Dissolving Dermal Fillers:
What you need to know

How to repair the skin after removing HA fillers?

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Hyaluronic acid dermal fillers have boomed overall the last 2 decades – lips, cheeks, facial contouring and anti-ageing purposes. Up till recently it was believed hyaluronic acid to be relatively safe and also temporary as it dissolves naturally within a maximum of 2 years. Fillers have different consistencies used for the different areas of the face, where some are thicker and last longer. Yet we never considered that a filler can last 10+ years… Fillers are also believed to be safe in terms of desired results gone wrong as they can be removed with injectable hyaluronidase, which breaks down hyaluronic acid dermal filler links and converts it back to water and co2. As much as this holds true for some , it doesn’t for all dermal fillers and also depends on the patient’s own anatomy, metabolism and lifestyle.

With the development of hyaluronic acid dermal fillers, they have become much longer lasting in our skin, more resistant to our natural hyaluronidase, and to dissolving injectable hyaluronidase or brand name Hyalase.

Current data suggests that hyaluronic acid fillers can last up to 10-12 years and changes that skin encounters while the hyaluronic acid filler is present is not always reversible. This is because our skin reacts to hyaluronic acid as the implant, which stimulates the skin’s reaction by the production of elastin, collagen, and natural hyaluronic acid. The dermal fillers placed deep in the skin to volumize and support muscles and fat pads, do not specifically impact the skin.

 Ageing skin, sun exposure, and unhealthy lifestyle changes result in the skin becoming less firm and able to maintain hyaluronic acid dermal filler at the deeper placement level. There is also ageing in other structures in the face i.e., fat pad placement, laxity in muscles, and ligaments. Hyaluronic acid with dynamic facial movements often migrates to more superficial skin layers and becomes more visible as puffiness and swelling, have recently been given the name – pillow face.

Clients are often unaware that hyaluronic acid dermal fillers may stay several years in the face and also keep injecting as advised every 6 months to a year for maintenance. Even though it might not be as visible at the time, years down the line the migration and side effects start showing. A recent article in the Daily Mail, written by beauty journalist Alice Heart-Davies shocked a lot of women and even aesthetic practitioners.

dissolving dermal fillers

I’ve got 20 years of filler stuck in my face’: It’s meant to dissolve over two years – but in an investigation that will shock any woman tempted by ‘tweakments’

– Alice’s MRI scan revealed the extraordinary truth


  • Alice Hart-Davis had an MRI scan of her face to see how much filler was there
  • She was stunned to be told there was 35 ml in total across different areas
  • Most fillers dissolve within a few years but some can last more than a decade

Source: Daily Mail (click to read the full article)

How are dermal fillers dissolved?

Dissolving dermal fillers like Juvederm, Restylane, Teoxane, and Belotero can be achieved by injecting Hyaluronidase enzyme. If your filler is non-hyaluronic acid based – e.g. Radiesse, Sculptra or Ellanse, then this treatment will not work. Non-hyaluronic acid fillers cannot be dissolved and can only be surgically removed.

Using hyaluronidase treatment to remove dermal fillers can result in sudden volume loss, increased skin laxity, fine wrinkling, and skin dryness. The effects are partly due to natural skin ageing and sudden reduction of volume and extra hyaluronic acid in the skin holding extra water content.

How can we repair the skin to improve overall appearance after dissolving dermal fillers?

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At Aestha Clinic our highly qualified and knowledgeable regenerative aesthetic experts have developed new treatment protocols to dissolve unwanted filler and reverse the effects of to give you back your natural looking appearance without any puffiness. We can reverse the so called ‘’Pillow Face’’.

These treatments are individual and would depend on the amount of filler injected and period of time since your first and last treatment, along many other factors that your Aestha Clinic doctor will discuss with you.  Please contact us for a consultation.

1. Epidermal Layer repair

First, we start from improving skin’s epidermal layer resistance, health, and overall skin cell turnover i.e., skin cell age. The most effective way to improve epidermal layer:

  • Tretinoin and antioxidant programmes
  • Non-ablative and ablative laser retinol induction
  • Light chemical peels to improve skin cells turnover
  • Microneedling  with Derma Pen, using antioxidants and nutrients to stimulate skin cells function

2. Dermal Layer – Extracellular Matrix

Dermal layer is partly consistent of extracellular matrix, which is the part where majority of hyaluronic acid will be placed and have the most impact following dermal filler removal. To restore extracellular matrix and not to get back to the same problems, we suggest:

  • Skinboosters to boost natural hyaluronic acid content
  • Stem Cells or Exosomes to improve skin’s health and turnover
  • Deeper collagen stimulating therapies such as RF microneedling and / or High Focused USS (HIFU) at low level energy

Exosomes and autologous human mesenthialian cell cultures have been the most promising treatment to restore skin health. Combination of RF microneedling with exosomes, stemcells or mesenthemial stem cell medium can target most of the skin layers from epidermal to subdermal extracellular matrix collagen induction.

3. Volumetric Changes

Volumetric changes in the face and extra skin can become dramatically appearing following the dissolving dermal fillers. Depending on the area in which dermal fillers were removed, you may want to consider:

  • Biofillers to temporarily stimulate volume restoration
  • Collagen biostimulators such as sculptra
  • Nano threads to redefine jawline
  • Fat transfer to restore volume or other surgical interventions.

4. Alternative to fillers for overall Skin Quality & Laxity

After dissolving dermal fillers we often feel skin becoming lax, less resistant, and sensitive with fine lines and wrinkling. Injectable treatments, especially involving hyaluronic acid may seem scary… an alternative to injectables to stimulate collagen induction and skin tightening:

  • Ablative lasers i.e. Erbium for darker skin types, and CO2 for lighter skin types
  • Radiofrequency – non-invasive: Hydratite facial
  • Radiofrequency for superficial skin texture improvement – eMATRIX by eTWO
  • More invasive – Secret PRO combining Rf microneedling and CO2 laser – a single session will give significant effects for skin tightening!

Every case is individual, depending on a person’s anatomy, age, dermal filler placement, amount and the amount that was removed. Our clinicians are experts in regenerative aesthetic medicine and experienced in variety of treatments to restore skin’s elasticity and more natural volume appearance, however, there is no single treatment, and it often takes up to 6-8 months to restore skin’s elasticity. Get in touch for your consultation.