Dermal fillers have become increasingly popular as a non-surgical method to rejuvenate the face, restore lost volume, smooth wrinkles, and contour facial features. They offer a quick way to achieve a more youthful appearance with minimal downtime. However, many people wonder about the longevity of these fillers and whether they can be dissolved if the results are unsatisfactory or complications arise. This article explores the science behind facial fillers, their dissolving process, and what to consider before undergoing such procedures.
What are Dermal Fillers?
Dermal fillers are injectable gels designed to add volume under the skin, diminishing signs of aging and enhancing natural features. These fillers consist of various substances, including:
- Hyaluronic Acid (HA): The most common type of filler, HA is a naturally occurring compound found in the body. HA fillers like Juvéderm and Restylane are favored for their natural-looking results and versatility.
- Calcium Hydroxylapatite (CaHA): A mineral-like compound found in bones, CaHA fillers such as Radiesse generally last longer than HA fillers.
- Poly-L-Lactic Acid: Fillers like Sculptra stimulate collagen production over time, enhancing the skin’s structure.
- Polymethylmethacrylate (PMMA): A synthetic, biocompatible substance used in some permanent fillers.
How Long Do Fillers Last?
The longevity of dermal fillers varies depending on the type of filler used, the area of injection, and the individual's metabolism.
- Hyaluronic Acid Fillers: Traditionally, HA fillers were thought to last between 6 to 18 months, gradually dissolving as the body metabolizes the hyaluronic acid. However, recent studies and observations suggest that HA fillers may persist for several years, offering longer-lasting support and potentially stimulating natural collagen formation.
- Calcium Hydroxylapatite Fillers: CaHA fillers can last up to 18 months.
- Poly-L-Lactic Acid Fillers: These fillers also have a longer-lasting effect due to their collagen-stimulating properties.
As dermal fillers slowly dissolve, the treated areas will gradually continue to age, and more filler may be needed over time to maintain the desired effect.
Can Fillers Migrate?
Yes, dermal filler can migrate from the initial injection site. This phenomenon occurs when the filler moves to other areas of the face. While there are no definitive numbers on how often this happens, it's crucial to understand the reasons behind it. Migration can occur due to:
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- Improper Injection: Injecting too much filler, injecting it in the wrong spot, or selecting the wrong type of filler can cause migration.
- Tissue Dynamics: Over time, fillers can move along muscle paths or areas of low resistance. This is common in areas like the lips, tear troughs, nasolabial folds, jawline, or chin.
- External Pressure: Fillers can be moved by repeatedly touching or massaging the area.
Signs of filler migration include unwanted fullness in areas where the filler was not initially injected.
Dissolving Fillers: Is It Possible?
The short answer is yes. Dissolving filler by medical means is possible, especially for hyaluronic acid-based fillers. The substance used to dissolve HA fillers is called hyaluronidase.
What is Hyaluronidase?
Hyaluronidase is an enzyme that breaks down hyaluronic acid. It occurs naturally in the body and is responsible for the natural degradation of HA fillers over time. Synthetic hyaluronidase is available as a medication to dissolve fillers more rapidly. Hylanex is one such brand of hyaluronidase, which has been used in medicine for decades to increase tissue permeability and drug absorption.
How Does Hyaluronidase Work?
When injected, hyaluronidase breaks down the bonds in the hyaluronic acid, allowing the body to metabolize it more quickly. This process effectively reverses the effects of the filler.
Preparing for Hyaluronidase Injections
Before undergoing hyaluronidase injections, a healthcare provider will give specific instructions to prepare for the treatment. These may include:
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- Avoiding medications or supplements that may increase bleeding, such as aspirin and fish oil.
- Stopping smoking several weeks before the procedure, as it can disrupt the healing process.
- Informing the healthcare provider of any allergies, especially to bee venom, as hyaluronidase injections can cause a severe allergic reaction (anaphylaxis) in individuals with such allergies.
The Dissolving Procedure
The procedure to dissolve lip filler typically takes between 10 and 15 minutes. Here’s what to expect:
- A healthcare provider may apply a numbing cream to the lips to minimize discomfort.
- Hyaluronidase is injected into the lips with a thin needle.
