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Dissolving Dermal Fillers

Our injectors at Cutis Dermatology Brisbane have the experience to deal with adverse filler events, including emergency and elective dermal filler reversal. We can handle all cases from simple misplaced fillers, through to complex lumps, nodules, & filler reactions. Hyalase or hyaluronidase is the reversal agent for hyaluronic acid dermal fillers. 

Key Points

  • Most cases of filler lumps will settle within 12-14 days of injection
  • For emergency cases (filler in an artery) go through AMET or your injector 
  • Urgent cases are seen by our dermatologists within a few hours
  • For misplaced filler or filler migration our injectors can dissolve most cases of hyaluronic acid fillers
  • For permanent-semi-permanent fillers, our dermatologists can MRI the area & action accordingly

Dermal Filler Dissolving at a glance

For: Dissolving dermal filler
Procedure time: 15 minutes
Duration of results: Permenant
Back to work: 1-2 sessions
Recovery: 0-4 days
Anaesthetic: Numbing within Hyalase
Your specialist: Nurse injector, dermatologist
How much: $- $$

Our results speak for themselves


Why choose Cutis Dermatology Brisbane for dermal filler reversal?

Because Cutis is the draining centre for all complex filler reactions in Queensland. Our dermatologists sit on the AMET Emergency Board, & we consult for Laser Clinics Australia. 

Our team of dermatologists & nurse injectors are the go-to clinicians for all the bad things that can & do happen with dermal fillers.

How soon can you have dermal fillers reversed?

If it is not acute, namely if it’s not in an artery, leave it 12-14 days. You would be surprised how many cases settle down with time. 

Your injector can guide you as to their protocols, soft tissue massage can settle lumps if it’s within 7-10 days from it was performed.  

Do we reverse fillers from other clinics?

Yes, we do several times a week. We have skills needed to perform this treatment correctly. If you had dermal filler injections at another clinic and are unhappy with the results, we can help. 

You could start by knowing what product was placed, the date it was done, & if possible, the amount in mls. or syringes. It helps. 

Which areas are usually treated with dermal filler removal agents?

  • Overfilled lips
  • Overfilled cheeks
  • Overfilled creases and wrinkles
  • Uneven results, lumps under the skin
  • Tiny lumps beneath the skin
  • Prolonged swelling e.g., tear troughs / under eyes
  • Tyndall (blue tear troughs)

What happens in an arterial occlusion?

Your first point of contact is your injector. They will either action the event or move it up the chain. They may contact AMET response advice network, & if appropriate they will personally contact our specialist dermatologists. From there things move very quickly.

If your injector requires some advice, their first point of contact is usually the supervising physician. 


How does dermal filler reversal work?

Hyaluronic acid fillers get broken down by an enzyme called hyaluronidase or Hyalse. This enzyme comes in an ampoule & requires mixing. All injectors will have this enzyme in their fridge. 


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We can handle all cases from simple misplaced fillers, through to complex lumps, nodules, & filler reactions. 

How many sessions will you require?

1-3 depending on the clinical scenario. Small foci of HA fillers only require one session. Granulomas & arterial occlusion will require between 2-4 sessions. Spacing between sessions depends on the clinical indication. Resistant areas include the tear troughs.

Who performs the procedure?

Our nurse injectors are super experienced. Our consultant dermatologists are involved in:

  • Complex cases of granulomas, inflections, & weird reactions
  • Emergency reversal of filler in an artery
  • Management of filler nodules resistant to hyaluronidase that may necessitate the use of anti-inflammatory agents &/or chemotherapy

Cutis Dermatology Brisbane is the tertiary referral centre for dermal fillers complications in Queensland.

What is the go with bee stings & hyaluronidase?

If you are allergic to bee stings, you will probably react with hyaluronidase (as bee & certain wasp stings have this enzyme). 

  • If you have an anaphylactic reaction to bee stings requiring adrenaline, this procedure cannot be performed in rooms. It must be done in a hospital by an allergist with resuscitation facilities nearby. Dermatologists are awful at managing blocked airways due to swelling.


  • If you just get swelling, we will cover you with anti-inflammatories & antihistamines prior to the procedure. You may swell up, but only for 12 to 24 hours. Hopefully.

What will I look like after the procedure?

If it’s a small area, for example a nodule on the lip or a focal area of filler, there’s minimal recovery time. If you have a high volume of filler, you can be bruised & swollen for a few days. Our injectors will warn you prior to the procedure.

How do we treat the Tyndall effect, namely blue under eye filler?

Tyndall is very common. Our injectors see cases from other clinics at least 3-4 times a day. It is due to the scattering of light through the skin in areas such as the undereye, though it can occur if-

  1. Filler is placed too superficially. 
  2. Filler is placed deep but migrates. 
  3. A filler with a high concentration of hyaluronic acid is used 

For TT or tear trough filler, the only way to treat Tyndall is to dissolve the filler under your eyes. You may require between 1-3+ sessions, spaced 10-14 days apart. 

Will I re-Tyndall if I have the tear trough refilled again?

You might, however our injectors are very careful in product placement & selection. If you have thin skin, there is every chance you will Tyndall again. 


In cases like these, our dermatologists can work around this with a wash of hyper dilute collagen stimulating fillers. They don’t Tyndall, but they take 3-4 months to have optimal results. 

Will hyaluronidase dissolve some of my natural collagen?

Yup, in theory. We are however very careful in placing the dissolving agent within a specified area. The amount needed depends on the clinical picture. 

The more focused & dilute the hyaluronidase, the more treatments required. 

When can I get filler again?

10-21 days later, after everything settles. Remember if you Tyndall with filler under your eyes, it may be because your skin in that area is very thin. 


Our injectors will guide you through the correct product, placement & candidate selection. 

Will I get the same reaction?

Possibly, but probably not. 


It depends on:

The type of filler used

  • Whether you have a true ‘allergy’ or just a cross reaction
  • Your immune system & health 
  • Your anatomy & histology (eg. thin skin in the TT area as discussed prior)
  • The product placement (depth, amount etc.)

How do I get started?

Possibly, but probably not. 

We suggest you see our nurse injectors. They are very experienced in reversing fillers. For more complex dermal filler reversal, you can see our senior procedural dermatologists. 

Ask us more about this treatment

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