Filler dissolving in Suwon: when is hyaluronidase injected, and when can filler be added again?

If filler you had injected appears to have spread sideways or its shape looks unnatural and this bothers you, it is worth first checking whether it can be dissolved. Hyaluronidase is an enzyme injection that breaks down hyaluronic acid; when injected where the filler is, it cuts the hyaluronic acid chains that make up the gel so that the filler gradually breaks down and is absorbed over about 24 to 48 hours.

Whether to dissolve filler is decided based on the filler's composition, how long ago it was injected, and whether swelling remains, and the timing for re-injection is decided at a consultation after swelling at the dissolved site has subsided. At our Suwon clinic, we first check during the consultation when, where, and what kind of filler was injected, and how far its edges extend when touched.

In this article, we go through how hyaluronidase dissolves filler, cases that are hard to dissolve and differences by area, when to dissolve and the treatment process, aftercare and when to re-treat, and side effects.

Filler dissolving at a glance

• Hyaluronidase is an enzyme that cuts hyaluronic acid chains, and its action is usually complete within 1 to 2 days.
• Non-hyaluronic acid fillers, fillers that have formed firm tissue, and sites with infection or granulomas are difficult to dissolve.
• Unless there is a blood vessel problem, the decision to dissolve is made after post-injection swelling has gone down and the shape can be assessed.
• The timing for re-injecting filler is decided in consultation with a physician after swelling at the dissolved site has subsided.

How does hyaluronidase dissolve filler?

Hyaluronic acid filler is a product made by linking together hyaluronic acid, a substance naturally present in the body, into a long-lasting gel. The body also has enzymes that slowly break it down, which is why filler is absorbed over several months, and hyaluronidase speeds this process up to within a few days by delivering the same type of enzyme all at once.

The enzyme works from the outside of the gel mass inward. So if the product is a tightly cross-linked gel or there is a large amount, it dissolves more slowly and may not all diminish at once, while loosely cross-linked products shrink quickly within a short time.

Filler dissolving: cases that are hard to dissolve and differences by area

Hyaluronidase does not work the same way on all fillers. Below are typical cases that are hard to dissolve.

The method also differs by area. The lips have thin mucous membranes and swell considerably, so filler there is dissolved a little at a time while checking that the original lip line returns; the forehead covers a wide area, so injections are divided across multiple points. The nose has dense blood vessels running close to the skin, so the area to dissolve is confirmed by touch and small amounts are injected at multiple points.

When is filler dissolved?

How the timing for dissolving is decided

Right after filler is injected, swelling makes it look larger and less natural than it really is. Unless there is a blood vessel problem, it is more accurate to wait for the swelling to go down, reassess the shape, and then decide whether to dissolve it, and dissolving in a hurry can easily throw off plans for re-injection.

If filler is suspected of compressing or blocking a blood vessel, it is dissolved immediately regardless of timing. Signs include the treated area turning pale or developing a net-like redness, along with worsening pain. Filler is also dissolved when remaining filler needs to be cleared before another surgery.

Treatment steps at our Suwon clinic

1. Personalized Consultation
2. Numbing Cream / Local Anesthesia
3. Disinfection
4. Treatment

The procedure takes about 10 minutes, and you can return to daily life right after. Hyaluronidase usually finishes working within 1 to 2 days, and if the composition of the previous filler is unknown, we explain the possibility that it may not dissolve before proceeding.

See the Hyaluronidase Treatment Guide

Care after hyaluronidase and when filler can be re-injected

• You can wash your face and wear makeup starting 1 hour after treatment, and the DuoDERM dressing placed on the injection sites is removed after 1 to 3 days.
• For 3 to 7 days after treatment, avoid heavy drinking, smoking, saunas and Korean bathhouses, hot baths, and strenuous exercise.
• If the injection site becomes red and swollen, use a cold compress to calm it.
• Do not rub or press hard on the dissolved area.

Swelling and a mild inflammatory reaction remain at the dissolved site for a few days, and re-injecting right away in this state may keep the filler from settling evenly. After dissolving, some of the hyaluronic acid originally in the skin also decreases, so the area may look temporarily hollow, but it gradually returns as the body replenishes its hyaluronic acid, so the re-treatment amount starts smaller than the first time, based on the shape after this period has passed.

Hyaluronidase side effects and precautions

Swelling, bruising, pain, or a foreign-body sensation may occur at the injection site, and most subside within 1 to 2 weeks. Where a large amount of filler remained, the skin may look temporarily loose or fine wrinkles may become more noticeable after dissolving, and the degree of reaction and speed of recovery vary from person to person.

Due to the nature of the drug, hyaluronidase can cause an allergic reaction in which the injection site becomes red and swollen, and a cold compress can help calm it. If you have a drug allergy, have ever swollen badly from a bee sting, are pregnant or breastfeeding, or have inflammation at the injection site, please let us know before treatment.

If you have difficulty breathing, or your whole face swells and hives spread, please go to an emergency room; if pain at the injection site keeps getting worse or the skin changes color, please contact the clinic right away.

What should be checked before dissolving filler?

If any of these apply, start with an examination of your filler

• The filler I had injected has spread sideways, and its edges look blurred.
• The two sides look different, or it feels lumpy to the touch.
• It seems the filler has spread beyond my lip line.
• I don't remember when or what kind of filler was injected.

If two or more of these apply, it is best to first check the composition and extent of the remaining filler. Whether to proceed, and the method and scope of treatment, are decided together at your consultation after a physician examines you.

In short, the key to dissolving filler is to first check the filler's composition and swelling, then decide when to re-inject after the dissolved area has settled.

FAQ

Q. How long does swelling from hyaluronidase last?

A. Swelling at the injection site usually goes down within a few days, and including bruising, pain, and a foreign-body sensation, most effects subside within 1 to 2 weeks. Areas with thin mucous membranes, such as the lips, may look more swollen, and a cold compress can help.

Q. Will all the filler dissolve with one dissolving injection?

A. It depends on the filler's composition and amount, and how tightly the gel is cross-linked. Hyaluronidase usually finishes working within 1 to 2 days, so if any remains when touched after that, we look at its condition and decide at the consultation whether to inject again.

Q. When can filler be re-injected after dissolving?

A. The timing for re-treatment is decided in consultation with a physician after swelling at the dissolved site has subsided. Re-injecting right away may keep the filler from settling evenly, so we look at your skin condition and the shape after dissolving and start with a smaller amount than the first time.

Q. If lip filler is dissolved, will my lips become smaller than they originally were?

A. During dissolving, some of the hyaluronic acid originally present also decreases, so the area may look temporarily thinner. This change gradually returns as the body replenishes its hyaluronic acid, so we plan the next steps, including whether to add filler, based on how your lips look after that.

Q. What should I do if I am worried about a hyaluronidase allergy?

A. If you have a drug allergy or have ever swollen badly from a bee sting, please tell us at your consultation. If redness and swelling develop after treatment, calm it with a cold compress, and if you have difficulty breathing, go to an emergency room immediately without delay.

Q. How can I find out the cost of filler dissolving?

A. The cost depends on the area and extent to be dissolved and the number of sessions. We explain it after confirming at your consultation which filler remains in which area and how much, and you can also check the options for dissolving injections on the treatment information page.