Sometimes it’s due to an unsatisfactory result, sometimes it’s due to changes in tastes and trends, but the process of dissolving lip filler has become more commonplace. The best thing about using hyaluronic acid injections is that they can be undone if needed. To hit the rewind button on a lip enhancement, the name of the game is an enzyme called hyaluronidase, which dissolves the filler. Here is everything you need to know about how it works and whether your lips will ever be the same.
What does the process of dissolving lip filler entail?
It’s only recommended to use hyaluronic acid dermal filler on the lips. “Some are easier to dissolve than others, but all can be dissolved or even extruded for removal,” says New York dermatologist Doris Day, MD. “The dissolver is an enzyme called hyaluronidase that dissolves the hyaluronic acid pretty much right on contact. It can sting or burn on injection and then the area is gently massaged to help increase contact with the solution and the hyaluronic acid. We can fully dissolve or ‘reverse sculpt’ by only dissolving some of the filler and recontouring in the process.”
Which fillers can be dissolved with hyaluronidase?
“Only fillers with hyaluronic acid, such as Juvéderm, Restylane, RHA and Revanesse can be dissolved with this enzyme,” explains Rochester, NY dermatologist Lesley Loss, MD. “Longer-lasting fillers like Radiesse and Sculptra, made of calcium hydroxyapetite and polyL lactic acid respectively, cannot be dissolved with hyaluronidase.”
How long does it take to dissolve?
According to Fort Myers, FL plastic surgeon Ralph R. Garramone, MD, you should see the enzyme take effect immediately. “Right after the product is injected you can see the filler dissipate and start to dissolve,” he says. “Usually at two days you can see the results of the filler dissolving, if more is needed at that time, at 48 hours more can be injected.”
Can you do it in one sitting?
How many sessions it takes to dissolve lip filler really depends on the case says New York dermatologist Marina Peredo, MD. Because each lip enhancement is different, the time it takes to do a revision requires patience as it can be a mystery as to what was used and how the filler will react. “Many times, it takes multiple sessions because it depends on the type of filler that was used and sometimes if you’re doing the revision, you may not know how much was injected and exactly where the fluid was injected by other injector. It can be a bit of a guessing game,” Dr. Peredo explains. “If the original injector used older filler like Restylane or Juvéderm Ultra that is an older technology and not crosslinked like the HA fillers we use more commonly now, it takes a lesser amount of hyaluronidase and fewer treatments to dissolve them. With newer fillers that are highly crosslinked, it can take a longer to dissolve.”
Does it hurt?
Melville, NY dermatologist Kally Papantoniou, MD says pain is not a factor and while there is a bit of a sting or a “bite” to the injections, you can expect to feel something similar to what you did when you first had them filled. “It is similar in pain to fillers, but with fewer injections, and topical numbing may be used if discomfort is an issue,” she notes.
“You’ll be swollen and it will take your body some time to absorb the byproduct, which is going to be water and some blood and serum,” adds Nashville plastic surgeon Daniel Hatef, MD.
Are your lips deflated afterward?
A common misconception is that the lips will look deflated or flat afterward, but Dr. Peredo says that’s not always the case. “No, they’re not going to be stretched out, but often the natural outcome is so much better than the over-inflated look. However, if lips are not proportionate when you dissolve them, you can get them re-filled but it’s the hardest thing to convince patients to take a break in between to see how they settle.”
Will it dissolve filler that was placed years ago?
While hyaluronic acid-based fillers are said to only last a year, maybe two at most, there are still accounts of patients having filler remain in their bodies longer than average. In these cases, the experts says hyaluronidase can still do its job. “Yes, it will,” notes Dr. Hatef. “Some of the filler will remain because the body has scarred into it and it is tough to resolve. But filler can be dissolved after a long period of time.”
“I have seen some fillers placed over a year ago that persist or have left an undesirable result,” adds Dr. Loss. “They can still be dissolved, but depending on the product it may require a few treatments. The fillers that last longer often require a few treatment sessions.”
According to New York oculoplastic surgeon Irene Gladstein, MD you should not let the age of the filler you want dissolved to discourage you. “I have personally dissolved filler in tear trough that was over 10 years of age,” she says. “The most important criteria is not the ‘age’ of the problem but the reassurance that product in question is indeed hyaluronic acid.”
How long before you can get lip filler again if you choose to?
Some injectors prefer to wait a few weeks after the dissolved filler has dissipated fully before re-injecting, but if the filler reversal is straightforward, Dr. Day says you don’t have to wait too long. “You can re-do the lip filler in as soon as one day to one week, depending on how much has been dissolved and how you feel,” she notes. “If there is bruising, it would be best to wait a few days for that to resolve before re-treating.”
Getting it right the first time
“It’s so much harder to dissolve lip filler than to start with the right lip enhancement, so I always tell people to go to a qualified injector and not look for a ‘deal’ or value,” advises Dr. Peredo. “In the end, you’re going to end up paying so much more if you need your lip filler dissolved. It’s expensive and every time I have a patient come in to have me ‘fix’ their lips and dissolve poorly placed or overdone fillers, it’s between $300 to $600 per session. So making sure you’re going to the right person to begin with is invaluable.”