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Dissolving Filler in the Face & Lips

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Dissolving filler is the process of using an enzyme called hyaluronidase (commonly known as hyalase) to break down hyaluronic acid filler that’s already in the tissue. The result: the filler dissolves within 24 to 48 hours, and the treated area returns to its pre-filler state. It’s one of the major safety advantages of HA-based fillers — and one of the main reasons we don’t recommend permanent fillers, which can’t be reversed.

This is the comprehensive guide to dissolving filler: when it’s appropriate, how the process works, what it costs, what to expect, and the common scenarios where patients consider dissolution. For the broader filler service context, see our .

What hyalase is and how it works

Hyaluronidase (hyalase) is an enzyme that breaks down hyaluronic acid — the active ingredient in HA-based dermal filler Dissolving (hyaluronidase) fillers. It works by the cross-linked bonds that hold the HA gel together, converting the gel into individual HA molecules that the body then naturally absorbs over the following days.

The enzyme is naturally present in the human body. The hyalase used clinically is manufactured as a purified, sterilised solution that’s injected directly into the area where filler dissolution is desired. The effect is targeted — only the filler in the immediate injection area is affected, and only HA-based products are dissolved.

Critically: hyalase only works on HA filler. Non-HA fillers — including calcium hydroxylapatite (Radiesse), poly-L-lactic acid (Sculptra), PMMA (Bellafill), and silicone-based — cannot be with hyalase. These products either gradually break down over much longer periods (1-3 years for Radiesse and Sculptra) or are essentially permanent (PMMA, silicone). This is one of several reasons we don’t use permanent or semi-permanent fillers at Centre for Surgery. For more on this, see our guide on .

When dissolving filler is the right answer

Several scenarios commonly prompt dissolution:

Result you’re unhappy with. The most common reason — the filler hasn’t produced the look you wanted. Maybe the lips are too big, the cheeks look heavy, or the overall result isn’t what was discussed at consultation. Dissolving allows a reset before re-treatment with adjusted technique.

Filler migration. Filler that has drifted from where it was placed, particularly common with lip filler — see our detailed guide on . Migrated filler requires hyalase to because the drifted product won’t move back into position on its own.

Overfilling over time. Patients who’ve had multiple rounds of top-up over years often accumulate more filler than they realise. The cumulative effect can produce a heavy, "done" appearance that they didn’t intend. A reset with hyalase, followed by more re-treatment, often restores natural appearance.

Lumps or asymmetry. Filler that hasn’t integrated smoothly — visible lumps, uneven distribution, asymmetric placement. Hyalase placed at the area can dissolve the affected filler without disturbing the rest.

Vascular emergency. The most urgent reason. If filler enters or compresses a blood vessel — causing skin colour changes, severe pain, or (rarely) visual disturbance — immediate hyalase reversal is required to restore blood flow. This is a medical emergency and Centre for Surgery keeps hyalase on-site for use if needed.

Pre-surgical preparation. Some surgical procedures benefit from dissolving existing filler beforehand — most commonly facelift in patients with significant accumulated facial filler. See our guide on for the detailed discussion.

Change of preference. Patients sometimes simply decide they no longer want enhanced features. Tastes change, life circumstances change, or the social context that motivated the original treatment has . Dissolution returns the area to its natural state.

reaction or biofilm. Rare but real — some patients develop late-onset reactions to filler, sometimes from a (bacterial colonisation around the product). Dissolution typically resolves these .

How the dissolving process works

Pre-treatment. A thorough consultation establishes what filler was placed, when, and where. If treatment was performed elsewhere, bring details if available — though hyalase works regardless of which HA brand was originally placed.

Allergy test. Hyalase carries a small risk of allergic reaction (well under 1% of patients). A patch test on the forearm 30 minutes before treatment confirms tolerance. For patients with known allergies to bee or wasp stings (the enzyme has cross-reactivity), particular caution is warranted.

The injection.

What happens next. The filler softens within hours and progressively dissolves over 24 to 48 hours. The treated area may initially look swollen as the enzyme works, then gradually returns to baseline as the dissolved HA is absorbed.

Follow-up. A review at 2-4 weeks assesses the result and determines whether dissolution sessions are needed. Some patients — particularly those with substantial accumulated filler — benefit from a second session 2-4 weeks after the first.

How many sessions are needed

For most patients, a single session is sufficient. However, several factors can increase the number of sessions required:

Multiple rounds of accumulated filler over years can create denser, more integrated filler that needs more enzyme to fully dissolve.

Different filler types in the same area — some HA products are more cross-linked (more resistant to breakdown) than others. Resilient may need higher hyalase doses.

Biofilm formation can shield filler from enzyme action, requiring repeated dissolution sessions sometimes combined with antibiotics.

