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Can Dermal Filler Results be Reversed?

Sometimes injectors make a small mistake and inject too much filler, and sometimes even when nothing goes wrong, the patient is still unhappy. And in very rare cases, dermal filler injections can stop blood flow to the area, which can cause tissue death called necrosis. No matter what the reason is, injectors may need to undo a dermal filler treatment. Depending on the filler used, you may or may not be able to reverse the effects of a dermal filler treatment. In this article, we look at some of the main ingredients in a variety of different dermal fillers to answer the question, “How to reverse the effects of dermal fillers?” Let’s jump right in.


Fillers like Radiesse, which are made of calcium hydroxylapatite, use microspheres in a gel to add volume to the dermis. In addition to giving the skin more volume immediately, these tiny spheres help collagen grow in the dermis by stimulating its growth. This means that even though the particles are breaking down inside the skin, the collagen is still growing to make the treatment results last. The effects may last for a year or longer, but they will start to wear off at some point.

There is no easy way to reverse the effects of calcium hydroxylapatite once injected. Some doctors have used corticosteroids to reduce swelling in the area, and others have used nitroglycerin paste to help improve blood flow to the area. Doctors may also use hyaluronidase to help break down the natural hyaluronic acid in the area. This makes more room for the filler and puts less pressure on the blood vessels. Breaking up the hyaluronic acid may also help reduce the overall size of the area to make the augmentation less obvious. But once the calcium hydroxylapatite filler is in a place, it will stay there for months until it breaks down on its own.


Fillers like Sculptra that contain poly-L-lactic acid work the same way as calcium hydroxylapatite fillers. The filler adds temporary volume to the dermis as the particles stimulate collagen growth and provide a scaffold within the dermis where the collagen can grow. As the poly-L-lactic acid breaks down, the collagen keeps growing, so the effects of the treatment can last for at least two years.

Like calcium hydroxylapatite fillers, poly-L-lactic acid cannot be easily taken out of the skin once it’s been injected. If lumps form, doctors may use a needle to break them up and make them less noticeable. Massage may also help smooth out the look of the nodules, and corticosteroids may help reduce swelling in the area. If there are major problems, doctors can use surgical excision to cut out the filler, but this is an invasive procedure and the results may not be ideal. There is really no effective way to break down the poly-L-lactic acid, and allowing it to gradually break down within the body may be the only option in most cases.


Most newer dermal fillers are made with hyaluronic acid, including major brands such as Juvederm and Restylane. Although this hyaluronic acid is produced from bacterial fermentation, it is similar to the hyaluronic acid found throughout the body’s tissues. This hyaluronic acid keeps water in the skin, which makes the skin look fuller. Because the filler tends to grow after it is injected because it absorbs water, inexperienced injectors may add too much volume to an area. Hyaluronic acid normally breaks down quickly in the body, but these fillers are made using special techniques, usually cross-linking, to make the hyaluronic acid particles stronger. Depending on the filler, this helps the hyaluronic acid last from a few months to a few years.

Hyaluronic acid fillers, on the other hand, are much easier to take out early than most other dermal fillers. Hyaluronidase is the enzyme that works with hyaluronic acid in the body. Hyaluronic acid fillers can be broken down in the body with the help of injectable forms of this enzyme, such as Liporase. Treatment with Liporase can effective reduce the amount of hyaluronic acid even after injection, which making the treated area reduce in size. Most of the time, these injections don’t cause any side effects, which makes them a good way to get rid of dermal fillers.


Patients are understandably hesitant to settle for changes to their face that they are not completely satisfied with. Once a person sees how they look after receiving cosmetic injections, they may wish to make adjustments immediately. Keeping in mind these options for removing dermal fillers may help you and your patient choose the right product for their needs. That’s one reason why hyaluronic acid-based fillers such as Juvederm make ideal sense for first-time dermal filler patients.

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