- The hyaluronidase breaks down the hyaluronic acid, dissolving the filler.
What to Expect After the Procedure
After the procedure, it is common to experience some swelling, bruising, and tenderness. These side effects usually subside within a few days. In some cases, healthcare providers may recommend corticosteroids or antihistamines to help manage swelling and other side effects.
It may take up to two weeks to see the full results of the dissolving process.
Can Filler Be Partially Dissolved?
Yes, it is possible to partially dissolve lip filler. This is often done to correct specific areas, such as a lump or an area of asymmetry. Healthcare providers typically use a smaller amount of hyaluronidase for partial dissolving.
Does It Hurt to Dissolve Lip Filler?
As with any injection, there may be some discomfort associated with the procedure. However, healthcare providers often apply a numbing cream to minimize pain.
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Can You Dissolve Lip Filler at Home?
No, dissolving lip filler should only be done by a qualified medical professional. Attempting to dissolve filler at home is not safe and can lead to complications.
Why Dissolve Fillers?
People choose to dissolve fillers for various reasons, both personal and aesthetic. Common reasons include:
- Undesirable Results: If the filler has migrated, creating a visible lump or asymmetry, dissolving it can restore the original appearance.
- Overfilling: If too much filler has been injected, resulting in an unnatural look, dissolving some or all of it can help achieve a more balanced result.
- Tyndall Effect: This occurs when filler is placed too shallow, causing a bluish hue to the skin. Dissolving the filler can correct this issue.
- Medical Reasons: In rare cases, complications such as infection, vascular occlusion (when filler blocks a blood vessel), or other adverse reactions may necessitate dissolving the filler.
- Surgical Procedures: A facial plastic surgeon may recommend dissolving existing filler before a surgical procedure like a facelift or lip lift to achieve optimal results.
- Personal Preference: Some individuals may simply change their mind about having fillers and prefer to return to their natural appearance.
Risks and Considerations
While dissolving fillers is generally safe, there are some risks and side effects to consider:
- Allergic Reactions: Although rare, some individuals may be allergic to hyaluronidase. It is crucial to inform your healthcare provider of any known allergies, especially to bee venom.
- Bruising and Swelling: These are common side effects that usually resolve within a few days.
- Skin Discoloration: In some cases, skin discoloration may occur.
- Over-Dissolving: It can be challenging to dissolve filler with precision, and there is a risk of dissolving more filler than intended.
- Damage to Natural Hyaluronic Acid: There is a theoretical risk that hyaluronidase could break down the body's own hyaluronic acid, although this is not a common occurrence.
The Importance of Choosing a Qualified Provider
Whether you’re getting fillers or having them dissolved, it is crucial to choose a qualified and experienced provider. Plastic surgeons and cosmetic dermatologists have extensive training in the anatomy of the face and the structure of the skin, nerves, muscles, and blood vessels. They can assess your needs, recommend the appropriate treatment, and perform the procedure safely and effectively.
What to Look for in a Provider
- Board Certification: Ensure that your provider is board-certified by a reputable medical board, such as the American Board of Plastic Surgery or the American Board of Dermatology.
- Experience: Look for a provider with extensive experience in performing dermal filler injections and dissolutions.
- Knowledge of Facial Anatomy: A thorough understanding of facial anatomy is essential to avoid complications and achieve natural-looking results.
- Artistic Eye: Choose a provider with an artistic eye who can assess your facial features and recommend a treatment plan that enhances your natural beauty.
- Emergency Preparedness: Ensure that the clinic has hyaluronidase on hand in case of a vascular occlusion or other emergency.
Alternatives to Dermal Fillers
For individuals who are hesitant about getting dermal fillers or want to explore other options, several alternatives can help achieve a plumping effect without needles:
- Hyaluronic Acid Serums: These serums can hydrate the skin and temporarily plump up fine lines and wrinkles.
- Skincare Products: Some skincare products contain ingredients that stimulate collagen production, improving skin elasticity and firmness.
- Professional Treatments: Procedures like microneedling, chemical peels, and laser resurfacing can improve skin texture and tone, reducing the appearance of fine lines and wrinkles.