Can You “Un-Do” Dermal Fillers?

Dermal filler injections are a popular way to temporarily smooth out fine lines and wrinkles, restore youthful volume to an aging face, and enhance cheek and lip contours without surgery or a lengthy recovery time.

In the hands of a board certified cosmetic surgeon or licensed physician assistant, or a registered nurse working under their supervision, dermal filler injections usually produce symmetrical, subtle, natural-looking results. The vast majority of patients who seek treatment from highly qualified individuals such as these are thrilled with their results.

However, cosmetic medicine isn’t an exact science, and even in the best hands patients occasionally have less than perfect outcomes with dermal fillers. While choosing a qualified provider can help you avoid mistakes common with less experienced individuals such as overfilling and asymmetry, in a small percentage of cases, a patient’s body simply reacts poorly to the product for no known reason, resulting in prolonged swelling or lumpiness. Other side effects such as infection and allergic reaction are rare, but can occur. And, on occasion, a patient may decide that fillers just aren’t for them after all.

If you don’t love your results from dermal filler injections, take heart knowing the effects are temporary. In many cases, a skilled cosmetic surgeon can make more immediate corrections or improve upon your previous results through one of several therapeutic treatments.

Can you reverse fillers when results are subpar?

If you are displeased with your final results, or wish they could look a bit better, the good news is that it is often possible for a skilled cosmetic surgeon to make corrections or improve the outcome of dermal fillers. The best approach to address the issue depends on the nature and severity of the problem as well as the type of filler that was originally injected.

Massage of the dermal filler treatment area

Mild symptoms such as moderate lumpiness or slight asymmetry can often be improved or resolved by massaging the area. Your provider can perform the massage or instruct you in the proper technique.

Treatment to remove Juvéderm and other hyaluronic acid fillers

Hyaluronic acid fillers, such as Juvéderm products (including VOLUMA and VOLBELLA), Restylane products, and Belotero, can be partially or completely removed with an enzyme called hyaluronidase. When injected into the affected areas, hyaluronidase dissolves the hyaluronic acid particles to help correct issues such as:

• Overfilling or dissatisfying results
• Excessive or prolonged swelling
• Infection in the treatment area
• A lumpy or irregular texture that doesn’t respond to massage
• Vascular compromise (occurs when filler is injected too close to a blood vessel, interfering with blood flow—extremely rare with a qualified, experienced injector)

Hyaluronidase isn’t perfect. The enzyme may remove a greater amount of filler than desired, requiring another filler treatment to achieve your original goals. Additionally, since products tend to be made from animal derivatives, certain patients may be at higher risk for allergic reaction and therefore not good candidates for the treatment. In most cases, however, hyaluronidase can spare a patient from months of living with the results of poorly performed filler injections.

Options to improve non-hyaluronic acid fillers

Hyaluronidase will not help with fillers such as Radiesse, Bellafill, and Sculptra. In certain patients, a steroid injection may help reverse the effects of some of these fillers to an extent, but the only surefire way to “undo” the results of these fillers is to wait for them to be absorbed by the body.

If you would rather not wait the year or more it may take for the filler to fade naturally, a skilled provider may be able to improve your results considerably through strategic placement of additional filler. Under certain rare circumstances, fillers can be surgically removed.

Deciding what to do next

Ultimately, fillers are temporary and the best “medicine” for subpar results is time. Your body will eventually metabolize the product; once this occurs you can choose to have another treatment if you wish. However, if you are experiencing pain or unusual swelling, or the area feels warm to the touch, see your provider or doctor as soon as possible—these are signs of infection that need to be addressed swiftly.

Prevention is the best cure

There is no substitute for getting your filler injections right the first time around. Choose a provider with the knowledge and experience to discern the appropriate filler for your needs and the skill to inject fillers safely and precisely to achieve a beautiful result. A board certified cosmetic surgeon or specially trained physician assistant, or a registered nurse working under their supervision, are most likely to meet these qualifications. Take time to learn about each provider’s reputation and experience, and ask to see before and after photos of other patients before moving forward.

Finding a board certified cosmetic surgeon in your area is easy—just use our Find a Surgeon tool to read each surgeon’s profile and get contact information for the practice.