As a nurse practitioner, educator, and business owner, I often find myself wondering: What do you really want to know? How can I best guide you so you feel informed, empowered, and truly part of the process? How do I tap into those burning questions rolling around in your head? Then—BAM!—I get one or two texts asking the exact same thing, and just like that…hello, next blog topic.
This week’s pressing inquiry: Can filler be dissolved?
The accurate (though mildly irritating) short answer: maybe.
The longer answer? Let’s break it down.
First, a quick filler refresher. Most volumizing fillers used in the U.S. are made from hyaluronic acid (HA)—a sugar molecule that closely mimics the HA your body naturally produces. Science tweaks it a bit to make it softer, firmer, stretchier, or longer-lasting. Ever feel like you’re slowly shriveling with age? (Rude, but true.) That’s partly because your body produces less natural HA over time.
Along with HA, your body also makes an enzyme called hyaluronidase, whose job is to break HA down. The amount you produce can differ from your bestie’s, which means you’ll metabolize filler differently. So when we talk about how long filler lasts—or whether it can be undone—we have to consider the type of HA used, how it was modified, and how much of this enzyme you naturally make.
Not all fillers are reversible. Fillers like calcium hydroxyapatite, polymethyl methacrylate (PMMA), biogels, or poly-L-lactic acid cannot be dissolved with hyaluronidase and may require surgery or simply time to fade.
Those of us who inject HA fillers keep pharmaceutical-grade hyaluronidase on hand. Its primary purpose is safety, in case of an injection-related concern. But increasingly, we also use it to help dissolve filler when someone wants a reset. Pillow face is officially OUT (hallelujah), and trout pout has swum away (thank goodness). If someone has gone a bit too far and wants to rediscover their original face, hyaluronidase can help speed things along rather than waiting months—or years.
If you liked your HA filler initially, but it’s no longer your vibe, has shifted, or seems to be swelling more as it breaks down, yes—hyaluronidase can be injected into the area in question. This is technically an off-label use, but it’s well within accepted industry standards.
Before you decide this is the path for you, here are a few important things to know:
1. As HA filler breaks down, it can attract more water. HA’s whole job is water retention (about 1,000 times its weight!), which may explain why swelling can appear—or reappear—years after injection.
2. Hyaluronidase has no on-label indication for dissolving filler. It also isn’t exactly comfortable. I call it spicy; others say it “hurts like heck.” Lidocaine helps, but there’s still some sting.
3. The enzyme can’t be perfectly controlled once injected. It’s a thin liquid and travels within the treated area. We aim carefully, but it does what it wants once inside.
4. Hyaluronidase breaks down all HA—natural and injected. Most effects are immediate, with continued reduction for up to a week. For this reason, most injectors won’t dissolve and refill in the same session.
5. It’s typically priced by the unit or vial. I usually start with one vial, then reassess in two weeks. You may need more than one treatment—or you may not. Patience is key.
6. Swelling isn’t always filler. Issues like impaired lymphatic drainage (from infection, injury, surgery, radiation, trauma, or age) can mimic filler swelling—so dissolving is not a guaranteed fix.
Now let’s talk about the elephant in the room: filler migration. No finger-pointing here—unless you’re self-injecting or ignoring post-care instructions (especially with lips). Migration happens for many reasons, usually a combination of factors. HA fillers are gels placed in dynamic areas with layered tissue and constantly moving muscles. You talk, chew, kiss, sleep, sip through straws, get facials—your face never rests. Add varying filler consistencies, integration with your tissue, injection technique, and natural breakdown, and migration can happen. No injector intentionally misplaces filler, but experience levels and ongoing education do vary. Bottom line? Don’t coupon your face. Enough said.
This doesn’t answer every question—but we have to start somewhere. For full pharmaceutical deep dives, the Prescribers’ Digital Reference and the FDA are always there if you want to nerd out.
