dermal filler removal
from correcting overfilled faces to complications management
If you are unhappy with your dermal filler and want to have it removed, we can help you determine the best course of action and explain the potential risks and benefits of dissolving the filler.
Dermal filler Removal
So, you decided to get some filler, but few days/ weeks later, you find yourself regretting your decision. Can you do something about it? Well, of course you can, however, it does depends on the type of filler injected into your skin.
Our first advice, always know exactly what is injected, before you commit to the procedure. Not all fillers can be dissolved. Only hyaluronic acid fillers, such as Juvederm, Restylane, Beloterro or Revanesse Versa are dissolvable fillers. Others, such as Sculptra, Radiesse or Bellafill are not dissolvable. Therefore, you should always know what product is injected.
Second, we do not recommend dissolving freshly injected filler, unless you are experiencing major complications, such as vascular occlusion. We will discuss this complication little later, which must be address immediately to avoid major tissue damage.
Once you committed to dissolving, we always recommend you to go back to the same injector, who performed your original procedure. Most injectors would include filler dissolving, as part of their service, and would not charge you extra to dissolve filler their injected. If this option is not available, we invite you to schedule an appointment with Dr. Natalya to help correct the result you are not happy with.
Ultrasound Guided Filler Dissolving
At Desert Bloom Skincare, we use an ultrasound guided filler dissolving method. During this procedure Hylenex, brand name for the hyaluronic acid dissolving enzyme called hyaluronidase, in injected into unwanted filler. Our high definition ultrasound device allows Dr. Natalya to accurately locate the filler and precisely deliver hyaluronidase. Thus, minimizing the amount of hyaluronidase needed to achieve the best result.
This technology is essential for locating and eliminating filler nodules, safely navigating and avoiding blood vessels to minimize trauma, especially in sensitive areas, as under eyes. Ultrasound guided method brings filler dissolving to new level of stately, accuracy and precision. We can use of high definition facial ultrasound to accurately examine and evaluate cause of various complications, from unwanted volume, filler migration, filler encapsulation, filler nodules and most dangerous, vascular occlusion.
Various complications can arise from injecting dermal filler. Most common is overfilling injected area. For example, overfilled lips, can cause dermal filler to migrate above the lip and cause mustache or muzzle like appearance. Not pretty! This can be easily corrected with hyaluronidase injection. Hyaluronidase will break up hyaluronic acid filler allowing body to absorb and eliminate remaining fluid. Keep in mind, this process will take time, expect minor to moderate swelling for few days post injection and complete resolution of filler 2 weeks after dissolving.
Filler encapsulation or filler nodules can appear in facial areas with thinner skin, such as under eyes, lips or temples. Some nodularity or uneven texture is expected after filler injections, but all should resolve after two weeks. If you have a persistent nodule, this likely needs to be dissolved. An ultrasound guided method is the best option, so we can inject less hyaluronidase to protect the other filler in your face.
Vascular occlusion, as the most serious complication
Lastly, the most dangerous complication is a vascular occlusion. This occurs, when filler is unintentionally injected into a blood vessel, causing a partial or complete block in a blood flow. This can result in severe tissue damage, tissue death (necrosis) or even blindness. This severe complication is fully avoidable in the hands of skilled physician. First, knowledge of anatomy, will help physician avoid all major blood vessels. Using dull cannula while injecting, instead of sharp needle, will significantly decrease chance of penetrating a blood vessel. And lastly, performing aspiration prior to each injection, can insure we are not injecting into a blood vessel.
But what are the signs of vascular occlusion? First is blanching, you might feel the area in your face, looks more pale then the rest of your face. This also might be the effect of lidocaine with epinephrine, so please consult your injector immediately, to clarify what was injected. Second, the area of vascular occlusion will develop unusual blood vessel pattern, called livedo reticularis. It will appear as you have lace like pattern of bluish blood vessels in affected side of the face. Lastly, the area will be very painful and continue to worsen. If left untreated, skin will start to die without proper blood flow, turning very dark and causing permanent damage.
With that said, if you are in doubt, please contact your injected immediately, as the affected area must be flushed with large amounts of hyaluronidase as soon as possible to restore proper blood flow to avoid further damage.
Hyaluronidase side effects
When a small amount of hyaluronidase is injected to dissolve a nodule or small amount of filler, the only temporary side effect is bruising and swelling. However, you are fell victim of vascular occlusion, large amounts of Hylenex will be injected to save your tissue, which can create skin dehydration and skin thinning. Hyaluronidase is an enzyme, which breaks up hyaluronic acid. Hyaluronic acid is a glucosaminoglycan (GAG), which naturally exists in our skin, joints and even bone, proving hydration and lubrication to our tissues. When we temporary remove it, it can cause your skin to appear dehydrated, making line and wrinkles more prominent. Good news is, this is temporary and your body will restore lost hyaluronic acid quickly. You however, can help this process by using medical grade skin care products containing hyaluronic acid.
Last few words about filler dissolving. If you are not happy with results of your filler, do not hesitate, get rid of it. If you are experiencing any filler complications, certainty get rid of it. Hyaluronidase injections are safe and effective solution to unwanted dermal filler. Do not live with your botched lip filler, or nodules under your eyes, let us help you correct these mistakes and restore your beautiful, natural face. Do not try to remove your filler at home. None of the home solutions are effective and some are plain dangerous. Of course, some of hyaluronic acid filler will dissolve by your body over time, but nodules and encapsulations can last for years. Dr. Natalya is a specialist in filler dissolving, she will be happy to assist you in your pursuit of beauty and health.
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