People arrive at this subject feeling embarrassed, and they should not. Being unhappy with filler is common, it is rarely the patient’s fault, and it is usually fixable. Melody Steel, Nurse Prescriber, sees patients who have had treatment elsewhere and want it assessed, corrected or dissolved — and the conversation always starts the same way: by looking properly at what is actually there.
What dissolving is
Hyaluronic acid fillers — which is most of the fillers used for lips, cheeks, chin and jawline — can be broken down using an enzyme called hyaluronidase. It is injected into the treated area, where it dissolves the hyaluronic acid so the body clears it. It is a prescription-only medicine, so it can only be used by an appropriate prescriber after a face-to-face assessment.
Importantly, this only applies to hyaluronic acid products. Collagen-stimulating and permanent or semi-permanent fillers cannot be dissolved this way, which is one reason establishing what was originally used matters so much.
Why people ask about it
- Filler that has migrated beyond where it was placed — commonly seen above the lip border
- Lumps, firmness, asymmetry or an uneven result
- Simply too much product, or a look that never settled into something they were happy with
- Filler placed in an area that does not suit their anatomy
- Old filler that has built up over years of repeated treatment
- Urgently, as part of managing a complication
It always starts with a consultation
This is not a treatment that can be quoted over a message or booked blind, and any clinic willing to do so is not one to trust with it. At your consultation Melody will assess the area properly, take a full history — what was injected, roughly when, how much, and by whom if you know — and discuss your medical history and any allergies.
Only then can she tell you honestly whether dissolving is appropriate, whether it will achieve what you are hoping for, whether a partial rather than complete dissolve makes more sense, and what the realistic outcome looks like. Sometimes the answer is that dissolving is not the right route at all, and she will say so.
What to expect afterwards
Swelling immediately after dissolving is normal and can be significant for a day or two — the area often looks worse before it looks better, which catches people out if they are not warned. The full result takes a couple of weeks to settle, and occasionally a second session is needed to complete the job.
One thing to be prepared for: dissolving removes filler, and the area will look as it did before treatment — which, if the original filler had been there a long time, may feel like a bigger change than expected. If you are considering re-treatment afterwards, we would normally wait at least a couple of weeks before assessing again, and there is never any obligation to proceed.
As with any treatment, results vary from person to person, and hyaluronidase carries its own risks including allergic reaction — all of which will be discussed with you properly beforehand.
If you think something is wrong right now
Most correction is elective and can wait for an appointment. But if you have had filler recently and are experiencing severe or increasing pain, skin that is blanching white, going dusky or mottled, or any change in your vision, do not wait — contact your original practitioner immediately, and if you cannot reach them seek urgent medical help. Our guide to what is normal after treatment and what is not sets out the warning signs in more detail.
No judgement
Nobody who comes to us for correction gets a lecture about where they had it done. The point of the appointment is to look at what is in front of us and work out the best way forward — calmly, honestly, and with a clear explanation of what is and is not achievable.