DERMAL FILLER DISSOLUTION

Dermal filler dissolution is a medical procedure in which an enzyme called hyaluronidase is injected into areas where hyaluronic acid dermal filler has been placed. It is important to note that dissolution is only possible for hyaluronic acid based fillers. Non hyaluronic acid fillers cannot be dissolved with this approach. Hyaluronidase works by breaking down the hyaluronic acid, allowing the body to reabsorb it naturally. At PI Aesthetics every dissolution procedure is performed under ultrasound guidance. This is not optional for us. Ultrasound allows us to visualize exactly where the filler is located and place the hyaluronidase precisely where it is needed, significantly improving both safety and outcomes. Many unsuccessful dissolution attempts are the result of treatment performed without this level of visibility, particularly when nodules or complex filler placement are involved.

Filler dissolution at PI Aesthetics is used to address a range of concerns including overfilled or poorly placed hyaluronic acid filler, under eye swelling or malar edema caused by filler related lymphatic obstruction, and delayed filler related nodules. In some cases dissolution is also used as part of a treatment plan to correct asymmetry or to start fresh before a new treatment approach is taken.

No. Hyaluronidase only works on hyaluronic acid based fillers, which include most of the commonly used products today such as Juvederm, RHA, Restylane and others. Non hyaluronic acid fillers, such as Sculptra, Radiesse, and certain combination products, cannot be dissolved with hyaluronidase. If you are unsure what product was used in your treatment, an in person assessment including ultrasound evaluation can help us determine the nature of what is present before any treatment is recommended.

Possibly, but an honest assessment is required first. Many patients are unsure of the exact product used in their treatment, particularly if it was performed in another country or at a practice that did not provide clear documentation. Some products marketed as fillers are combination products or non hyaluronic acid based, and attempting dissolution without knowing what is present carries real risk. We use ultrasound assessment to evaluate the filler before recommending any treatment, and we will give you an honest picture of what is possible based on what we find.

Malar edema is swelling in the under eye and cheek area that can occur after dermal filler treatment, most commonly when filler placed in or near the under eye area causes lymphatic obstruction. It can appear gradually over weeks or months after treatment and is one of the more common and distressing filler related complications we see. In appropriate candidates, targeted dissolution with hyaluronidase can significantly improve or resolve this concern. An ultrasound assessment is an important part of evaluating and treating malar edema safely and effectively.

Delayed filler related nodules are firm lumps that can develop weeks, months, or even years after filler treatment. They can be caused by a range of factors including inflammatory responses, or biofilm formation. Treatment depends on the nature and cause of the nodule, and not all nodules respond to dissolution alone. An in person assessment is required to determine the most appropriate approach. We treat delayed filler related nodules at PI Aesthetics and have the clinical expertise and ultrasound capability to evaluate and manage them.

This varies considerably depending on the type and amount of filler present, how long it has been in place, and the specific concern being addressed. Some patients see significant improvement after a single session. Others require multiple sessions spaced several weeks apart. We will give you a realistic estimate during your consultation based on your specific situation, and we will be honest with you if the outcome you are hoping for may not be fully achievable through dissolution alone.

This is one of the most important questions we address during consultation and it is not always straightforward. Some patients attribute concerns to filler that are actually related to natural aging, anatomy, or other factors. In those cases dissolution may not produce the improvement the patient is expecting, and proceeding without that honest assessment does the patient a disservice. Our evaluation, including ultrasound assessment, helps us determine what is actually present and whether dissolution is likely to address the concern. We will always give you an honest answer, even if it is not the one you were hoping for.

Ultrasound guidance is a required part of every dissolution procedure we perform at PI Aesthetics, not an optional add on. It allows us to see beneath the skin in real time, identifying the exact location, depth, and nature of the filler or nodule being treated before a single injection is made. This level of precision is what separates a successful dissolution from one that falls short, particularly for delayed nodules where blind injection of hyaluronidase is significantly less effective and carries higher risk. We do not perform dissolution without it.

A vascular occlusion is a rare but serious complication that can occur when filler is inadvertently injected into or compresses a blood vessel, restricting blood flow to surrounding tissue. It is a medical emergency that requires immediate treatment with hyaluronidase. This is fundamentally different from elective filler dissolution, which is a planned procedure performed in a controlled setting. If you believe you are experiencing a vascular occlusion, you must contact the provider who performed your treatment immediately or seek emergency medical care. PI Aesthetics does not accept self referrals for emergent vascular occlusion treatment.

All patients seeking filler dissolution at PI Aesthetics are required to complete a phone prescreening before a consultation is scheduled. This allows us to understand your concern, gather relevant information about your treatment history, and determine whether an in person consultation is the appropriate next step. This process exists to protect you and to ensure we can provide the level of care your situation requires. Please have as much information available as possible about the product used, the provider who performed your treatment, and when the treatment was done.

After dissolution you may experience mild swelling, redness, and tenderness in the treated area, which typically resolves within a few days. The timeline for seeing results varies considerably from patient to patient and depends on the type and amount of filler being dissolved. In some cases improvement is visible within minutes of treatment as the hyaluronidase begins working immediately. In others the response is more gradual, developing over several weeks as the body reabsorbs the broken down filler. In some cases a follow up session is needed once the initial response has fully settled. Your doctor will give you detailed aftercare instructions and a realistic picture of what to expect based on your specific situation, and will schedule a follow up appointment to assess your results once they have had time to develop.

Filler dissolution is an advanced procedure that requires careful patient selection. Good candidates are patients with confirmed or suspected hyaluronic acid filler who have a clearly identifiable concern that dissolution is likely to address. Patients who are unsure what product was used, who have had treatments performed outside of a medical setting, or whose concerns may not be filler related will require thorough evaluation before any treatment is recommended. This service requires advanced clinical training, ultrasound capability, and a high standard of patient assessment. It is not a routine procedure and we approach it with the same level of care and thoughtfulness we bring to every treatment we perform.