Getting fillers dissolved? Here's what to expect

Celebrities like Amy Schumer and Courteney Cox have been open in recent years about getting their facial fillers dissolved in favor of a more natural look. And if you're considering going down the same route, there are a few things to keep in mind before going through with it, experts say.

"Probably the biggest reason is just a different choice of aesthetic or recommendations of a new person who's treating them," Dr. Evan Rieder, a board-certified dermatologist and psychologist in New York City, tells TODAY.com.

In the same way "bell bottoms go out of style and skinny jeans come into style, people are doing this now with fillers," he explains. While many people used to want an "overfilled" look, the public seems to be gravitating towards a more toned-down style these days, he says.

The other major reason people have fillers dissolved is that something didn't go as expected during the injection process. And in rare cases, that can be a medical emergency.

For instance, the filler may have "inadvertently been injected into a blood vessel or close to a blood vessel, and that is an immediate problem because it can result in tissue loss," Dr. Ivona Percec, associate director of cosmetic surgery at Penn Medicine, tells TODAY.com.

"Even worse, if it travels to the vessel that supplies the blood to the eye, it can cause blindness in very rare instances," she adds.

Whether you have aesthetic concerns or medical concerns, it's worth it to check with your provider about potentially getting your filler dissolved. Depending on the issue, the type of filler and the area of your face, you may have a lot of options.

What types of fillers can be dissolved?

Only fillers made with hyaluronic acid can be dissolved (known by brand names Juvederm and Restylane, for instance). The hyaluronic acid they contain is a "synthetic version of what's normally found in our dermis," Rieder explains, and it gives the skin its plumpness.

Hyaluronic acid fillers can be quickly dissolved with the injection of an enzyme, hyaluronidase, which "breaks down hyaluronic acid into smaller particles so that your body can absorb it quickly," Percec explains. We also naturally make hyaluronidase in our bodies, which is why fillers degrade over time on their own, she says.

Without hyaluronidase injections, fillers typically last between six months and a few years depending on the product and the area of the face.

Other non-hyaluronic acid fillers can't be reversed with this enzyme — and, in many cases, can't be reversed at all. (But they're still made to be temporary and will naturally wear off over time.)

The vast majority of people are getting hyaluronic acid fillers “because they do have the best safety profile in terms of reversibility,” Rieder says.

What is the process like?

The process for dissolving fillers depends on the reason you're getting them dissolved. If it's not a medical emergency, getting fillers dissolved is typically a simple procedure that can be done gradually or in a single appointment.

For instance, after the swelling and bruising have subsided, maybe you don't like the look of your filler. "Let's say a cheek is too full or a lip is too big and you waited the appropriate amount of time to pass, then you can ask your provider to dissolve it," Percec explains.

With their guidance, you may be able to have dissolved all at once or over the course of a few appointments.

“We use it to fine-tune things,” Rieder explains. If someone has a “tiny little nodule, or a filler goes into a place where it’s not supposed to go,” the provider can dissolve it for more precise results, he says. And if you don't want to completely dissolve your filler, your provider may also dilute the enzyme to just "take it down a notch," Percec says.

But if it's a medical emergency, "it's a lot of needles, and it's a lot of hand-holding," Rieder says. People typically notice those serious issues during the appointment, while waiting in the office after the injection or that night at home, Percec says, so it can generally be resolved quickly.

How soon can you dissolve fillers after getting them?

You can dissolve filler immediately, which is what happens in those rare emergency situations, Percec says.

But, outside of medical emergencies, she recommends giving your new filler about a month to settle before deciding whether or not you like the results.

“The worst thing you can do for your tissues is to play this yo-yo game where you’re constantly putting in filler and dissolving it,” she says. “Going back and forth is really traumatizing (for your skin).”

How long does it take to see results of dissolving fillers?

You'll start to see results almost instantly, the experts say. But it may take a few days to weeks to see the full results.

If you have an actual lump that you're trying to get rid of, "you can feel and see it (dissolve) immediately," Percec says. "The majority of the effect is immediate, but it continues to improve over the next couple of weeks."

Rieder typically schedules a follow-up appointment two weeks later to make sure everything is going well.

How much does it cost to have fillers dissolved?

The exact cost will likely depend on why you're having it dissolved, the provider you're seeing and the area of the country you’re in.

If there was an issue with the original filler and you're returning to the same provider, they may not charge anything to resolve the problem. In the case of a medical emergency after injecting filler, “I would say most providers don’t charge a fee,” Percec says, “Some providers may also waive the fees for the fillers for that patient for that given session.”

For someone with excessive swelling or an allergic reaction, for instance, "you're less likely to charge them," Percec says, "except for maybe what it costs for the enzyme itself or the use of the room." A fee like that could be around $50.

Even after a thorough discussion before the initial filler injection, sometimes a patient simply doesn't like the way the filler looks. In cases like that, "providers like myself typically find it reasonable to charge the patient a procedure fee, like an injectable fee," Percec explains. "It's not usually nearly as much as what the filler would cost because it requires less skill and the product itself is less costly."

At the high end, Percec says she may charge up to $500 to dissolve filler in a more complex area of the face. Rieder also says most cases will probably be "in the hundreds" of dollars range.

Unfortunately, when patients are coming in to have filler dissolved, it’s not uncommon for them to have lost track of which type of filler and how much they had injected elsewhere, Rieder explains.

That can make it more challenging — and expensive — to reverse the filler.

“I’ll know what technique I use in every patient and which products and how much, so I know exactly what I would have to do to dissolve that product,” Percec explains. “But a patient who’s been injected by somebody else may not know how much, exactly when or what product was used.” They may even have more than one product injected in the same area, she adds.

Rieder agrees: "If you're dissolving someone's work that's not your own, you may be taking on additional liability."

All of that is yet another argument for sticking to licensed providers who you trust and, ideally, can see consistently, the experts say.

This article was originally published on TODAY.com