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Filler Dissolving · What Can and Cannot Be Reversed

Which Fillers Cannot Be Dissolved?

Only hyaluronic acid has an off switch.

Hyaluronidase dissolves hyaluronic acid filler and nothing else. Medical Director Dr Sin Yong lists the filler types that cannot be dissolved, how long each stays, how to find out which one you have, and what can be done when a non-dissolvable filler causes a problem.

Treatment page: dissolve filler and filler correction in Singapore.

WhatsApp to Enquire →Key facts ↓
HA only
Dissolves with the enzyme
Not dissolvable
Stimulators, permanent fillers, fat
Scan
To tell which you have
Months to years
How long they stay
Assessed and planned by Dr Sin Yong, Medical Director · MBBS (NUS) · MRCS (Edinburgh) · MSc Aesthetic Medicine (London) · MSc Practical Dermatology (Cardiff) · Professional Diploma in Obstetrics & Gynaecology (RCPI) · Designated DEKA Centre of Excellence
In short

Only hyaluronic acid (HA) filler can be dissolved, using the enzyme hyaluronidase. Fillers that cannot be dissolved include calcium hydroxylapatite, poly-L-lactic acid, polycaprolactone, PDLLA, collagen, permanent fillers such as PMMA and silicone, and your own grafted fat. These are managed with time, targeted treatment of a lump or, in selected cases, a laser protocol or surgery. An ultrasound scan helps show which type you have.

Reviewed by Dr Sin Yong, Medical Director, IN Eternity Clinic · Updated
Key facts
  • Hyaluronidase acts on hyaluronic acid only: it has no effect on other filler materials [1].
  • Collagen stimulators fade slowly: the carrier gel is absorbed first and the particles over a much longer period, which differs by product.
  • Permanent fillers stay: PMMA and silicone are not broken down by the body, and problems can appear years later [2].
  • A mixed picture is common: faces treated over many years often contain more than one material, in layers.
  • Ultrasound helps identify the type: different materials have different appearances on a scan [3].
The list

Filler types and whether they dissolve

  • Hyaluronic acid (HA). Dissolves with hyaluronidase. Most lip, under-eye, cheek and chin fillers are HA.
  • Calcium hydroxylapatite. Does not dissolve with hyaluronidase. Absorbed by the body over about a year or more.
  • Poly-L-lactic acid (PLLA). Does not dissolve. A collagen stimulator; nodules are managed with targeted injections, massage protocols and time.
  • Polycaprolactone (PCL). Does not dissolve. Long-lasting, so problems also last longer.
  • PDLLA with a hyaluronic acid carrier. The HA part can be dissolved; the PDLLA particles cannot.
  • Collagen fillers. Do not dissolve with hyaluronidase. Absorbed over months.
  • PMMA, silicone and other permanent fillers. Do not dissolve and are not absorbed [2].
  • Fat grafting. Living tissue, not a filler gel. It cannot be dissolved.
What can be done

Options when a filler does not dissolve

  • Time. Many non-HA products are absorbed gradually. A small, calm lump is often watched.
  • Targeted treatment. An inflamed or firm nodule may be treated with small anti-inflammatory injections, placed under ultrasound guidance.
  • Dissolving the HA component. Where hyaluronic acid has been layered with another product, removing the HA can reduce the bulk.
  • Laser protocol. In selected cases Dr Sin Yong uses a laser protocol, Time Freeze Laser, to reduce excess and firm the overlying skin.
  • Surgical removal. A last resort for a persistent, discrete nodule, by referral to a surgeon.
  • What is avoided: adding more filler over a lump, or injecting the enzyme into a product it cannot affect.
Finding out

How to tell which filler you have

Start with records: the clinic that treated you should be able to tell you the product and the date. If records are missing, an ultrasound scan helps, because hyaluronic acid, calcium-based fillers and permanent materials look different on screen [3]. See filler ultrasound scan in Singapore.

Before treatment

Why reversibility matters when choosing a filler

Reversibility is the main reason hyaluronic acid is usually chosen for a first treatment and for areas where a small error shows, such as the lips and under the eyes. Longer-lasting products have a place, but they ask for more certainty about dose and placement, because they cannot be taken back. See filler correction in Singapore and collagen stimulator side effects. Results vary between people, and suitability is decided at consultation.

Questions

Frequently asked questions

Which fillers cannot be dissolved?

Calcium hydroxylapatite, poly-L-lactic acid, polycaprolactone, PDLLA particles, collagen, permanent fillers such as PMMA and silicone, and grafted fat. Only hyaluronic acid responds to hyaluronidase.

Can you dissolve fillers completely?

Hyaluronic acid filler can usually be dissolved almost completely, though it may take more than one session and tiny amounts can remain. Other filler types cannot be dissolved at all.

Can fillers be completely removed?

Hyaluronic acid filler can be dissolved. Non-dissolvable fillers are absorbed over time or, rarely, removed surgically. Complete removal is not always possible.

Can calcium-based filler be dissolved?

Not with hyaluronidase. It is absorbed by the body over about a year or more. Visible deposits are managed with time and targeted treatment.

Can filler be dissolved if I do not know what it is?

It should be identified first. Injecting hyaluronidase into a non-HA product does nothing useful. Records or an ultrasound scan usually settle the question.

Do non-dissolvable fillers go away on their own?

Collagen stimulators and collagen fillers are absorbed gradually over months to years. Permanent fillers such as PMMA and silicone are not.

Is a filler that cannot be dissolved unsafe?

No. These products are widely used. The difference is that mistakes cannot be reversed quickly, so dose, depth and the choice of area matter more.

Related at IN Eternity: Filler correction · Ellansé removal · Sculptra lumps and nodules · Collagen injection complications · Fat grafting correction

Book an assessment

IN Eternity Clinic, 9 Scotts Road, #12-01 Pacific Plaza, Singapore 228210. By appointment with Medical Director Dr Sin Yong. Monday to Saturday, 11am to 8pm. WhatsApp or call +65 8815 3008. At IN Eternity Clinic a consultation fee applies, and it is waived if you go ahead with any medical treatment; the fee is S

20.

WhatsApp to Enquire →Call +65 8815 3008
S
Dr Sin Yong
MBBS (NUS) · MRCS (Edinburgh) · MSc Aesthetic Medicine (London) · MSc Practical Dermatology (Cardiff) · Professional Diploma in Obstetrics & Gynaecology (RCPI)
International KOL — CLASSYS · HIRONIC · DEKA · ALMA · FOTONA · LUTRONIC
→ Dr Sin Yong's full profile

References

  1. Jung H. Hyaluronidase: an overview of its properties, applications, and side effects. Arch Plast Surg 2020;47(4):297-300. doi:10.5999/aps.2020.00752
  2. Funt D, Pavicic T. Dermal fillers in aesthetics: an overview of adverse events and treatment approaches. Clin Cosmet Investig Dermatol 2013;6:295-316. PubMed
  3. Wortsman X. Identification and complications of cosmetic fillers: sonography first. J Ultrasound Med 2015;34(7):1163-1172. doi:10.7863/ultra.34.7.1163

Figures taken from the published papers and abstracts. Results vary between people; suitability is decided at an in-person consultation.

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