Dissolving Cheek Filler Naturally and with Hyaluronidase
Cheek augmentation with dermal fillers provides a minimally invasive way to restore volume and contour to the midface. But since fillers are not permanent, patients eventually face dissolution of the injected product.
Those unsatisfied with their results or seeking quicker removal have two options: allowing natural dissolution over months or using hyaluronidase to accelerate breakdown in days.
This article explores timelines, procedures, benefits, and considerations of both techniques for dissolving cheek fillers.
Natural Dissolution of Cheek Filler
Hyaluronic acid fillers like Juvederm Voluma and Restylane Lyft are designed to be gradually absorbed by the body over time. But several factors affect the longevity:
Types of Fillers
Denser, more crosslinked Hyaluronic Acid fillers that lift and volumize, such as Voluma, tend to last approximately 9-12 months in the cheeks. Softer fillers like Restylane Silk breakdown quicker in around 6-9 months.
Here's a look into different types of dermal fillers and their typical absorption timelines:
- Hyaluronic Acid (HA) Fillers:
- Juvederm Ultra, Ultra Plus: Lasts 6-12 months, often used for lips and nasolabial folds.
- Juvederm Voluma: Designed for deep injection into the cheek area, lasts up to 24 months due to its dense and highly crosslinked structure.
- Restylane: Includes products like Restylane-L, Silk (for lips), Lyft (for cheeks), and Refyne/Defyne (for laugh lines), with durability ranging from 6 to 18 months depending on the specific product and treatment area.
- Belotero Balance: Integrates into the skin for soft correction of mild to moderate lines, typically lasts about 6-12 months.
- Calcium Hydroxylapatite (CaHA) Fillers:
- Radiesse: A denser filler used for deeper wrinkles and volume loss, particularly in the cheeks and jawline, lasting around 12-18 months.
- Poly-L-lactic Acid Fillers:
- Sculptra: Not a traditional filler, but a collagen stimulator that gradually increases volume through the body's own collagen production, effects can last more than 2 years.
- Polymethylmethacrylate (PMMA) Fillers:
- Bellafill: Offers long-lasting results by creating a scaffold for your own collagen to build upon, with results that can last 5 years or more for the correction of nasolabial folds.
- Autologous Fat Injections (Fat Transfer):
- Duration: Highly variable; some effects may be permanent, though some of the transferred fat may be absorbed in the first few months.
| Filler Type | Composition | Common Use Cases | Duration |
| Juvederm Ultra, Ultra Plus | Hyaluronic Acid | Lips, nasolabial folds | 6-12 months |
| Juvederm Voluma | Hyaluronic Acid (dense) | Cheeks | Up to 24 months |
| Restylane Series | Hyaluronic Acid | Lips, cheeks, laugh lines | 6-18 months |
| Belotero Balance | Hyaluronic Acid | Mild to moderate lines | 6-12 months |
| Radiesse | Calcium Hydroxylapatite | Deep wrinkles, volume loss | 12-18 months |
| Sculptra | Poly-L-lactic Acid | Volume increase, collagen stimulation | Over 2 years |
| Bellafill | Polymethylmethacrylate (PMMA) | Nasolabial folds | 5 years+ |
| Autologous Fat Injections | Fat | Varies | Variable |
Metabolism
Patients with faster metabolisms absorb and degrade fillers quicker. Those with slower metabolisms retain products longer, closer to 12-18 months.
Placement Area
Less mobile areas with minimal muscular activity, like the upper cheeks, retain fillers longer than the lower cheeks near dynamic nasolabial folds.
Injection Amount
The more syringes of filler placed, the longer dissolution takes. Volumes of 2-3 syringes per cheek prolong absorption.
Lifestyle
Factors like smoking, sun exposure, alcohol use, and diet may potentially influence breakdown rates but robust data is lacking.
Overall, most patients can expect cheek fillers to fully dissipate in 9-14 months through natural processes. But duration varies widely from 6-18 months based on individual factors.
Accelerated Dissolution with Hyaluronidase
Injecting the enzyme hyaluronidase rapidly degrades cheek filler for those seeking quicker removal.
What is Hyaluronidase?
Hyaluronidase is an injectable enzyme that breaks down hyaluronic acid. It occurs naturally in the body but can also be synthesized for targeted filler dissolution.
How it Works
Injected into filler deposits, hyaluronidase cleaves the HA molecular chains. This allows the degraded product to dissipate via the body's natural clearance mechanisms.
Speed of Results
One benefit of hyaluronidase is the quick results it provides:
- It starts degrading HA filler instantly upon injection.
- Some initial contour changes visible immediately, but swelling can obscure effects.
- Most filler dissolved within 24 hours, with full results in 1-3 days as swelling resolves.
