We’ve written before about the difference between fillers and Botox, or fillers and thread lifts. But let’s dive a little deeper into dermal fillers themselves – specifically, about how well they hold up and what your options are if you need to get a filler fixed or modified.
Dissolution of fillers can happen over time if the filler material is designed to be temporary (like those made from hyaluronic acid, or HA). The body gradually breaks down the material and absorbs it. In some cases, patients may choose to have their filler dissolved early if they are unhappy with the results or experience complications.
Why Dissolve Fillers?
Reasons for dissolving fillers may be medical or cosmetic in nature, and related to product selection, placement, or adverse effects.
Medical Reasons for Dissolving Fillers
One medical reason for dissolving fillers is vascular occlusion. This happens when a filler is injected near an artery, stopping blood flow beyond that point and leading to serious medical complications. The filler can also cause an adverse reaction if injected incorrectly;
a 2020 study by several doctors and dermatologists found that:
“Most soft tissue fillers used in cosmetic practice consist of hyaluronic acid, and although hyaluronic acid is well-tolerated outside the vessel wall, it is highly inflammatory within blood vessels.”***
Another reason would be infection of the area, as it can cause inflammation, swelling, and possibly other (more severe) complications.
Cosmetic Reasons for Dissolving Fillers
Cosmetic reasons for dissolving fillers might include the use of the wrong product or improper placement. If the filler used is too thick or thin for the area being treated, or if it is placed too shallow or deep within the skin, it can look unnatural or cause other issues. For example, filler placed too close to the surface of the skin in the tear trough area can cause a bluish tint known as
the Tyndall effect.
Choosing to dissolve filler is a decision best made in consultation with a qualified professional, who can properly assess risks and benefits.
Does Filler Dissolve or Migrate?
Filler can do both, depending on various factors such as the type of filler used, the location of injection, and individual patient characteristics. Often this comes down to
rheology – the actual physics and adhesive properties of the filler and the substances of which it is composed. These properties determine how the filler material flows and behaves once it is injected into the body, with some more cohesive and less prone to migration.
Why Fillers Migrate
Filler migration occurs when the injected material moves away from the intended location and settles in a different area. This may be a result of:
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improper injection technique, such as injecting too much filler in one spot or injecting too deeply
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the natural movement of the face as we talk, smile, and make other facial expressions, causing the filler to shift or settle
We have more information about dermal fillers in other blogs – or you can get the information straight from the source by reaching out to us with questions!
Which Fillers Cannot be Dissolved?
Dissolving dermal fillers uses a protein enzyme known as hyaluronidase, which breaks down the hyaluronic acid found in fillers. So, fillers made without that protein involved – certain brands, such as Radiesse, Bellafill, and Sculptra – are therefore not dissolvable.
When visualized with an ultrasound, these non-dissolvable fillers appear very white, due to their high density (which makes them resistant to dissolution). If you want to be sure that your fillers can be dissolved down the road, choose a hyaluronic brand like Juvederm or Teoxane.
Dissolving Nodules and Granulomas
Nodules and granulomas are two potential complications that can occur following dermal filler injections
Nodules are small bumps that can form shortly after filler injections, typically within days or weeks. These may be caused by improper injection technique, the use of low-quality fillers, or a reaction to the filler material itself. They can be treated with dissolving injections.
Granulomas are similar – small, firm bumps that can form around the filler injection site. They are typically caused by a foreign body reaction to the filler material. While granulomas are rare, they can occur with any type of filler material, including hyaluronic acid fillers.
They are also a good candidate for dissolution, being a preferred alternative to surgery.
Both nodules and granulomas are relatively rare complications, as found in
a 2016 study for the Journal of Clinical and Aesthetic Dermatology:
“A four-year retrospective study reported a 0.6- to 0.8-percent incidence of hypersensitivity reactions including nodules to hyaluronic acid dermal fillers. True foreign body granulomas are rare with an estimated incidence of between 0.01 and one percent.”
Facial Swelling with Filler
Over the last few years, we have seen a rise in swelling that accompanies dermal fillers. To minimize the risk of complications, guidelines now advise against administering fillers within two weeks before or after receiving a COVID-19 vaccine. This recommendation is based on a growing body of evidence demonstrating a correlation between vaccine administration and swelling, as well as an increased risk of developing granulomas. Part of our intake form now asks if you have had a COVID vaccine recently –
this information helps us assess the risk of an adverse reaction.
Does Your Face Go Back to Normal After Fillers?
If you decide not to get new fillers, your skin will adapt and its natural elasticity will bring it back to its previous appearance. Keep in mind that overfilling can cause stretching and sagging, though – which is why it’s so important to use a trained professional for any and all filler injections!
How Long Do Fillers Take to Dissolve on their Own?
Non-HA fillers, such as Radiesse and Sculptra, are designed to stimulate collagen production and may last years longer than HA fillers. In some cases, they may not even dissolve on their own, requiring a specific treatment to remove them.
Filler Injections in Calgary, Alberta
Getting a filler can be great for your appearance – if it’s done safely, properly, and in the exact way you want. Our team of nurse practitioners, nurse injectors, and other medical professionals has years of experience in delivering just that to our clients…so when you’re ready to see if fillers are right for you, simply reach out and let us know!
***Martyn King, Emma Davies, Sharon King, Cormac Convery, Lee Walker, Linda Mather. Management of a Vascular Occlusion Associated with Cosmetic Injections. The Journal of Clinical and Aesthetic Dermatology, January 2020, 13(1): E53-E58.
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