In this “Ask Dr. Volha” post series, Dr. Volha provides weekly answers to the most frequently asked questions from her patients regarding Filler Dissolve. You can read them here. If you have a question for Dr. Volha, share it with us, and we’ll include your answer in the next update.
Is the filler dissolver more painful than the filler injection itself?
The level of pain associated with dissolving dermal fillers depends largely on the treatment area, the injection depth, and the type of filler being dissolved.
For example, when filler migrates to the upper lip area, the dissolving process may cause a burning or shooting sensation due to the presence of major blood vessels and nerves emerging from the upper jaw. In contrast, dissolving filler under the eyes is generally associated with minimal discomfort.
To maximize patient comfort and minimize distress, a local anesthetic is routinely applied to numb the treatment area before the injection.
Does the pain of filler dissolver apply to all areas of the face?
While discomfort can occur when dissolving filler in any area of the face (including the under-eyes, cheeks, chin, and lips), the level of pain varies significantly depending on the treatment area. The lips are generally considered the most sensitive area due to their high concentration of nerve endings. To effectively manage discomfort during more extensive dissolving procedures, practitioners may perform a nerve block inside the mouth to fully numb the lips. For minor corrections or small amounts of filler located just above the lip line, a topical local anesthetic is usually sufficient.
Does the dissolver destroy natural lip tissue and make it smaller?
Hyalase (hyaluronidase) does not dissolve muscle or fat tissue, which make up the majority of the lips. Its primary function is to break down hyaluronic acid.
While the enzyme may temporarily degrade a small amount of the body’s naturally occurring hyaluronic acid, this is considered safe because the body continuously produces and replenishes its own hyaluronic acid.
However, a recovery period of three to four weeks between treatment sessions is recommended to allow the tissue to fully settle and respond. For this reason, undergoing dissolving treatments on a weekly basis is not advisable and may negatively affect the skin’s integrity.
Is it possible to be allergic to the filler dissolving agent?
It is possible to develop an allergy to Hyalase (hyaluronidase), and the risk of hypersensitivity may increase with repeated exposure.
For this reason, a patch test is recommended before each treatment session, including for patients who have previously tolerated the enzyme. If the test site becomes raised, red, itchy, or develops urticaria, the injection should not proceed.
Accordingly, patients should consider dermal fillers a long-term treatment commitment. Repeated cycles of filling, dissolving, and reinjection are generally discouraged, as they may increase the risk of adverse immune reactions, including allergic responses.
This “Ask Dr. Volha” session highlights that while filler dissolving can cause localized discomfort depending on the facial area, professional numbing techniques and nerve blocks can effectively manage the pain.
Furthermore, hyalase specifically targets hyaluronic acid without destroying natural lip muscle or fat, and the body quickly replenishes any naturally lost acid. However, due to the risk of developing an allergy to the dissolving agent with repeated exposure, procedures must always be preceded by a patch test and approached with caution.
If you have any questions about cosmetic treatments that you’d like Dr. Volha to answer, share them with us!
