Filler Dissolve
Ultrasound-Guided. Precise. Restorative
At Spectrum Skin Clinic, we specialize in ultrasound-guided filler dissolving using hyaluronidase (Hylenex) to safely and accurately correct complications from dermal fillers. Whether you’re experiencing swelling, migration, nodules, or unwanted volume, our approach provides targeted correction with minimized risk. We have performed over 100+ dissolving cases, with more than four years of ultrasound-based expertise—and a total of six to seven years managing filler complications overall.
Ultrasound-Guided. Precise. Restorative
At Spectrum Skin Clinic, we specialize in ultrasound-guided filler dissolving using hyaluronidase (Hylenex) to safely and accurately correct complications from dermal fillers. Whether you’re experiencing swelling, migration, nodules, or unwanted volume, our approach provides targeted correction with minimized risk. We have performed over 100+ dissolving cases, with more than four years of ultrasound-based expertise—and a total of six to seven years managing filler complications overall.
What Is Hylenex and What Fillers Can Be Dissolved?
Hylenex is a recombinant hyaluronidase enzyme that breaks down hyaluronic acid (HA) fillers. It works by catalyzing the degradation of HA gel into smaller particles that are naturally metabolized by the body.
Fillers that can be dissolved include:
- Juvederm (Voluma, Ultra, Vollure, Volbella)
- Restylane family (Lyft, Silk, Kysse, Eyelight, Refyne, Defyne)
- Belotero Balance
- Revanesse Versa and Lips+
- Most other FDA-approved HA-based dermal fillers
Important: Non-HA fillers like Sculptra, Radiesse, or Bellafill cannot be dissolved with hyaluronidase.
What Is Hylenex and What Fillers Can Be Dissolved?
Hylenex is a recombinant hyaluronidase enzyme that breaks down hyaluronic acid (HA) fillers. It works by catalyzing the degradation of HA gel into smaller particles that are naturally metabolized by the body.
Fillers that can be dissolved include:
- Juvederm (Voluma, Ultra, Vollure, Volbella)
- Restylane family (Lyft, Silk, Kysse, Eyelight, Refyne, Defyne)
- Belotero Balance
- Revanesse Versa and Lips+
- Most other FDA-approved HA-based dermal fillers
Important: Non-HA fillers like Sculptra, Radiesse, or Bellafill cannot be dissolved with hyaluronidase.
Why Would Someone Dissolve Filler?
Indications for filler reversal include:
- Filler migration (e.g., lip filler drifting into surrounding tissue)
- Swelling or puffiness not resolving after 2+ weeks
- Allergic reaction or immune cross-reactivity
- Lumps, bumps, uneven texture
- Delayed-onset nodules or granulomas
- Overfilling or unnatural aesthetic outcome
Even in cases where fillers were placed years ago, persistent filler or swelling may still respond to hyaluronidase with proper ultrasound targeting.
Why Would Someone Dissolve Filler?
Indications for filler reversal include:
- Filler migration (e.g., lip filler drifting into surrounding tissue)
- Swelling or puffiness not resolving after 2+ weeks
- Allergic reaction or immune cross-reactivity
- Lumps, bumps, uneven texture
- Delayed-onset nodules or granulomas
- Overfilling or unnatural aesthetic outcome
Even in cases where fillers were placed years ago, persistent filler or swelling may still respond to hyaluronidase with proper ultrasound targeting.
Why Use Ultrasound Guidance?
Ultrasound allows us to:
- Visualize filler in real time
- Identify depth, quantity, and location of migrated product
- Reduce unnecessary dissolving in surrounding healthy tissue
- Customize dosage (often requiring multiple vials of Hylenex for safe, complete dissolving)
- Monitor vascular anatomy to reduce risk of injury
Although ultrasound improves precision, some cases require more than one session to fully remove deeper or older filler material.
Why Use Ultrasound Guidance?
Ultrasound allows us to:
- Visualize filler in real time
- Identify depth, quantity, and location of migrated product
- Reduce unnecessary dissolving in surrounding healthy tissue
- Customize dosage (often requiring multiple vials of Hylenex for safe, complete dissolving)
- Monitor vascular anatomy to reduce risk of injury
Although ultrasound improves precision, some cases require more than one session to fully remove deeper or older filler material.
