Treatments

By palmeiraclinic@gmail.com

Hyaluronidase & Filler Removal

Hyaluronidase breaks down hyaluronic acid filler that is unwanted or misplaced

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A clinician-led assessment for patients who are concerned about previous hyaluronic acid dermal filler. Where appropriate, hyaluronidase may be prescribed and used to break down hyaluronic acid filler that is unwanted, misplaced or contributing to problems such as overfilling, migration, asymmetry or selected lumps. Not every concern requires dissolving, and not every type of filler can be removed with hyaluronidase, so the first step is careful assessment of what has previously been injected and what you would like to achieve.

Quick Summary

Time

45 mins

Downtime

Minimal

Pain Level

Virtually pain free with numbing creams.

Response

Instantly

Longevity

Results are long lasting

Investment

£350

What it is and how it works

Dermal filler does not always need to be dissolved simply because a patient no longer likes the result. Sometimes swelling, product choice, placement, facial anatomy or the amount of filler present needs to be assessed before deciding on the best next step. For suitable hyaluronic acid fillers, hyaluronidase can break down hyaluronic acid within the treated area. This can be useful where filler has been over-corrected, placed in an unwanted position, migrated, produced a visible blue-grey Tyndall effect, or contributed to selected nodules or an unsatisfactory cosmetic result. Hyaluronidase does not provide a universal way of removing every injectable product. It is used for hyaluronic acid filler; other filler materials and biostimulatory products require different assessment and management.

What it may help with

  • Clinician-led assessment before deciding whether dissolving is appropriate
  • Can reduce or remove suitable hyaluronic acid filler
  • Can help correct overfilling, migration and selected unwanted filler results
  • Allows a staged rather than ‘dissolve everything’ approach where appropriate
  • Can create a clearer baseline before future facial planning
  • Focuses on restoring proportion rather than automatically adding more filler

Suitable for

• Filler that looks or feels over-corrected • Migration or unwanted spread of hyaluronic acid filler • Visible or palpable lumps where hyaluronidase is clinically appropriate • Asymmetry related to previous filler • Tyndall effect from superficially placed hyaluronic acid filler • An aesthetic result that no longer suits the patient’s facial proportions or goals • Correction before considering a carefully planned future treatment • Management of certain filler complications where clinically indicated Aesthetic dissatisfaction and a suspected filler complication are not the same situation. Acute severe pain, blanching, dusky or mottled skin, visual symptoms or other signs of vascular compromise require urgent clinical assessment rather than a routine filler-removal appointment. This service may be suitable for adults who have previously received hyaluronic acid dermal filler and would like a clinical assessment because they are unhappy with its position, amount, appearance or a suspected filler-related problem. Where possible, bring details of previous treatments, including the product used, treatment area, approximate date and amount injected. If the filler type is uncertain, this may affect whether dissolving can be recommended.

Areas treated

  • Lips and perioral area
  • Cheeks and mid-face
  • Tear-trough / under-eye area where clinically appropriate
  • Chin and jawline
  • Nasolabial or marionette areas
  • Other previously treated facial areas following individual assessment

What happens on the day

Your appointment begins with a detailed history and facial assessment. We discuss what was injected, when it was treated, what has changed since treatment and what you would now like to improve. The area is examined to determine whether the problem appears consistent with hyaluronic acid filler and whether dissolving is likely to help. If hyaluronidase is considered appropriate, the clinician will discuss its off-label use, expected effect, alternatives, limitations and risks, including the possibility of an allergic reaction. Because hyaluronidase is a prescription-only medicine, treatment requires an appropriate clinical assessment and prescribing process. The medicine is then injected into the selected area according to the clinical findings. The amount and distribution needed vary according to the filler, its location, the amount present and the objective of treatment. Complete removal is not always necessary or achievable in a single session.

