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Is it safe to dissolve lip fillers?

Save Face gives you the lowdown on dissolving lips fillers, and ask is it safe, does it hurt, what’s involved, and will your lips go back to normal afterwards.

Is it safe to dissolve lip fillers?

Here at Save Face, we have noticed a rise in members of the public seeking out services for dermal filler dissolving, in particular lip fillers, increasingly due to dissatisfaction with their look or because of migration of the filler due to over filling over time; wanting it erased so they can ‘start again’. Here’s everything you need to know about dissolving lip fillers…

The cosmetic use of dermal fillers has been around for several decades, but more recently there has been an explosion in their use and popularity, much of which can be attributed to the development and innovation surrounding filler products that are based on hyaluronic acid gels, and the rise of celebrity and social media influencers.

Hyaluronic acid (HA) is a sugar-based molecule found in our bodies that attracts water, acting as both a natural moisturiser within the skin and a lubricant and cushion for other tissues.

Unlike collagen fillers of old – favoured by the Hollywood elite in the 80s and 90s – or the more permanent implantable products that came to market in the early noughties, hyaluronic acid-based fillers have one major advantage…they can be reversed or dissolved using a product called hyaluronidase.

This is critical in an emergency, if, for example, the filler product accidentally enters a blood vessel during the treatment, any hyaluronic acid filler injected can be dissolved to recover blood flow to the skin if a vein or artery has been blocked. However, a newer trend has emerged more recently, with the use of hyaluronidase as a requested ‘eraser’ for undesirable lip filler. In fact, we have even heard about ‘dissolving clinics’, specifically marketing, and targeting those who are looking to have filler removed because of over filling or migration. Sadly, some people are even being told that they ‘must’ have their previous filler removed before the practitioner will commence any treatment, this may not be appropriate, and far from best practice.

Why do people get their lip filler dissolved?

A person may want to dissolve their lip filler for many reasons, but increasingly it is becoming common to want to have a more natural look and reverse the long-term effects of over filling with multiple brands, and thicknesses; that can lead to the filler spreading beyond the lip border or creating isolated lumps within the lips if the products have not been placed accurately or have hardened in places due to chronic over filling.

Other reasons include, not liking their new look after a treatment, a poorly performed treatment that has created an unnatural appearance either by adding too much at once, causing asymmetry, or incorrect placement that leaves product in the wrong area of the lip, commonly seen with filler appearing beyond and above the vermillion border with some style trends. This is often mentioned as migration or filler spreading but is in fact usually down to over filling or inexperienced placement as the gels in modern products are less likely to spread if used correctly by properly trained practitioners. Search for a Save Face accredited dermal filler provider.

How long after getting lip filler can I get it dissolved?

There is a temptation to walk out of a clinic after having dermal filler, go home, wake up the next morning, look in the mirror and declare that you hate them, and you want the procedure reversed.

In the hours and days after dermal filler treatment, especially in the lips, there will be considerable swelling, and even bruising; this will affect the initial result of the aesthetic enhancement, lips can appear uneven, bumpy, too full, or red. It can take 2-3 weeks for the product to settle within the tissue and for the swelling to subside, at which point, you will probably look in the mirror and declare that you love them! The key is patience, don’t be in a rush to demand that you want your lips dissolved.

Most cosmetic clinics will be happy to arrange a review appointment with you after a fortnight if, once settled, you are still not happy with the result. It is not recommended to have filler reversal until at least 2 weeks post treatment, unless there is an emergency that is causing a compromise to the blood supply in the lip(s) or the rest of the face, which will be obvious within hours of treatment due to extended pain, discomfort, and lip/facial discolouration.

How do you dissolve lip fillers?

Like hyaluronic acid itself, hyaluronidase exists naturally in our bodies and is an enzyme used to break down natural hyaluronic acid when it is no longer required.

Synthetic versions of hyaluronidase are manufactured as medicines – you may hear Hyalase mentioned in relation to filler dissolving, however, this product has been recently rebranded as simply Hyaluronidase. In the UK, Hyaluronidase is the only licensed medicine that can be used to dissolve HA dermal fillers. It is not directly licensed for this use, but the law permits off-label or off-licence use with informed consent if it is in the best interest of the patient.

Medical hyaluronidase is prescription only and comes in an ampoule or vial as a white powder that your practitioner will mix with the correct amount of diluent before injecting it into the area where dissolving of hyaluronic acid is required. This can take multiple injections, and may need repeating, depending on the specific filler product and how the molecules are bound. It will get to work immediately and start to dissolve the weakest of the HA molecules, continuing to work for several hours; it can, however, take up to a fortnight to judge the full effect due to swelling and bruising which will need time to settle. Due to the action of the hyaluronidase, it is very difficult to just dissolve one small lump or area as the product spreads upon injection, so it’s possible that your whole lip enhancement will be reversed.

