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There are many different types of dermal or soft tissue fillers, but those used most commonly are the hyaluronic acid based fillers. So why are these the most popular? To put it simply, they are dissolvable. What we mean by that is that hyaluronic acid can be broken down by an enzyme called hyaluronidase. Hyaluronidase is a prescription only medication, so it is vital that you go to a medical professional for these treatments. Any practitioner injecting dermal filler should have hyaluronidase in their emergency kit, don’t be afraid to check this with them.

So why is it good to use a filler that can be dissolved? There are 2 main uses of hyaluronidase: in an emergency (such as a vascular occlusion), and in an elective dissolve. Although rare, vascular occlusions are the most serious complication of dermal filler treatments. This occurs when filler is injected into a blood vessel, it acts like a clot and and blocks any further blood flow. This means that tissues relying on blood supply from this vessel will be starved of oxygen, and will die. Early recognition and treatment of vascular occlusions is essential to prevent long term scarring or tissue loss.

Elective Dissolving

Elective filler dissolving is different, and often used to reverse poorly placed, or migrated filler. It can also be used to dissolve fillers in those that have changed their mind about the procedure. However it is important to note that hyaluronidase is an enzyme not a magic potion, and although we commonly refer to it as “dissolving” it does not actually do this. The enzyme acts by breaking the bonds between the hyaluronic acid molecules (both in the filler AND in your own skin). Once the particles are smaller, the body can break the remainder down more easily, however some may remain.

We most commonly see patients wanting to dissolve the fillers in their lips, due to lumps or filler migration. More recently there has been a movement towards having a more natural look, with many celebrities like Molly Mae getting their over-filler lips/jawlines/cheeks, etc. dissolved so that they can start again with more natural fillers.


Before having an elective dissolve, you will need to undergo a patch/skin prick test to rule out allergy. Anyone with a severe allergy to bee stings (which contain hyaluronidase) should carefully consider having dermal fillers, as they will not be able to dissolve in an emergency or as an elective procedure. The patch test takes around 20 minutes, and is usually carried out on your forearm. In an emergency dissolve, patch tests are not required.