Unclear filler history — when the patient doesn’t know what was originally placed, may proceed across multiple sessions to ensure adequate dissolution without over-treating.

Most patients are dissolved within 1-2 sessions. Persistent residual filler beyond that is uncommon.

Does it hurt?

The injection itself is brief and tolerable. The very fine needle used produces discomfort — similar to or less than the original filler treatment. Patients commonly report:

Topical anaesthetic can be for particularly anxious patients but isn’t necessary for most. The procedure is significantly less uncomfortable than most people expect.

What to expect afterwards

Immediately: mild swelling and possible small bruising at injection sites. Some redness for a few hours.

First 24 hours: the filler begins visibly softening and reducing. The treated area may look slightly swollen as the enzyme works.

24-48 hours: filler dissolution substantially complete. The treated area returns toward its pre-filler state.

1-2 weeks: any residual swelling resolves. Final result at the 2-week mark.

Restrictions:

For more on the broader filler aftercare framework, see our and .

The "reset and rebuild" approach

For patients who want to restart their filler journey with better technique, the standard approach at Centre for Surgery is:

Stage 1: full dissolution of existing filler with .

Stage 2: recovery period of 2-4 weeks to allow the tissue to settle and any product to fully resolve.

Stage 3: honest reassessment of the patient’s natural anatomy without filler influence. Often patients discover their underlying anatomy needs less than they thought.

Stage 4: conservative re-treatment with appropriate volume and technique, if appropriate. Sometimes patients choose to remain filler-free at this point.

Stage 5: long-term maintenance plan with modest volumes at appropriate intervals, with periodic full dissolution every months to prevent accumulation.

This approach prevents the cycle of accumulating filler that produces the "done" many patients want to escape.

Risks and considerations

Common (mild and self-limiting):

Less common:

Rare:

A thorough consultation your individual risk profile based on filler history, skin type, and overall health.

What you can’t dissolve

Hyalase is specific to hyaluronic acid. It does not work on:

Patients with non-HA filler that they want removed face significantly more limited options. For some, the only answer is patience while the product naturally degrades; for others, surgical removal of nodules or tissue may be considered. This is why we recommend HA-based products for all elective filler treatment — the reversibility is a fundamental safety feature.

Cost

At Centre for Surgery, filler dissolving treatment is priced per session — typically:

For patients dissolving filler placed elsewhere, no fee is charged for the dissolution consultation. , including 0% APR, are available.

Common questions

No — dissolving returns the lips to their natural pre-filler state. Some patients feel their lips look "thin" or "deflated" immediately after dissolving because they’ve been accustomed to filled appearance for months or years. Within 4-8 weeks, the lips look like the patient’s natural lips again. For more, see our guide on .

breaks down HA — both the filler and any local natural HA in the immediate injection area. The natural HA within days. There’s no permanent damage to the lip, cheek, or other treated tissue.

Minimum 2 weeks, ideally 4 weeks. The longer wait allows full tissue assessment and proper planning of conservative re-treatment.

Yes — hyalase works on HA filler regardless of how long it’s been in place. Older filler may need slightly higher doses but the dissolution still works effectively.

This is common, particularly when treatment was performed elsewhere. can still proceed — hyalase works on all HA brands. If non-HA filler was originally placed, the hyalase won’t dissolve it, which itself confirms the product type.

No specific treatment — just standard aftercare (gentle handling, no heat, no exercise for 24 hours). Most patients find the recovery substantially easier than the original filler treatment.

Yes — patients sometimes opt for full-face of filler from multiple areas. This may require 2-3 sessions over 4-8 weeks to complete dissolution, depending on the volume and locations .

Vascular occlusion (filler blocking a blood vessel) requires immediate hyalase reversal — within hours, ideally within minutes for best outcome. Centre for Surgery keeps hyalase on-site for emergency use. If you’ve had filler elsewhere and develop symptoms (skin colour changes, severe pain, visual disturbance), seek immediate medical attention — at our clinic, by phone on , or via A&E if outside clinic hours.

For minor adjustments, sometimes additional filler placed strategically in adjacent areas can rebalance the result without needing to dissolve. For more substantial changes, dissolution is usually the most reliable path. The honest answer comes from consultation rather than online assessment.

Centre for Surgery · CQC-regulated · GMC specialist-registered surgeons · · · ·

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Centre for Surgery is a CQC-regulated private hospital on London’s Baker Street, delivering plastic and cosmetic surgery through GMC-registered specialist surgeons. Our expertise spans facial procedures including and , , for men, and body contouring procedures such as and . Patient safety, surgical and natural-looking results sit at the heart of everything we do.

Centre for Surgery is a CQC-regulated hospital on London’s iconic , offering plastic and cosmetic surgery led by GMC-registered consultant surgeons.

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