Skin care

Reversing dermal fillers with hyaluronidase

Article medically reviewed by Dr. Gavin Chan (MBBS, cosmetic doctor, liposuctionist)

Templestowe Lower, Berwick and Beaumaris Clinics

Dr. Gavin Chan has a background in intensive care, anaesthesia, and emergency medicine. Since 2005, Dr. Chan has provided cosmetic procedures, including anti-wrinkle injections, dermal fillers, liposuction and laser treatments. He is a doctor trainer for various dermal fillers and anti-wrinkle injections. Read More



You know that facial volume loss is a key factor in the ageing process, resulting in skin folds, wrinkles, and a ‘flattening’ of your face. And while you’re not expecting to look like a totally younger version of yourself; you’re excited about what dermal filler treatment can do. Radiant glowing skin with less wrinkles and lines, without surgery and no downtime – yes please!

After the cosmetic injection treatment, you were happy with the results but a few weeks have passed now and you really don’t like them. Don’t panic though, if you have a problem with filler treatments they can be reversed using an enzyme that dissolves the filler called hyaluronidase. Dr Gavin Chan explains how filler treatment can be easily reversed.

What is hyaluronic acid and hyaluronidase?

Hyaluronic acid and hyaluronidase occur naturally in your body. Hyaluronic acid is an essential component of the nerve tissues, skin, and connective tissues. This hydrophilic (water loving) molecule keeps your skin soft and your joints flexible. Dr Gavin Chan explains that hyaluronic acid is broken down in the body by the enzyme hyaluronidase with up to one third of the body’s hyaluronic acid getting turned over every day.

Unlike the body’s natural molecules, the dermal fillers have cross linked chains which results in an increased resilience to the breakdown of the fillers by the body’s own hyaluronidases. This ensures the dermal fillers metabolise at slower rate in the body over a period of 3 to 24 months.

What is hyaluronidase used for?

According to Dr Gavin Chan in cosmetic medicine, hyaluronidase is predominantly used to dissolve dermal fillers that have been placed unevenly, incorrectly or excessively. This enzyme is injected into the vicinity of the dermal filler that needs to be dissolved. The effect of the hyaluronidase injection is very rapid and will start to work immediately on the cosmetic fillers to dissolve and metabolise them. During this process the bodies own molecules will also be dissolved, however it will be replaced quickly due to its natural rapid turnover rate. It is important to note that hyaluronidase will not affect dermal fillers made from substances other than the natural occurring substance found in the body.

One of the most common areas hyaluronidase is used to dissolve cosmetic filler is around the eye area. Because the skin around this area is delicate and thin, if it has been over treated with filler it will be easily visible.

Hyaluronidase is also used in emergency situations if dermal filler has been mistakably injected into an artery that has caused an occlusion of the blood supply. While this is rare, it highlights the importance of visiting a reputable medical clinic for your dermal filler treatment. Cosmetic Doctors and Cosmetic Nurses at medical clinics that focus on cosmetic medicine have hyaluronidase on hand to prevent unfavourable outcomes as a result of intra-arterial injection of fillers. When this occasionally happens it can result in death of the skin (causing scarring) and blindness. Having hyaluronidase on hand can help avoid complications of this occurring.

Why do people want to have their dermal fillers reversed?

Dr Gavin Chan explains there are 7 main reasons why people want to have their dermal fillers reversed.

7 uses for hyalurondidase

Reason 1 for getting dermal filler reversed: Incorrectly placed filler

If dermal filler has been incorrectly placed, it can be corrected.

Reason 2 for getting dermal filler reversed: Too much filler

Having too much dermal filler treatment can lead to a result that looks unnatural and ‘not like you’. We can help you correct this.

Reason 3 for getting dermal filler reversed: Asymmetrical filler

If dermal filler has been placed asymmetrically in your face, it can be reversed. You don’t need to put up with asymmetrical filler.

Reason 4 for getting dermal filler reversed: Lumps

Lumps and bumps after having dermal filler can occur. If these do not go away after a few weeks, we can help you correct them.

Reason 5 for getting dermal filler reversed: Tyndall’s effect

Dermal filler is a clear gel so when light reflects through the skin it will appear to be a blue colour. The Tyndall effect is a light to dark blue discoloration that appears mainly around the eye area if the fillers are injected too superficially into the skin.

Reason 6 for getting dermal filler reversed: Infected filler or granuloma

For patients with this issue it is important that they are on a course of antibiotics prior to dissolving the filler. If the filler is dissolved while it’s infected, the infection will spread as the hyaluronidase breaks it down.

Reason 7 for getting dermal filler reversed: Emergency arterial occlusion

While this is very rare it can happen when the filler is injected too close to an artery. An experienced and highly trained Cosmetic Doctor and Cosmetic Nurse will notice this because when an artery has been occluded or partially occluded the skin will become blanched, white or mottled indicating a lack of blood supply

Are there any side effects to hyaluronidase?

It is important to note that there are some side effects to hyaluronidase you need to be aware of. The most common side effect is swelling and bruising. This usually settles down a few days after the treatment. While allergy in the injection area is very rare, it can be severe and may include the risk of anaphylaxis. This is usually more prevalent in those who are allergic to bee-stings.

The most difficult part of using hyaluronidase is estimating the dosage amount required to dissolve the filler. In some cases, there will be not enough used, while in others there is too much. This may require a second or third visit to add more filler or to use more hyaluronidase.

Where to get the best filler injection reversal in Melbourne

Since 2005 our highly trained and experienced Cosmetic Doctors and Cosmetic Nurse have treated thousands of people with filler injections. Our team led by Dr Gavin Chan believe that your face needs to move naturally and that a subtle approach is always the best. We believe there is no substitute for getting your dermal injections right the first time, however, if you don’t like the results or have negative side effects they can be reversed.

Find out how we can help you. Call us on 1300 863 824 or fill in the form below.