As the field of cosmetic dermatology continues to advance, one procedure gaining popularity is dermal filler dissolving using hyaluronidase. Dermal fillers, such as hyaluronic acid-based products, have been widely used to enhance facial features and reduce the signs of aging. However, there are situations where patients may wish to reverse the effects of fillers or correct any irregularities. This is where hyaluronidase comes into play. In this blog post, we will delve into the fascinating world of dermal filler dissolving and explore the important role of hyaluronidase in this process.
Understanding Dermal Fillers:
Dermal fillers have revolutionized the aesthetic industry by providing a non-surgical solution for facial rejuvenation. These injectable gels are typically composed of hyaluronic acid, a substance naturally found in the human body. They work by restoring volume, smoothing out wrinkles, and enhancing facial contours. Dermal fillers offer immediate results with minimal downtime, making them a popular choice among patients seeking quick cosmetic improvements.
The Need for Dermal Filler Dissolving:
While dermal fillers are generally safe and effective, there are instances where patients may desire their removal. Common reasons for seeking dermal filler dissolving include:
- Patient dissatisfaction: Sometimes, the desired results are not achieved, or the patient is unhappy with the outcome.
- Adverse reactions: Allergic reactions, infection, or inflammation can occur following filler injections.
- Uneven distribution: Improper injection techniques or migration of filler material can result in lumps, asymmetry, or contour irregularities.
- Filler degradation: Over time, dermal fillers naturally break down. However, in some cases, patients may wish to expedite the process.
The Role of Hyaluronidase:
Hyaluronidase is an enzyme that breaks down hyaluronic acid, the primary component of most dermal fillers. It works by cleaving the bonds between hyaluronic acid molecules, allowing for their rapid dissolution and absorption. Hyaluronidase can be thought of as the “eraser” of dermal fillers, as it effectively reverses their effects.
The dissolving process using hyaluronidase is relatively quick and straightforward. A skilled healthcare professional will inject small amounts of the enzyme into the treated area, targeting the specific areas where the dermal filler needs to be dissolved. The hyaluronidase breaks down the filler, and the body’s natural metabolic processes take care of the rest. Results are typically noticeable within 24 to 48 hours, but individual experiences may vary.
What to Expect When Dissolving Fillers:
When opting for filler dissolving, the process is usually straightforward and typically requires one to two sessions. However, if satisfactory results are not achieved after two sessions of hyaluronidase treatment, additional steps may be taken to assess the situation. In such cases, an MRI may be recommended to determine if the filler is still present or if there are other underlying concerns.
It’s important to note that hyaluronidase is specifically designed to dissolve hyaluronic acid-based fillers. Other types of semi-permanent or permanent fillers cannot be removed with hyaluronidase. If the filler has hardened or changed in consistency, it may indicate the formation of granulomas or a delayed type IV hypersensitivity reaction. These conditions require alternative treatments as they are immune-mediated responses to the filler.
Preparing for Filler Dissolving:
Before undergoing filler dissolving, you will have a consultation with a practitioner who will discuss your goals and provide detailed information about the procedure. During this consultation, the cost of treatment will also be discussed.
The Filler Dissolving Process:
The actual filler dissolving treatment is typically brief, lasting only a few minutes. The practitioner will inject hyaluronidase into the specific area where the unwanted filler is located. They may also gently massage the injection site to ensure even distribution of the enzyme. In the event of a strong reaction, such as swelling or redness, you may be required to remain in the clinic for a short period to ensure that it does not progress to anaphylaxis, although the risk of this is very small.
Aftercare for Filler Dissolving:
Bruising and swelling may occur for a few days following the treatment. It is essential to note that when overfilled areas are dissolved, especially if they have been overfilled for an extended period, the change in appearance after hyaluronidase injection can be unexpected. The skin may appear more wrinkled, deflated, or loose, particularly within the first day after the procedure.
The longer the filler has been in place, the more noticeable these differences may be. It’s important to understand that hyaluronidase only removes the filler and does not permanently affect your natural hyaluronic acid. Skin changes resulting from the absence of filler may need to be addressed with energy-based devices or surgical procedures to tighten the skin.
Possible Side Effects of Hyaluronidase:
The most common side effects of hyaluronidase injections are injection-related reactions, such as swelling and bruising. Allergic reactions, including anaphylaxis, are uncommon but have been reported in approximately 1 in 2000 cases. To mitigate the risk, a test patch will be performed before the hyaluronidase treatment, especially for individuals with a history of allergies, including bee sting allergies, as hyaluronidase is also found in bee venom.
The Challenge of Dosage and Additional Treatments:
Determining the appropriate amount of hyaluronidase required to dissolve the filler can be challenging. Over-dissolving or under-dissolving can occur, and in such cases, subsequent visits may be necessary. This can involve either adding more filler if over-dissolved or retreating with more hyaluronidase if under-dissolved.
Frequently Asked Questions about Filler Dissolving with Hyaluronidase:
- Can all dermal fillers be dissolved?
No, only hyaluronic acid-based dermal fillers can be dissolved with hyaluronidase. Other types of fillers, such as semi-permanent or permanent ones, cannot be removed using hyaluronidase.
- Does hyaluronidase dissolve natural hyaluronic acid?
Hyaluronidase injections specifically target and dissolve hyaluronic acid fillers. The body’s natural hyaluronic acid, which is constantly turned over by naturally occurring hyaluronidase, is not affected by injected hyaluronidase.
- How long does it take for fillers to dissolve with hyaluronidase?
Hyaluronidase has an immediate effect, although the full results may not be immediately apparent due to swelling in the treated area. The precise amount of hyaluronidase needed can be challenging to determine, and subsequent treatments may be required to target and dissolve the filler accurately.
- How many sessions are required?
Typically, one to two sessions of hyaluronidase treatment are sufficient to dissolve or remove hyaluronic acid dermal fillers. However, in rare cases, multiple treatments may be necessary.
It is important to note that the number of treatments required can vary depending on factors such as the type/brand and amount of filler used, the location of the filler, and individual patient characteristics. Your healthcare professional will assess your specific situation and determine the appropriate course of action to achieve the desired results effectively and safely.
- How soon can I get new filler after hyaluronidase treatment?
It is generally recommended to wait at least 2 weeks after dissolving the filler before replacing it with new filler. This allows any swelling to subside and ensures that the hyaluronidase does not affect the effectiveness of the new filler.
