Filler dissolving is the treatment people look up when something about their filler no longer feels right: a lump that will not settle, a lip border that has blurred, a chin or jawline that reads heavier than it should, or simply the wish to go back to a clean baseline before anything else is planned. The treatment itself is straightforward. The part worth understanding before you book is what it can and cannot do, and what the first fortnight afterwards actually looks like.
This article answers the questions we are asked most often. The full treatment page, with how it is performed at the clinic, is here: filler dissolving in Melbourne.
What filler dissolving is
Filler dissolving uses hyaluronidase, an enzyme that breaks down hyaluronic acid. Hyaluronic acid is what most modern dermal fillers are made from, so hyaluronidase unpicks the filler rather than hiding it, and the effect is immediate: the enzyme begins working within minutes and continues over the following 24 to 48 hours.
Two things follow from that, and both matter.
The first is that hyaluronidase acts on hyaluronic acid and nothing else. If what was placed was not a hyaluronic acid filler, dissolving will not remove it, which is why the consultation starts with establishing what was injected, where and when.
The second is that the enzyme does not distinguish between the filler and the hyaluronic acid your own tissue holds in that area. That native hyaluronic acid is temporarily broken down too, which is why the treated area can look deflated or simply unfamiliar on day one and day two. It rehydrates and rebounds within a few days.
What it treats
At the clinic, filler dissolving is used for the problems filler can create and for the decision to start again.
- Lumps and nodules that have not settled with time or massage.
- Migration, where filler has moved outside the zone it was placed in. Lip borders are the most familiar example, and we have written separately on why lip filler migrates and how likely it really is.
- Overfilling, where the area reads heavy or distorted rather than balanced. This is a common reason for dissolving around the chin and jawline, where a small excess changes the whole lower face.
- Intermittent puffiness or a bluish discolouration over older filler.
- Vascular occlusion, the rare complication where filler obstructs blood flow. This is urgent rather than elective, and it is treated the same day.
- A clean baseline before a new plan, so that what is placed next is placed into tissue as it really is.
Direct, or under ultrasound guidance
There are two routes at Aesthetic Doctors Australia: dissolving directly, and dissolving with precision under ultrasound guidance.
Ultrasound earns its place when nobody is certain what is in the tissue or exactly where it sits, which is the usual situation with filler placed years ago, or elsewhere, or in several rounds. Dr Rakib Uddin uses it in three ways: vascular mapping, to locate the blood vessels before filler is placed in areas where precision matters most, such as the nose; evaluating old filler, so that lumps, intermittent puffiness and blue discolouration can be seen within the tissue rather than guessed at; and managing filler complications, where the enzyme has to reach a specific deposit quickly and accurately.
Seeing the deposit before treating it means the enzyme can be aimed at the filler rather than spread across the area, which is the whole argument for the guided route.
Who it suits, and who should wait
Filler dissolving suits you if there is a defined problem to solve, or a clear decision to return to baseline, and you are willing to see the area through an unflattering week.
It suits you less well if you are looking for an instant improvement in appearance. Dissolving removes volume; it does not replace it. When filler that has been in place a long time is dissolved, it is common to see temporary hollowing or sagging in the area, and that is the filler being gone rather than a sign of damage. Despite what circulates on social media, there is no scientific evidence that dissolving filler damages your natural facial tissues.
It also suits you less well if you need the area to look its best within the next two or three weeks. If there is an event in the diary, the sensible order is to wait, dissolve afterwards, and plan from there.
What to expect, week by week
What follows is the pattern we see and the aftercare we give. The full instructions are on the filler dissolving aftercare page.
The first 24 to 72 hours. Significant swelling in the first day, sometimes more than the original filler treatment caused. An empty or hollow look on day one and day two before the tissue rebounds. Mild bruising at the injection points, which can be more noticeable around the lips. Tenderness to touch and with movement. A strong sense that the area looks different before it looks right.
Day three to day seven. Swelling settles and the deflated look improves.
Week two. The area looks closer to its pre-filler baseline, which is the point at which it can be judged.
Week two to week four. A planned review, to assess whether further dissolving is needed or whether new and smaller filler placement is appropriate. We arrange a follow-up at two weeks as standard.
Filler dissolving is rarely a single decision. Most plans include that review and a conversation about what, if anything, comes next.
Refilling: why we ask you to wait
The loss of volume immediately after a major dissolve can feel alarming, and the instinct to refill straight away is a strong one. Dr Rakib asks for patience instead, and does not guarantee immediate refilling of the area. After a long period of swelling and distortion, the tissue, including the lymphatic system, needs time to recover before anyone can see what is actually there. Placing new filler into a swollen, recently emptied area is placing it blind.
Safety, and when to call us
Hyaluronidase is derived from animal protein, and very rare allergic reactions are possible. Contact the clinic immediately in the event of severe escalating pain, blanching, dusky discolouration, vision changes, or signs of an allergic reaction such as widespread hives, wheezing or swelling of the lips or tongue beyond the treated area.
Routine swelling, bruising and tenderness in the first few days are expected and do not need a call. The list above does.
Common questions
- How quickly does filler dissolving work?
Hyaluronidase begins breaking the filler down within minutes and continues over 24 to 48 hours, so the volume change is immediate even though the final appearance takes a fortnight to read.
- Will it dissolve all of the filler?
Often, though not always in one session. That is what the review at two to four weeks is for: to see what remains once swelling has gone and decide whether a second treatment is warranted.
- Does dissolving damage my own tissue?
There is no scientific evidence that it does. The enzyme also breaks down the hyaluronic acid your tissue holds in that area, which is temporary and rehydrates within a few days.
- Can filler dissolving remove any filler?
It removes hyaluronic acid filler. Other materials are not affected by hyaluronidase, so what was originally placed decides whether dissolving is the right treatment at all.
- Do I need the ultrasound guided route?
Not always. It is most useful when the filler is old, was placed elsewhere, or cannot be located reliably by examination alone, and when a specific deposit has to be reached accurately.
- How long would the filler have lasted if I left it?
Hyaluronic acid fillers are temporary and typically break down over six to twelve months, so waiting is a genuine option where the concern is mild and nothing is wrong clinically.
- Can I have new filler at the same appointment?
No. The area needs to settle and be reassessed first, which is why the review is built into the plan.
The next step
If you are weighing up filler dissolving, the useful first step is a consultation where the filler can be assessed properly, including with ultrasound where that helps. At that appointment we will listen to your concern, provide a thorough medical and aesthetic consultation, explain a step by step treatment plan where treatment is appropriate, and go through the aftercare, which does a great deal of the work here.
Book a consultation with Dr Rakib Uddin at Aesthetic Doctors Australia in Kew, Melbourne, or read the filler dissolving treatment page first.