This allows precise, localized targeting of unwanted filler for rapid improvement.
Benefits
Reasons providers recommend hyaluronidase include:
- Reversing excessive volume or overfilled appearance
- Softening lumps, bumps, and irregularities
- Smoothing asymmetries or correcting poor technique
- Managing rare complications like impending necrosis
- Accommodating changing aesthetic preferences
By accelerating HA degradation, hyaluronidase offers faster filler removal than natural dissolution.
When to Consider Filler Removal
Patients may seek premature cheek filler removal for several reasons:
Overfilled Look
Excessive amounts can sometimes be deposited, leading to an overly augmented, unnatural appearance that patients wish to tone down.
Filler Migration
Gravity, muscle movements, and compression can cause cheek filler to descend into undesired areas like below the eyes.
Lumps or Bumps
Improper injection technique can occasionally cause granulomas, nodules, or bumpiness that patients want smoothed out.
Change of Heart
Patients satisfied initially may later want removal as beauty standards, lifestyles, or preferences evolve over time.
There are no rules governing appropriate timing. Patients bothered enough to request accelerated dissolution can discuss options with their provider.
Important Considerations
While effective for cheek filler removal, hyaluronidase carries considerations:
Consult an Expert
Only properly trained practitioners should perform this technique for optimal safety and results.
Potential Side Effects
Swelling, bruising, redness, and discomfort can occur but typically resolve within a week.
Additional Costs
Dissolving filler with hyaluronidase involves extra costs beyond the original cheek augmentation fees.
Working with properly qualified injectors ensures appropriate patient selection, effective technique, smooth recoveries, and natural-looking outcomes.
Need More Info? Here Are Answers to Top Cheek Filler Dissolution Questions
Can I partially dissolve cheek fillers with hyaluronidase?
Yes, hyaluronidase allows for precise, controlled dissolution. A skilled injector can target specific areas to reduce volume gradually, achieving a more subtle and natural adjustment as opposed to complete removal.
Does dissolving cheek fillers cause skin sagging?
While some worry about sagging, this is typically temporary. If filler was providing significant lift, there might be a period of adjustment while your skin's natural collagen and elastin support rebuilds. Long-term sagging is not usually a concern with hyaluronic acid based fillers.
Is there anything I can do to make my cheek filler last longer?
While some factors are out of your control, certain lifestyle choices may marginally impact filler longevity. These include staying hydrated, using sunscreen diligently, avoiding smoking, and managing stress to potentially minimize breakdown. However, the most significant factors are still the type of filler used and your individual metabolism.
Can Exercise Accelerate the Breakdown of Facial Fillers?
While direct evidence is limited, some believe that regular, intense exercise could potentially accelerate the metabolism of hyaluronic acid-based fillers due to increased blood flow and metabolic rate.
However, the effect is likely to be minimal for most individuals. Maintaining a healthy lifestyle, including regular exercise, is important, and any significant changes to the longevity of fillers due to exercise are not typically a concern.
If you are an athlete or highly active, discuss this with your injector to tailor your treatment plan accordingly.
How long should I wait between getting cheek filler dissolved and having it re-injected?
It's generally recommended to wait at least 1-2 weeks after hyaluronidase to allow swelling to subside fully and the skin to settle. This helps ensure accurate assessment and placement for your subsequent filler treatment.
Can I dissolve my own cheek fillers with hyaluronidase at home?
Absolutely not! Hyaluronidase must only be administered by a qualified medical professional. Attempting at-home injections carries severe risks of complications, including tissue damage, infection, and even blindness.
How to Prepare for and What to Expect During a Hyaluronidase Treatment?
Before undergoing hyaluronidase treatment to dissolve cheek fillers, avoid taking blood-thinning medications and supplements to reduce the risk of bruising.
Inform your practitioner about any allergies, especially bee venom allergies, as hyaluronidase can cause allergic reactions in rare cases.
During the procedure, hyaluronidase is injected into the area with the unwanted filler, and the process is relatively quick, usually taking less than 30 minutes.
Some patients report mild discomfort, swelling, and bruising, which typically subside within a few days. Results can be seen within 24 to 48 hours as the filler begins to dissolve. Follow your practitioner's aftercare instructions closely for optimal recovery and results.
Conclusion
For cheek fillers, patients can either wait 6-18 months for natural dissolution or pursue accelerated removal with hyaluronidase injections.
This rapid-acting enzyme starts degrading HA filler within minutes, achieving noticeable effects in 1-3 days.
While a safe and effective option, hyaluronidase does carry risks like swelling, costs, and potentially over-dissolution.
Careful consideration and consultation with an expert can help patients make the best choice aligned with their aesthetic goals and preferences.
