Not every hyaluronic acid treatment turns out the way it was imagined. Sometimes a lip looks fuller than planned, a filler settles unevenly, or the face as a whole appears heavier than before. This is precisely where hyaluronic acid has a decisive advantage over other filling materials: it is reversible. With the enzyme hyaluronidase – widely known by the brand name Hylase® – hyaluronic acid that has been injected can be dissolved again in a targeted way.
Dr Özdemir performs this correction at his practice in Vienna-Döbling – including cases where the original treatment was carried out elsewhere.
When does dissolving hyaluronic acid make sense?
- Too much volume – lips, cheeks or chin look overfilled or unnatural.
- An uneven result – the filler sits asymmetrically, in strands, or as a palpable nodule.
- Injected too superficially – close beneath the skin, hyaluronic acid can shine through with a bluish tint (Tyndall effect), particularly under the eyes.
- Migration of the material – on the lips in particular, filler moves beyond the natural contour over the years.
- Persistent swelling or nodules that have not settled weeks after the treatment.
- Before rebuilding – a depot that has accumulated over the years can be removed first, so the area can then be rebuilt more sparingly and precisely.
Equally valid: the simple wish to return to your original appearance is reason enough. You do not need a medical problem to ask for dissolution.
Also after treatments at another practice
A large proportion of the patients who come to have filler dissolved were originally treated elsewhere. That is neither an obstacle nor a reason for an awkward conversation – it is a common and entirely normal reason to come.
It helps if you can bring information on which product was used, how much was injected and when the treatment took place. This is often stated on the invoice or treatment record. If those details are not available, treatment is still possible: the assessment is then based on palpation and appearance, dosing is more cautious, and a second session follows if required.
What can be dissolved – and what cannot
Hyaluronidase acts on hyaluronic acid only. All common hyaluronic fillers can be broken down with it, regardless of manufacturer. More heavily cross-linked, particularly firm products require somewhat more enzyme or a second session.
Not dissolvable are permanent and semi-permanent materials – such as silicone oil, polymethyl methacrylate (PMMA), poly-L-lactic acid or calcium hydroxylapatite. They do not respond to the enzyme. If it is unclear what was injected, this is addressed openly before treatment: attempting to dissolve permanent material achieves nothing, and you should not pay for a treatment that cannot work in your case.
How the treatment works
It begins with a detailed consultation and examination of the treated area. Your medical history is taken as well – including any known allergies, since allergic reactions to hyaluronidase are rare but possible.
The treatment itself takes around 15 to 30 minutes. The enzyme is placed with a very fine needle exactly where the hyaluronic acid lies. On request, the skin is prepared beforehand with a numbing cream; an injected local anaesthetic is usually not necessary.
Dosage is the decisive factor. The aim is not to dissolve as much as possible, but exactly as much as needed – on the lips especially, the difference between a balanced correction and a result that looks too empty comes down to a few units. For that reason the approach is deliberately conservative, with the option to refine later.
After the treatment
The enzyme starts working immediately; the breakdown is largely complete within 24 to 48 hours. An initial change is often visible right after the treatment, but the final result can only be judged after two to three days, once the swelling caused by the treatment itself has subsided.
The injection points may show mild swelling, redness and tenderness. As a rule you are presentable again after one to two days. You should avoid sport for about two days, as well as sauna and intense heat.
Where a very firm depot has built up over years, a second session may be required. It takes place no earlier than one to two weeks later, so that the result of the first treatment can be judged reliably.
Rebuilding after dissolution
If you would like filler again after the correction, the usual waiting period is two to four weeks. Hyaluronidase temporarily breaks down part of your body's own hyaluronic acid in the treated area as well – this regenerates by itself within a few weeks. Waiting gives you a more reliable and longer-lasting result.
Consultation in Vienna-Döbling
Not every unsatisfactory result needs to be dissolved. Shortly after a treatment much of what you see is still swelling and settles on its own; sometimes a small addition elsewhere is enough to bring the area back into balance. What makes sense in your case is something we discuss calmly during the consultation – honestly and without time pressure.
