At Fresh Faces Rx, we love hyaluronic acid (HA) fillers—they’re versatile, effective, and reversible. That last point is key: unlike permanent or semi-permanent products, HA fillers can be dissolved safely using an enzyme called hyaluronidase (brand name: Hylanex).
Whether you’ve experienced filler migration, overcorrection, puffiness, or just want a fresh start, dissolving filler isn’t a failure—it’s a form of refinement. And we’re here to explain exactly how it works.
What is Hylanex (Hyaluronidase), and How Does It Work?
Hylanex is an enzyme that breaks down hyaluronic acid, the same material used in most dermal fillers (like Juvederm, Restylane, and RHA). It’s been used in medicine for decades to increase tissue permeability and drug absorption. But here’s what most people don’t realize: Hylanex isn’t just cosmetic—it’s also a lifesaving drug in other medical contexts.
Used in NICUs and Emergency Care
In neonatal intensive care units (NICUs), hyaluronidase is used to treat IV infiltration injuries in premature infants—some weighing as little as two pounds. It helps disperse IV fluids trapped under the skin, preventing tissue damage in the most delicate patients. This means the safety data is extensive—far beyond what most aesthetic patients are told. When used correctly, Hylanex is not only safe, but tissue-protective.
Will It Destroy My Tissue or Collagen?
This is a common fear—and a common myth. Hyaluronidase is selective to hyaluronic acid. It doesn’t break down your natural collagen or elastin. In fact, dissolving unwanted filler can stimulate collagen remodeling, especially in areas like the lips, tear troughs, or under-eyes, where chronic puffiness can block circulation and lymphatic drainage. We’ve seen patients’ lips and eyes look better post-dissolving—healthier, less puffy, more defined.
Dissolving: What It’s Really Like
We use advanced techniques—including ultrasound-guided injections—to precisely target migrated or misplaced filler. This is especially helpful for complex areas like the tear troughs, where filler can migrate over time or be misinjected. We also buffer and dilute Hylanex for increased comfort and control. This makes the treatment well-tolerated for most patients, especially when we’re just gently touching up an area (like softening a migrated lip edge) rather than dissolving everything. In some cases—especially in long-standing or heavily cross-linked filler—we may need 2–3 sessions to fully clear the area.
Why Does Filler Migrate in the First Place?
Migration isn’t always due to a “bad injection.” Over time, fillers—especially more cohesive or cross-linked types—can move along muscle paths or areas of low resistance. Think of it like toothpaste moving inside a balloon.
This is common in areas like:
– Lips (above and below the vermillion border)
– Tear troughs (spreading toward the mid-cheek)
– Nasolabial folds
– Jawline or chin
Migration is not your fault. It’s not shameful. It’s just tissue dynamics—and it’s completely normal to dissolve and reset. Dissolving Doesn’t Mean Erasing Everything
We can use Hylanex:
– To refine or “spot dissolve” a specific area (like a lip shelf or filler lump)
– To blend areas with minor asymmetry
– Or to fully dissolve and start fresh
– Dissolving is not a punishment. It’s a powerful tool in the hands of an ethical, trained
injector.
What to Expect: Before + Aftercare
Swelling and bruising are very common and expected, especially in delicate areas like the lips or under-eyes. You may look more puffy before you look better. The filler will dissolve quickly—usually within 24–72 hours—but the tissue may take a few weeks to fully settle.
Prepare for:
– Swelling for 2–5 days
– Possible bruising
– A temporary “deflated” appearance in areas where filler was removed
– We’ll help guide you through your timeline and give you clear recommendations on when (or if) to re-treat.
Contraindications to Hylanex:
– Allergy to hyaluronidase or wasp venom (they share enzymes)
– Known sensitivity to bovine or ovine (animal-derived) proteins (in older versions—most modern products are recombinant and safe)
– Current infections or inflamed treatment area. If you’re unsure, we’ll conduct a full medical history review and patch testing if needed.
Hylanex is More Than Cosmetic—It’s Emergency Medicine
Any clinic that injects dermal filler should always have a sufficient supply of Hylanex on hand. In the rare but serious event of a vascular occlusion (when filler blocks a blood
vessel), hyaluronidase is the first-line emergency treatment. At Fresh Faces Rx, we always have at least 16 vials in stock—ready for treatment, reversal, and safety.
Because we don’t just enhance beauty—we protect it. Let’s Normalize Dissolving. Dissolving doesn’t mean something went wrong. It means we’re paying attention. It means we’re evolving. And it means your results are still under your control. Your face isn’t fixed. It’s fluid. And you deserve care that adjusts with you. If you’re unsure about your current filler, or curious whether dissolving might help, let’s talk. There’s power in the reset.
✨ Fresh Faces Rx | Portland & Lake Oswego’s Top MedSpa
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✨ Dr. JoDee M. Anderson, MD, a leading aesthetic medicine expert, is dedicated to natural
beauty, longevity, and precision-based treatments at @FreshFacesRx. Our licensed professionals
specialize in Botox, fillers, and non-surgical facial rejuvenation to enhance confidence while
prioritizing patient safety and ethical aesthetics.
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