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Hyaluronidase: Dissolving HA-Based Dermal Fillers Naturally

Dissolving Dermal Fillers Naturally

Dermal fillers are substances injected under the skin to add volume to certain areas, especially the face. Although many dermal fillers claim to be “non-permanent”, they still last for a decent length of time. If results are unsatisfactory, patients may need to live with the appearance for a couple of months and even up to a year. Fortunately, these non-permanent fillers can be readily dissolved with proper methods: Using hyaluronidase.

Hyaluronic acid in dermal fillers

In many fillers, the main constituent is hyaluronic acid (also known as hyaluronan or HA), which is a substance found naturally in our connective tissue, skin, and nerve tissues. HA keeps our skin soft and gives fluidity to our joints. In HA-based dermal fillers, HA chains are bound by with cross-links, which give it a gel-like consistency. They are commonly used in treatments of folds, lines and wrinkles, as well as enhancement and volume creation in lips, cheeks, chins, and noses.

The following are common HA-based fillers:

• Juvederm
• Restylane
• Teosyal
• Belotero
• Stylage

HA digestion with hyaluronidase

As HA is a natural substance found in our body, it can be naturally broken down via metabolic processes. The main protein enzyme in this action is hyaluronidase, which is naturally produced by the human body. Our natural supply of hyaluronidase usually digests excess/old HA molecules naturally found in our body, but they can also break down most HA-based fillers. This is why HA fillers are generally safe to use, but often do not last very long.

Hyaluronidase breaks down dermal fillers by the process of hydrolysis, where water is used to break down larger molecules into 2 or more smaller constituents. As enzyme reactions are highly specific, the surrounding tissue is unaffected by this action. Because of this, most HA-based filler procedures are easily reversible because of hyaluronidase readily digests HA. By carefully injecting controlled amounts of hyaluronidase into the correct areas, HA-fillers in undesirable areas can be permanently dissolved, effectively reversing unsatisfactory results or as a response to emergency situations where dermal filler has been accidentally injected into blood vessels.

However, hyaluronidase does not work on permanent or semi-permanent dermal fillers such as Ellanse and Radiesse. As these fillers are not made from HA, they will not react to hyaluronidase and cannot be easily removed.

How do you dissolve dermal fillers?

Firstly, the doctor will assess the patients face and discuss with the patient to determine the areas of concern. After which, injections sites will be marked and hyaluronidase will be injected carefully into these sites. Topical anaesthesia (numbing cream) may be applied if required.


When do you need to dissolve dermal fillers?

When performed by trained and experience professionals, most dermal filler procedures are safe and produce satisfactory results. In the rare occasion where complications do arise, hyaluronidase is a safe and effective measure to reverse results of the filler procedures. The following are some of the possible complications which can be resolved with hyaluronidase:

• Tyndall effect – bluish tinge
• Lumps and irregularities
• Overfilling, fillers misplacement and spreading
• Granuloma
• Accidental injection into vascular tissues

How many treatments are required?

In most cases, only one or two injections of hyaluronidase are sufficient. 

Is the treatment painful?

Numbing cream or local anaesthesia can be administered during the procedure so there will be minimal discomfort.

How long is the procedure?

The procedure may take 20 to 60 minutes or longer, depending on the number of injections required.

When can I see results?

Most small lumps and bumps will resolve within 24 hours while larger lumps may require slightly longer.

What are the possible side effects/ Is there any downtime?

Dissolving dermal fillers is a safe procedure. However, there may be slight discomfort during the procedure.

After the treatment, there may be mild redness and bruising which will be resolve in the next few hours. Allergic reactions are rare. Patients can typically return to daily activities immediately.