What Are Fillers?
Dermal fillers are injectable substances primarily composed of hyaluronic acid, used for facial contouring and volume replacement. They add structure and balance to facial features, enhancing areas such as the jawline, chin, cheekbones, and lips. The various viscosities of fillers allow for different applications, from creating a structured jawline to adding a soft suppleness to the lips. The art of using dermal fillers requires both skill and an aesthetic eye.
Types of Fillers and Their Dissolvability
Fillers can be categorized based on their composition:
- Hyaluronic Acid Fillers: These are the most common and can be dissolved using hyaluronidase, an enzyme that breaks down hyaluronic acid.
- Hydroxyapatite Fillers: These cannot be dissolved with hyaluronidase and are more structured.
- Silicone Fillers and Fat Transfers: These are permanent and cannot be dissolved.
Common Reasons for Dissolving Fillers
Dissolving fillers may be necessary for several reasons:
- Asymmetry: Uneven results can be corrected by dissolving the filler.
- Adverse Events: Rare complications like vascular occlusion require immediate dissolution.
- Nodule Formation: Inflammatory responses can cause nodules that may need to be softened with hyaluronidase.
- Patient Preference: Occasionally, patients may decide they do not like the result and opt to dissolve the filler.
- Overfilling: Continuous application of new filler over old filler can lead to an unnatural look, making dissolution necessary to start afresh.
Filler Migration and Its Effects
Filler migration occurs due to improper technique, inappropriate filler choice, or overfilling. This can affect areas with high muscle movement, such as the cheeks and lips. Migration can also result from rapid weight loss or natural aging, though this is usually less noticeable.
Correcting Overfilled Areas
Overfilled areas, particularly the tear troughs, often need correction through dissolving. The tear trough requires minimal filler, and overfilling can lead to swelling due to water retention, as filler is hydrophilic and attracts water. Proper placement and judicious use are crucial in this sensitive area.
Negative Effects Correctable by Dissolving Fillers
Dissolving fillers can address issues such as asymmetry, nodular formations, and the rare but serious vascular occlusion. Prompt treatment with hyaluronidase and other methods to restore blood flow is essential in such cases.
Aesthetic Changes and Trends
Trends in aesthetics can lead to patients wanting to dissolve their fillers. For example, the trend has shifted from larger, more voluptuous lips to a daintier look in 2024, prompting some patients to opt for dissolution and re-injection of a more refined filler.
The Process of Dissolving Fillers
Dissolving fillers involves injecting hyaluronidase with a fine needle. This enzyme causes a burning sensation but can be mixed with sodium bicarbonate to reduce discomfort. The enzyme’s activity can last from 30 hours to a week, with a recommended waiting period of at least two weeks before any re-injection.
Cost of Dissolving Fillers
The cost varies depending on the location, the amount of enzyme used, and the injector’s expertise. It generally aligns with the cost of filler treatments.
Side Effects and Aftercare
Possible side effects include incomplete or uneven removal and asymmetry. Multiple treatments may be necessary to achieve the desired result. Aftercare involves managing bruising and swelling with arnica gel or tablets and icing the area. Massaging should be avoided to prevent increased swelling.
Key Considerations
Studies show varying durations for the activity of hyaluronidase, emphasizing the importance of waiting at least two weeks after dissolving filler before considering re-injection to ensure optimal results.