Common Treatment Areas for Filler Dissolve
- Under Eye (Tear Trough) – puffiness, Tyndall effect, or persistent swelling
- Lips – filler migration, lip line distortion, or nodules
- Nasolabial folds or cheeks – heaviness or overprojection
- Jawline or chin – misplacement or poor filler integration
Common Treatment Areas for Filler Dissolve
- Under Eye (Tear Trough) – puffiness, Tyndall effect, or persistent swelling
- Lips – filler migration, lip line distortion, or nodules
- Nasolabial folds or cheeks – heaviness or overprojection
- Jawline or chin – misplacement or poor filler integration
What to Expect During and After Treatment
Treatment involves cleansing the area and injecting Hylenex precisely into the targeted filler pocket using a fine needle or cannula, often under real-time ultrasound imaging. You may experience:
- Mild swelling or stinging at the injection site
- Bruising or tenderness for 2–4 days
- Temporary post-inflammatory hyperpigmentation (PIH) in rare cases, especially in darker skin tones
- Partial resolution after first session, with follow-up needed in 1–2 weeks
What to Expect During and After Treatment
Treatment involves cleansing the area and injecting Hylenex precisely into the targeted filler pocket using a fine needle or cannula, often under real-time ultrasound imaging. You may experience:
- Mild swelling or stinging at the injection site
- Bruising or tenderness for 2–4 days
- Temporary post-inflammatory hyperpigmentation (PIH) in rare cases, especially in darker skin tones
- Partial resolution after first session, with follow-up needed in 1–2 weeks
Post-Dissolve Treatments to Improve Results
In some cases, dissolving filler can temporarily disrupt skin tone or texture. We offer combination therapies to restore skin health and balance after treatment:
- RF microneedling (Matrix PRO, Sublative) – improves collagen support
- CO2 laser or Secret PRO – enhances texture and promotes skin remodeling
- Lymphatic massage – supports fluid drainage and reduces puffiness post-dissolve
- PRFM (Platelet-Rich Fibrin Matrix) – used post-dissolve to support tissue regeneration and reduce inflammation
- Medical-grade skincare (e.g., SkinCeuticals) – targeted antioxidants, barrier-repair serums, and pigment control
- HydraFacial or light-based treatments – for hydration, tone, and pigment balance
Post-Dissolve Treatments to Improve Results
In some cases, dissolving filler can temporarily disrupt skin tone or texture. We offer combination therapies to restore skin health and balance after treatment:
- RF microneedling (Matrix PRO, Sublative) – improves collagen support
- CO2 laser or Secret PRO – enhances texture and promotes skin remodeling
- Lymphatic massage – supports fluid drainage and reduces puffiness post-dissolve
- PRFM (Platelet-Rich Fibrin Matrix) – used post-dissolve to support tissue regeneration and reduce inflammation
- Medical-grade skincare (e.g., SkinCeuticals) – targeted antioxidants, barrier-repair serums, and pigment control
- HydraFacial or light-based treatments – for hydration, tone, and pigment balance
When Can You Refill After Dissolving?
In most cases, the area can be refilled 7–10 days after full resolution of swelling and inflammation. Our team will reassess structure and symmetry before proceeding, ensuring product is placed strategically and conservatively to avoid the same complication.
Some patients may benefit from PRFM or Rejuran before refilling to support the tissue and restore skin health.
When Can You Refill After Dissolving?
In most cases, the area can be refilled 7–10 days after full resolution of swelling and inflammation. Our team will reassess structure and symmetry before proceeding, ensuring product is placed strategically and conservatively to avoid the same complication.
Some patients may benefit from PRFM or Rejuran before refilling to support the tissue and restore skin health.
Our Experience at Spectrum Skin Clinic
- Over 100+ vials of hyaluronidase (Hylenex) used in clinical practice
- 6–7 years of experience managing filler complications, including the last 4 years with ultrasound-guided dissolving
- Extensive experience treating complications referred from other clinics
- Aesthetic and medical experience combined—led by Dr. Sabeen Munib, a physician trained in advanced dermal filler and ultrasound techniques
Our Experience at Spectrum Skin Clinic
- Over 100+ vials of hyaluronidase (Hylenex) used in clinical practice
- 6–7 years of experience managing filler complications, including the last 4 years with ultrasound-guided dissolving
- Extensive experience treating complications referred from other clinics
- Aesthetic and medical experience combined—led by Dr. Sabeen Munib, a physician trained in advanced dermal filler and ultrasound techniques
