Does Dissolving Fillers Ruin Your Face?

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What are Dermal Fillers, and What Can They Do?

Dermal fillers, commonly just called “fillers”, are an injectable gel-like substance made of hyaluronic acid - which is a naturally occuring substance in the skin and body.

Fillers can be used to replace lost volume, fill deep lines, plump lips and add contour and structure where there is none - think week chins, wobbly jawlines and sunken temples, providing a temporary but effective solution for restoring a youthful appearance or improving facial proportions or features.

Different fillers have different viscosities...some are "soft", others are "stiff". A good practitioner will select the right filler for the right job. Stiff fillers are great for contouring jawlines and chins, soft fillers are great for lips.

But, have we gone a little filler wild over the last few years…and is the filler boom catching up to us?

Overfilling and dissolving…a problematic duo

For many, when fillers are mentioned, their initial thoughts are “fake” “pillow face” “ duck lips”. And a good number of celebrities, who had veered into this territory, have had their fillers reversed successfully. But what led to the overfilling in the first place, and is dissolving really the magical solution it seems to be?

A perfect filler storm has been brewing over the last ten years.

• We've lost sight of "normal" because social media apps are full of filtered, enhanced and frankly, unrealistic faces. Our digital diets warping what we see as “normal”.
• Perception drift can affect those who have had filler treatments. Individuals gradually become accustomed to their altered appearance, and this can prompt them to seek additional treatments.
• Lack of regulation with no standardised training requirements for aesthetic practitioners, so whether you’re a maxillofacial surgeon or a plumber, you can train in fillers and be injecting within a matter of days. Additionally, filler products are unregulated, with knockoff products readily available.
• Profits over patient care happens with some unethical practitioners. A good practitioner will refuse to treat a patient who is not a great candidate. Other practitioners are just happy to take the money - this contributes to overfilling.
• Fillers hang around in the body longer than anyone thought - including the product manufacturers…like decades longer! In the early days of filler, a “top up” was recommended every 6-12 months. We now know that dermal fillers have been found in tissues 12 years after they were placed.
• Fillers are hydrophilic. This means they attract water, which causes them to swell. If you think of layers upon layers of fillers, added to the skin over many years, causing the skin and tissues to continuously be stretched and plumped, past their natural capacity. This results in some undersirable effects when the fillers are dissolved.

But it’s OK, because fillers can be dissolved...Right?

Yes, they can. But filler dissolving is not without it’s drawbacks.

Hyaluronidase is an enzyme that catalyses the breakdown of hyaluronic acid. When used to dissolve fillers, hyaluronidase breaks down the cross-linked hyaluronic acid molecules, allowing the body to absorb and eliminate them. The enzyme works relatively quickly, offering a prompt resolution to overfilled areas.

Sounds perfect, right? Simply dissolve fillers you don’t want. MAGIC!

Well, aside from the obvious risk of swelling, redness and potential bleeding in the areas that have been dissolved. Not to mention that if you’ve got a bee or wasp allergy, you can have your filler dissolved…it’s really not quite that easy.

Hyaluronidase is a blunt instrument. Less blunt with ultrasound guidance, but blunt nonetheless.

Hyaluronidase can’t tell the difference between synthetic filler that has been injected and your own hyaluronic acid. This causes treated areas to lose their fullness in a relatively short time frame - up to 48 hours. This can leave the skin in the treated area looking awful. Baggy, saggy, deflated and lax. This is particularly true where large areas of filler have been dissolved.

And it’s a double whammy, because the injected filler was masking natural age-related volume loss…so it’s entirely possible that, if you’ve had multiple filler treatments over a period of 5-10 years, and get your filler dissolved, you’ve not only lost the filler, but you’re also 5-10 years older! Many people feel they look significantly worse after having their filler dissolved.

Plus, different fillers dissolve at different rates. Some fillers are very hard to dissolve, so more hyaluronidase over multiple dissolving sessions might be needed, further increasing the chance of eroding your own natural hyaluronic acid.

Over time, your body can replace it’s own, dissolved hyaluronic acid, but this can take time, which is why many who have had extensive filler dissolving opt to have more subtle, natural looking filler treatments a few weeks after their dissolving session. Almost like a refresh following the reset.

How do you Avoid the Need to Dissolve?

It stands to reason that if we’re only recently understanding the longevity and effects of dermal fillers, with practitioners now able to hone their practice from decades of fillers being on the market, there’s a lag in our understanding relating to hyaluronidase and filler dissolving.

Dissolving fillers with hyaluronidase provides a solution to the challenges of overfilling, but it shouldn’t be used as an easy out.

The best approach is to choose a practitioner who will select the correct product, place it correctly and be able to build a treatment plan to ensure you look your very best for years to come.

If you're interested to find out how fillers can be used in your face to help you refresh and rejuvenate your appearance, or are looking for a practitioner to dissolve your fillers, why not check out the practitioners near you - simply click here and search

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