Short Answer: Dermal Fillers Rarely Don’t Dissolve, But It Can Happen

Most dermal fillers are designed to gradually dissolve over time. However, in rare cases, fillers may persist longer than expected or not break down at all. This issue typically occurs with semi-permanent or permanent fillers, but can occasionally happen with hyaluronic acid fillers due to factors like injection technique, filler type, or individual metabolic response.

Why Don’t Some Dermal Fillers Dissolve?

Dermal fillers may not dissolve as expected for several reasons. Understanding these factors can help determine the best course of action:

• Type of Filler: Non-hyaluronic acid fillers, such as calcium hydroxylapatite (Radiesse) or polymethyl methacrylate (Bellafill), are not naturally broken down by the body and can last several years or indefinitely.
• Injection Depth and Technique: Fillers injected too deeply or in large amounts may integrate into the surrounding tissue, making it difficult for the body to metabolize them.
• Metabolic Rate: Individuals with a slower metabolism may experience fillers lasting longer than usual.
• Immune Response: The body may encapsulate the filler material, forming granulomas that prevent the filler from breaking down naturally.

What Are the Signs of Fillers Not Dissolving?

When fillers don’t dissolve, you may notice persistent lumps, firmness, or asymmetry long after the expected duration. Common signs include:

• Prolonged Lumps: Firm or hard lumps that remain months or even years after the initial treatment.
• Persistent Swelling: Swelling that doesn’t subside or reoccurs intermittently.
• Asymmetry: One side of the face appears fuller or uneven compared to the other.
• Granulomas: Small, firm nodules caused by an immune reaction to the filler material.

If you experience any of these symptoms, consult your injector for an evaluation and possible treatment options.

Can Hyaluronic Acid Fillers Be Dissolved?

Yes, hyaluronic acid (HA) fillers can be dissolved using an enzyme called hyaluronidase. This enzyme breaks down HA fillers within 24 to 48 hours, allowing the body to absorb and eliminate the filler material. Hyaluronidase is an effective solution for correcting unwanted results, lumps, or overfilling, but it’s only applicable for HA-based fillers like Juvederm or Restylane, not for non-HA fillers.

What If Non-Hyaluronic Acid Fillers Don’t Dissolve?

If non-hyaluronic acid fillers such as Radiesse, Sculptra, or Bellafill do not dissolve, the treatment options are more limited. In such cases, you may need to consider the following approaches:

• Massage and Steroid Injections: Gentle massage combined with corticosteroid injections can reduce inflammation and help soften lumps caused by granulomas.
• Surgical Removal: For long-lasting fillers that cannot be dissolved, surgical excision may be necessary to remove the material.
• Laser Treatments: Certain lasers may help break down filler material or stimulate the body’s natural processes to reduce the filler over time.

Consulting with a skilled injector or surgeon is essential for evaluating the best treatment plan for persistent fillers.

What Are Granulomas and How Are They Treated?

Granulomas are firm, small lumps that form when the body treats the filler material as a foreign substance. They are a rare but possible reaction to any type of dermal filler. Granulomas may develop weeks, months, or even years after treatment and can cause discomfort or visible irregularities. Common treatments include:

• Corticosteroid Injections: Reduces inflammation and helps break down the granuloma.
• Hyaluronidase (For HA Fillers): Dissolves the filler if the granuloma is associated with a hyaluronic acid filler.
• Surgical Removal: For granulomas that do not respond to other treatments, surgical excision may be necessary.

How to Avoid Fillers That Don’t Dissolve

Choosing the right filler and injector is crucial to avoiding complications like persistent fillers. Consider these tips:

• Select Temporary Fillers: Start with hyaluronic acid fillers, as they can be dissolved if needed.
• Choose a Qualified Injector: An experienced injector understands proper placement and technique, reducing the risk of long-term complications.
• Start with Small Amounts: Gradual, conservative filler use minimizes the risk of unwanted long-lasting results.
• Monitor for Signs of Complications: Regular follow-ups can help detect and address issues early.

When to See a Specialist

If you suspect that your dermal fillers are not dissolving as expected, consult a specialist immediately. Early intervention can prevent further complications and provide more treatment options. Look for a provider with experience in managing filler-related issues, including using hyaluronidase or performing surgical excisions.

Conclusion

While most dermal fillers dissolve naturally over time, persistent fillers can occur due to filler type, injection technique, or individual factors. Hyaluronic acid fillers can be dissolved with hyaluronidase, but non-HA fillers may require more invasive approaches. Choosing a skilled injector and staying informed about filler properties are key to achieving safe, long-lasting results.