Downtime and Aftercare

Temporary redness, swelling, tenderness and bruising can occur after treatment. The area may initially look more swollen or uneven before settling, so the immediate appearance should not be treated as the final result. You will receive individual aftercare and instructions about when the area should be reviewed. Further treatment is only considered after reassessment if clinically appropriate.

Risks and side effects

Common short-term effects include redness, swelling, tenderness, bruising and temporary unevenness at the injection sites. Hyaluronidase can cause allergic reactions. Rarely, a severe systemic allergic reaction such as anaphylaxis can occur, which is why treatment should take place in an appropriate clinical setting with the ability to recognise and manage complications. The enzyme can also affect naturally occurring hyaluronic acid in the tissues locally, although the body continually produces and turns over its own hyaluronic acid. Cosmetic outcome can be difficult to predict precisely, particularly when the original product, amount or placement is uncertain. More than one session may sometimes be required.

Contraindications

Treatment may need to be postponed or avoided where there is active infection or significant inflammation at the treatment site, a relevant known hypersensitivity, or another medical factor that alters the risk of treatment. Pregnancy or breastfeeding, current medicines, previous allergic reactions, previous filler complications and uncertainty about the material previously injected should all be discussed during assessment. If the previous injectable is not a hyaluronic acid filler, hyaluronidase may not be an appropriate removal method.

Concerns this treatment may help

    Frequently Asked Questions

    No. Hyaluronidase breaks down hyaluronic acid, so it is used for suitable hyaluronic acid fillers. Other filler materials and biostimulatory products cannot be assumed to respond to it. If you know which product was used previously, bring this information to your consultation.

    No. Hyaluronidase breaks down hyaluronic acid, so it is used for suitable hyaluronic acid fillers. Other filler materials and biostimulatory products cannot be assumed to respond to it. If you know which product was used previously, bring this information to your consultation.

    Not necessarily. Depending on the problem and the distribution of filler, a clinician may consider targeted or staged correction. The aim is to treat the actual problem rather than automatically dissolve every previously treated area.

    Not necessarily. Depending on the problem and the distribution of filler, a clinician may consider targeted or staged correction. The aim is to treat the actual problem rather than automatically dissolve every previously treated area.

    Hyaluronidase starts acting rapidly, but swelling from the injections can make the immediate appearance misleading. Enzymatic activity can continue over roughly 24-48 hours, after which the area can be reassessed as it settles.

    Hyaluronidase starts acting rapidly, but swelling from the injections can make the immediate appearance misleading. Enzymatic activity can continue over roughly 24-48 hours, after which the area can be reassessed as it settles.

    Not always. The response depends on factors including the type and amount of hyaluronic acid filler, its location and cross-linking, how long it has been present and the amount of hyaluronidase used. A further assessment or treatment may sometimes be required.

    Not always. The response depends on factors including the type and amount of hyaluronic acid filler, its location and cross-linking, how long it has been present and the amount of hyaluronidase used. A further assessment or treatment may sometimes be required.

    There is no reason to plan replacement filler automatically. The area should first be allowed to settle and be reassessed. If further filler is later appropriate, timing and treatment should be based on the condition of the tissues, your anatomy and the reason the previous filler was dissolved.

    There is no reason to plan replacement filler automatically. The area should first be allowed to settle and be reassessed. If further filler is later appropriate, timing and treatment should be based on the condition of the tissues, your anatomy and the reason the previous filler was dissolved.

    Related Reading

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      • Dermal Fillers

      • Lip Filler

      DISCLAIMER

      Important information

      All treatments are subject to a consultation and medical assessment. Aesthetic outcomes depend on many unique factors, including individual anatomy, skin quality, age, medical history, and lifestyle habits. No specific result can be guaranteed. The information on this page is for general education and is not a substitute for personal medical advice.
      Photos and descriptions on this website represent typical outcomes but do not guarantee that your results will be the same.

      Next steps

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      Your first appointment is about understanding your skin and what matters to you. We’ll explain your options honestly, and there’s no obligation to go ahead with treatment. If you want any further information please contact us.

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