Looking to undo? Hyaluronidase might be an answer
As a nurse practitioner, educator, and business owner, I often find myself wondering: What do you really want to know? How can I best guide you so you feel informed, empowered, and truly part of the process? How do I tap into those burning questions rolling around in your head? Then—BAM!—I get one or two texts asking the exact same thing, and just like that…hello, next blog topic.
This week’s pressing inquiry: Can filler be dissolved?
The accurate (though mildly irritating) short answer: maybe.
The longer answer? Let’s break it down.
First, a quick filler refresher. Most volumizing fillers used in the U.S. are made from hyaluronic acid (HA)—a sugar molecule that closely mimics the HA your body naturally produces. Science tweaks it a bit to make it softer, firmer, stretchier, or longer-lasting. Ever feel like you’re slowly shriveling with age? (Rude, but true.) That’s partly because your body produces less natural HA over time.
Along with HA, your body also makes an enzyme called hyaluronidase, whose job is to break HA down. The amount you produce can differ from your bestie’s, which means you’ll metabolize filler differently. So when we talk about how long filler lasts—or whether it can be undone—we have to consider the type of HA used, how it was modified, and how much of this enzyme you naturally make.
Not all fillers are reversible. Fillers like calcium hydroxyapatite, polymethyl methacrylate (PMMA), biogels, or poly-L-lactic acid cannot be dissolved with hyaluronidase and may require surgery or simply time to fade.
Those of us who inject HA fillers keep pharmaceutical-grade hyaluronidase on hand. Its primary purpose is safety, in case of an injection-related concern. But increasingly, we also use it to help dissolve filler when someone wants a reset. Pillow face is officially OUT (hallelujah), and trout pout has swum away (thank goodness). If someone has gone a bit too far and wants to rediscover their original face, hyaluronidase can help speed things along rather than waiting months—or years.
If you liked your HA filler initially, but it’s no longer your vibe, has shifted, or seems to be swelling more as it breaks down, yes—hyaluronidase can be injected into the area in question. This is technically an off-label use, but it’s well within accepted industry standards.
Before you decide this is the path for you, here are a few important things to know:
1. As HA filler breaks down, it can attract more water. HA’s whole job is water retention (about 1,000 times its weight!), which may explain why swelling can appear—or reappear—years after injection.
2. Hyaluronidase has no on-label indication for dissolving filler. It also isn’t exactly comfortable. I call it spicy; others say it “hurts like heck.” Lidocaine helps, but there’s still some sting.
3. The enzyme can’t be perfectly controlled once injected. It’s a thin liquid and travels within the treated area. We aim carefully, but it does what it wants once inside.
4. Hyaluronidase breaks down all HA—natural and injected. Most effects are immediate, with continued reduction for up to a week. For this reason, most injectors won’t dissolve and refill in the same session.
5. It’s typically priced by the unit or vial. I usually start with one vial, then reassess in two weeks. You may need more than one treatment—or you may not. Patience is key.
6. Swelling isn’t always filler. Issues like impaired lymphatic drainage (from infection, injury, surgery, radiation, trauma, or age) can mimic filler swelling—so dissolving is not a guaranteed fix.
Now let’s talk about the elephant in the room: filler migration. No finger-pointing here—unless you’re self-injecting or ignoring post-care instructions (especially with lips). Migration happens for many reasons, usually a combination of factors. HA fillers are gels placed in dynamic areas with layered tissue and constantly moving muscles. You talk, chew, kiss, sleep, sip through straws, get facials—your face never rests. Add varying filler consistencies, integration with your tissue, injection technique, and natural breakdown, and migration can happen. No injector intentionally misplaces filler, but experience levels and ongoing education do vary. Bottom line? Don’t coupon your face. Enough said.
This doesn’t answer every question—but we have to start somewhere. For full pharmaceutical deep dives, the Prescribers’ Digital Reference and the FDA are always there if you want to nerd out.