter. That is why, before the procedure, we ask you which product was used, when, and into which layer.
How Is It Done?
First we look at where the complaint is coming from. Is there too much volume, asymmetry, product sitting in the wrong layer, or swelling that has developed around the product? If possible, we ask for the product name and the date of the previous treatment. An allergy to the enzyme is possible, so we do a test first if we think it’s needed.
We give the enzyme into the target area with a fine needle, in small amounts. The procedure takes about 15 minutes on average. We adjust the amount to the area and to the structure of the filler. We don’t try to dissolve everything in one session; we go step by step, because the enzyme can also affect the surrounding tissue’s own hyaluronic acid. If needed, we plan a second session.
Who Is It For?
We do it for patients who are unhappy with filler they’ve had, who see excess or asymmetry in the area, or who feel the product is in the wrong place. It comes up most often in the lips and under the eyes. In these thin-skinned areas the product shows more. When filler done elsewhere has thrown off the proportions, we sometimes correct it by dissolving and sometimes by supporting the area that is lacking.
Sudden pain, colour change or pallor after filler suggests vascular occlusion, a blocked blood vessel, and needs urgent assessment. If this happens, contact the clinic without waiting. Pregnancy and breastfeeding, active infection in the area, known allergy to the enzyme and bleeding disorders all change the plan.
Process & Recovery
Assessment
We find the source of the complaint. If possible, we ask for the name of the previous product and the date it was injected. If the product isn’t hyaluronic acid, the plan is different from the start.
Treatment
We give the enzyme into the target area with a fine needle, in small amounts. The procedure takes about 15 minutes. We keep the amount limited so we can proceed in a controlled way.
First 48 hours
Swelling, redness and tenderness occur in the area, and bruising is possible. Because of the early swelling, we don’t judge the result at this stage.
Week 1
The effect of dissolving usually settles within a week. We watch the area during this time and plan a second session if needed.
Decision on new treatment
If you are thinking about filler again, we first wait for the tissue to recover. We decide on the timing together at the review.
Results & Duration
The change usually starts in the first few days and becomes clear within a week. What you see in the first 48 hours is misleading because of swelling, so we look at the result at the end of the week.
Dissolving may not be complete in one session. A second session may be needed, especially with long-standing, dense products. Because the enzyme can also affect the surrounding tissue’s own hyaluronic acid, the area may temporarily lose some volume or feel slightly sunken. This usually recovers within weeks.
What Is Not Promised
Hyaluronidase only dissolves fillers that contain hyaluronic acid. Calcium hydroxyapatite, poly-L-lactic acid and permanent fillers aren’t reversed this way. In those cases the plan is different, and we discuss it from the start.
I can’t tell you we will return the area exactly to how it was before treatment. The enzyme doesn’t tighten sagging skin or undo tissue stretching caused by the filler. We don’t promise a particular rate of dissolving or that it will be finished in one session. We deliberately keep the amount of enzyme controlled.
Key Benefits
- Quick correction
- Controlled dissolving
- Shape control
“With dissolving, you shouldn’t make big claims. We give the enzyme in a controlled way and wait a week. If the filler hasn’t fully dissolved, we add a little more at the review.”
— Dr. Sinan Akyürek
Frequently Asked Questions
Can every filler be dissolved?
No. The enzyme only dissolves fillers that contain hyaluronic acid. Calcium hydroxyapatite, poly-L-lactic acid and permanent fillers can’t be reversed this way.
When is the effect seen?
The change starts in the first days and usually becomes clear within a week. We don’t go by what you see in the first 48 hours, because of the swelling.
Is one session enough?
Most of the time, yes. Long-standing, dense products may need a second session. We deliberately keep the amount controlled.
Will it harm my own tissue?
It can have a temporary effect. The enzyme can also act on the surrounding tissue’s own hyaluronic acid, and the area may feel as if it has lost some volume. This usually recovers within weeks.
Can I have filler again afterwards?
Yes, once the tissue has recovered. We set the timing at the review.
Is the procedure painful?
You feel a brief stinging and burning. We give the enzyme with a fine needle, in small amounts. The area may be tender for a few days afterwards.
Is it also used in emergencies?
Sudden pain, colour change and pallor after filler suggest vascular occlusion and need urgent assessment. If you notice this, contact the clinic without waiting.
Is there a risk of allergy?
Yes. Allergic reactions to the enzyme have been reported. We do a test beforehand if we think it’s needed, and if you have a known allergy, the plan changes.