02 Jun Are fillers and botox permanent or can fillers be removed

In our clinic, we can get patients who have had filler elsewhere and are unhappy with the results. This is often the case for filler in the tear trough used to correct dark circles under the eyes (see blog on dark circles under the eyes), overfilled cheeks and lips that are either overfilled or appear uneven.

• Hyaluronic acid (HA)

  The most popular fillers are made of hyaluronic acid (HA) which is a component of many cells in our body.It is a clear gel and contains these HA molecules that are linked to each other.

• What is hyaluronidase?

  The ‘antidote’ is called hyaluronidase, it is an enzyme which cuts the links between these molecules and allows them to break free and be dissolved in our body. The effects start immediately and continue for a few days. Some type of hyaluronic acid have more links than others and so it can take more hyaluronidase or more time to dissolve them.

  Hyaluronidase comes in a few forms and concentrations, the most commonly used ones are made from a bovine source. There is a potential for allergic reactions even if this is rare, so we usually perform a skin test with a small quantity on the forearm and wait 15 minutes to see if there is a reaction. If there is no reaction we can proceed to dissolving the hyaluronic acid filler on the face or elsewhere.

• Radiesse and Sculptra

  Other fillers such as Radiesse have two components, one of them being a gel and the other calcium hydroxyapatite which is a biological stimulant of the skin and tissues, these respond less readily to injections of hyaluronidase.

  Sculptra is made of small molecules of Poly L Lactic acid, the same substance suture material is made from, this product is a pure bio stimulant that works gradually over time after multiple injections, it does not respond to hyaluronidase.

• Botox

  Botox injections last for 3 months and usually require an adjustment to balance out the muscles rather than a reversal of the effect. In the case of a droopy eye, Iodipine eye drops will directly stimulate the muscles of the eye to open, the effect is immediate. It is typically used for a few weeks until the problem goes away.