Does massaging lip filler break it down?

Hyaluronic acid-based gel fillers will eventually dissolve naturally within the skin, due to the presence of human or natural hyaluronidase. The science behind the manufacture of the products as a gel means that they are created to be more stable than natural HA and thus will not breakdown as rapidly. Depending on the product, how the molecules are chained together, and how it is made, it could be anywhere from 6-18 months before the body has completely dissolved the molecules.

Although massaging can help to encourage the body, and its natural hyaluronidase to break down the dermal filler more quickly than if you left it alone, it would still take your body a long time to break down the product and you would need to engage in daily, vigorous massaging of the area for several weeks to see any real speed up in the natural metabolism and breakdown of the HA.

If you find that you have a small lump or bump of filler product within the lips, then let your practitioner know as this can often be resolved with simple massage, but it’s important to let them have a look for you.

Is hyaluronidase dangerous?

Lip filler dissolving using hyaluronidase is widely available to patients and is regarded as a safe way to break down hyaluronic acid-based dermal fillers. Having said that, it is not without risks.

If you are already allergic to bee stings, for example, to the point of an anaphylactic reaction, then you will not be suitable for hyaluronidase treatment. Similarly, mild sensitivity reactions or marked swelling can occur, but are usually self-settling within a few hours. The enzyme targets hyaluronic acid and does not distinguish between your own and that of the filler, however, any of your own that is lost will be replenished within hours. It also cannot be used during pregnancy or if you are breast feeding.

If you have chosen to dissolve your dermal filler, and it is not an emergency, you may be given a pre-test into the skin of your arm, this may show a marked sensitivity, in which case you should not have hyaluronidase treatment for cosmetic reasons.

Some patients have complained on social media, of their faces being permanently disfigured or having experienced serious illness after being treated with hyaluronidase. There is no evidence at all to support such claims, the medicine has been used in high doses in healthcare since the 1950s and has a good safety profile. However, if you have had significant volumes of filler in place over the years, then the loss of this volume can leave poor cosmetic results and the change in appearance may be quite shocking. Consider and discuss possible consequences, including the costs of correction, with your aesthetic clinician.

Is dissolving lip filler painful?

The short answer is probably yes. The lips are one of the most sensitive areas of the face with multiple nerve endings and the hyaluronidase is quite acidic, so it does sting.

Often, when you have dermal filler placed in the lips, you are given both a numbing cream beforehand, and the practitioner will use a product that contains lidocaine, a local anaesthetic that is included in the syringe with the dermal filler, all of which reduces any discomfort during injection. With hyaluronidase, your practitioner can offer you the numbing cream, and may reconstitute the enzyme with lidocaine for injection, so it is likely that you will notice a stinging sensation as the product goes into your lip, but then it will go numb. There are alternative diluents, such as saline which can be used and have no numbing effect. Often multiple injections are required, alongside massaging the lip to help the product flow through the tissue.

Everyone’s pain threshold is different, but it is certainly not something to undertake on a whim, especially if you could easily wait for the filler to naturally dissolve. You will also have swollen and tender lips for a little while afterwards. For some, the swelling can be extraordinary, but does settle within hours if that is the only symptom. A healthcare professional would be able to distinguish between expected swelling and more serious symptoms of allergic reaction.

Do your lips go back to normal after dissolving fillers?

After the hyaluronidase enzyme has broken down the HA in the filler and your body has naturally excreted the debris through your lymphatic system, your lips should return to normal. This usually takes a couple of weeks, and during that time your body will also replenish some natural hyaluronic acid to the area.

If you have had too frequent or excessive dermal filler treatments that have resulted in large quantities of product stretching the proportions of your lips into an oversized pout, there is a chance that the skin will appear a little deflated to begin with after dissolving, and the lips will need time to recover.

Can I have my lips refilled after lip filler dissolving?

Yes, although you will be asked to wait a minimum of two weeks to allow the treated area to recover, and to ensure any swelling or trauma to your lips from the injections has subsided and healed.

There is no quick fix or instant result with this so you should be mindful of anyone who does not suggest a decent delay between dissolving your lip filler and refilling your lips, the hyaluronidase can still be active for up to 48 hours and time must be allowed for the area to recover from any trauma.

Learn more about lip enhancement with dermal fillers.

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