Filler Removal (Hyaluronidase)

It only works on Hyaluronic Acid fillers. It cannot dissolve permanent or semi-permanent fillers like Radiesse or Sculptra.

Hyaluronidase is an enzyme that breaks down hyaluronic acid (HA) — the same molecule that HA-based dermal fillers are made from. When injected into the area where filler is placed, the enzyme cleaves the cross-linked HA into smaller pieces that the body absorbs and clears within days. The action is selective: it acts on HA only, leaving surrounding tissue (which contains natural HA at much lower concentrations) essentially unaffected.

Hyaluronidase dissolves ONLY hyaluronic acid (HA) fillers — Juvederm, Restylane, Teosyal, Belotero, and other HA brands. It does NOT dissolve non-HA fillers: Radiesse (calcium hydroxylapatite), Sculptra (poly-L-lactic acid), Bellafill (PMMA microspheres), or silicone. These products are metabolised by the body on their own schedule (years for PLLA/CaHA, permanent for PMMA/silicone) and require different interventions if correction is needed. This is one reason knowing what filler is in your face matters — bring previous treatment records to your consultation.

Hyaluronidase (sold in UK as Hyalase) is a Prescription Only Medicine (POM). It can only be administered by an appropriately qualified prescribing medical professional — typically a doctor, dentist, nurse prescriber, or pharmacist prescriber. The reason for this strict control is that hyaluronidase can cause allergic reactions in rare cases (including anaphylaxis) and dose calculation requires medical expertise. At INNODERM all filler removal is performed by GMC-registered clinicians.

Hyaluronidase has been used in medicine for decades — its safety profile is well-characterised. The main risks are: localised allergic reaction at the injection site (uncommon); systemic allergic reaction including anaphylaxis (very rare but documented — typically more likely in patients with known bee or wasp venom allergy because hyaluronidase products historically derive from animal source); overdissolution of natural HA in surrounding tissue if dosing is excessive (uncommon with experienced injectors); and infection at the injection site (rare with sterile technique). A patch test is sometimes recommended for patients with known allergy history.

One scenario requires immediate hyaluronidase: suspected vascular occlusion. If HA filler accidentally compresses or enters a blood vessel, blood flow to the surrounding skin (or worse, the eye) is at risk — this presents within minutes-to-hours as severe pain, blanching or purplish discolouration of skin, and visual changes if the eye is affected. Hyaluronidase in this scenario can rescue the tissue if administered fast enough. INNODERM clinicians are trained to recognise vascular complications and act immediately. Any acute filler complication — even at a different clinic where you originally had filler — warrants immediate medical attention.

Most of the dissolution happens within 24–48 hours of injection. The full effect is usually visible within 3–7 days as residual swelling subsides. Sometimes a second hyaluronidase session is needed for thicker or older filler that did not fully dissolve in the first pass — this is reassessed at 2 weeks. Note that the area will look temporarily deflated immediately after dissolution because both the filler and the tissue swelling around it are gone — your natural baseline will return as the area settles.

We recommend waiting at least 2 weeks (some practitioners prefer 4 weeks) between dissolving HA filler and placing new filler in the same area. This allows residual hyaluronidase to clear fully — placing new HA filler too soon risks the residual enzyme partially dissolving the new product, wasting it. It also lets you and your practitioner properly assess your natural baseline before deciding on a fresh treatment plan. The full reassessment usually happens at the 2-week follow-up.

No — hyaluronidase is highly selective for HA and the surrounding tissue is largely unaffected by appropriate dosing. Some patients worry that years of repeated filler will have stretched the skin permanently and that dissolving will leave loose tissue. In practice, the tissue usually contracts back to or near its baseline because HA fillers do not permanently expand skin the way long-term high-volume placement of more permanent products can. If significant tissue laxity is present, that is usually due to natural ageing rather than the filler itself, and can be addressed separately.