As it turns out, fillers are kind of like tattoos. (Kind of.)
When Courteney Cox mentioned in an interview last week that she dissolved all the fillers in her face, we had one major question: how? For the answer to that, The Lookbook turned to New York plastic Surgeon and RealSelf contributor Dr. David Shafer. He’s a national peer trainer for Botox and dermal fillers and he’s appeared on The Real Housewives of New York City. Every week in his practice, he has consultations with patients who want to remove the fillers they’ve gotten from another doctor.
“The vast majority of people that have fillers out there do look natural, do look normal,” he says. “It’s when you have some anomaly happen with somebody or they went to somebody who wasn’t trained very well. That’s when people get into trouble with it.” But luckily, some types of fillers can be reversed almost immediately. Confused? So were we, so we asked all our most pressing questions. Read on!
1. Wait, why does filler dissolve?
Hyaluronic acid filler (the kind that’s injected in cheeks or lips) is derived from a natural molecule you already have in your skin that provides hydration or moisture. “The only difference is in the laboratory they connect them by these chemical bonds, that’s what makes it stay in it shape while it’s in your body,” explains Dr. Shafer. “But over about eight months to two years, your body starts to metabolize it and break apart those bonds and then you just absorb it like you would your normal natural hyaluronic acid.”
2. How do you dissolve fillers on purpose?
Folks who don’t want to wait around for fillers to dissolve — like Courteney — can speed up the process. In the past four years or so, doctors have started to inject an enzyme that breaks the chemical bonds in the hyaluronic acid filler. “It’s breaking apart the gel under the skin and your body just absorbs it like it would your own natural hyaluronic acid that you normally have under your skin,” Dr. Shafer says.
3. What’s the process like?
Dissolving fillers happens fast: the enyzme is injected into where the filler is with a teeny, tiny needle. “It’s not a painful procedure,” says Dr. Shafer. “Usually patients say they feel a little bit of warmth or tingling in the area as the enzyme’s working.” He’ll often see a result right away, but it could take up to 24 hours to work completely. He then recommends that patients make another appointment two days after the injection for a reevaluation to see if they need a little more melting.
4. How much does it cost?
Dr. Shafer doesn’t charge his patients to dissolve fillers he’s injected, but the procedure starts at $400 per treatment for new patients.
Frequently Asked Questions
Hyaluronic acid fillers dissolve because they are made from a natural molecule found in your skin that provides hydration. In the lab, these molecules are chemically bonded to maintain their shape, but over 8 months to 2 years, your body metabolizes and breaks these bonds, absorbing the filler naturally.
Fillers can be dissolved quickly by injecting an enzyme that breaks the chemical bonds in hyaluronic acid fillers. This enzyme breaks apart the gel under the skin, allowing the body to absorb it just like natural hyaluronic acid, speeding up the dissolution process.
The procedure involves injecting a small amount of enzyme into the area with a tiny needle. It is generally not painful, with patients feeling slight warmth or tingling. Results can be seen immediately or within 24 hours, and a follow-up appointment is recommended to assess if additional treatment is needed.
The cost to dissolve fillers typically starts at around $400 per treatment for new patients. Some doctors, like Dr. Shafer, may not charge to dissolve fillers they originally injected themselves.
No, only hyaluronic acid fillers can be dissolved with enzyme injections. Other fillers like Radiesse and Sculptra, which are made from different materials, cannot be immediately dissolved and may require waiting for them to wear off or other treatments.
If a non-hyaluronic filler like Radiesse, Sculptra, or off-market substances such as silicone need removal, enzyme injections won’t work. Patients may have to wait for the filler to naturally degrade, undergo surgery, or pursue other treatments to camouflage or remove the filler.
Researching your doctor ensures you receive treatment from a trained professional who uses appropriate techniques and products. This reduces the risk of unnatural results or complications and avoids the need for corrective procedures later on.
Unnatural results often occur when patients see untrained providers or undergo excessive treatments pushed by doctors or peer pressure. This can lead to a loss of perspective on what looks natural, resulting in overdone appearances.
Radiesse fillers last about one to one and a half years, while Sculptra fillers last approximately two to three years. Both are made from materials that stimulate collagen or provide structural support but cannot be dissolved quickly like hyaluronic acid fillers.
During the enzyme injection to dissolve fillers, patients may feel a slight warmth or tingling sensation in the treated area. The procedure is generally not painful and is performed with a very small needle.
Fillers injected in unregulated or informal settings may be difficult to dissolve if the type of filler is unknown or not hyaluronic acid. In such cases, enzyme injections may not work, and patients might need to wait for natural degradation, have surgery, or seek other treatments.
