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WhatsApp: 305.317.2091 Ultrasound-Guided Filler Dissolving
Around the eyes, persistent hyaluronic acid (HA) filler can contribute to a range of undesirable visual effects. Sometimes minor and sometimes very noticeable, undissolved HA filler can lead to swelling, contour changes, or an appearance that may otherwise be attributed solely to aging or anatomy. For patients considering oculoplastic surgery, identifying and addressing previous filler is an important part of the treatment plan. At Dr. Sarah Avila’s practice in Miami, we offer ultrasound-guided filler dissolving to help restore your natural facial contours.
Why Dissolve Fillers
Cosmetic issues aside, patients will generally need to dissolve filler before surgery. Doing so is crucial to giving your surgeon a clearer picture of the patient’s underlying anatomy. Most oculofacial procedures will require a fully accurate understanding of your facial structures, including procedures such as
- Lower blepharoplasty
- Upper blepharoplasty
- Eyelid rejuvenation
- Midface procedures
- Fat repositioning or fat grafting
- Facial rejuvenation procedures
How We Dissolve Filler
At Dr. Avila’s oculoplastic practice, we use the Clarius high-resolution ultrasound system to evaluate filler beneath the skin in real time. This imaging technique lets us:
- See the location and depth of existing filler
- Assess surrounding tissues and blood vessels
- Develop a more precise treatment plan
Such an approach is particularly valuable for procedures around the eyes. In this delicate and complex area, even small amounts of misplaced or persistent filler can cause noticeable swelling or contour changes.
For the filler itself, we use hyaluronidase injections, which are the gold standard for breaking down HA fillers. The formula begins working immediately, with the majority of HA filler broken down within 72 hours.
Why Use Ultrasound
Traditionally, HA dissolution has often been performed by feel and based on external anatomy alone. However, the challenge is that filler may not be exactly where we expect it to be. It can persist longer than expected, migrate, or it may sit in a different tissue plane. Using external anatomy as a guideline can lead to incomplete or unbalanced filler dissolution.
High-frequency ultrasound is increasingly used in aesthetic medicine to identify existing filler and guide treatment of filler-related complications. With ultrasound, we can actually look beneath the skin. Using the Clarius device for ultrasound allows us to:
- Identify the presence, location, and depth of filler
- Distinguish filler from surrounding tissue and vascular structures
- Evaluate the anatomy around the eyes before treatment
- Precisely guide treatment to the areas containing hyaluronic acid filler
- Reassess the area after treatment to determine whether additional treatment is
necessary
What Happens During Ultrasound-Guided Dissolving?
Locating the Filler
The process begins with a detailed ultrasound examination of the area. Ultrasound is a fully noninvasive imaging method and involves no radiation. Instead, it uses high-frequency sound waves to map the filler and evaluate the surrounding anatomy, including nearby blood vessels.
Dissolving the Filler
Once we identify the filler, we use ultrasound to guide the needle directly into the area containing the HA filler. A targeted amount of hyaluronidase, an enzyme that breaks down hyaluronic acid filler, is then delivered precisely where it is needed.
Reasses
We can then reassess the area with ultrasound to evaluate the response. When appropriate, we may deem additional treatment appropriate to fully dissolve the filler.
Better Diagnosis. Better Planning. Better Results.
As an oculoplastic practice focused specifically on the anatomy and function of the eyelids and surrounding facial structures, we believe that precision matters especially when treating the delicate area around the eyes. When surgery is ultimately appropriate, ultrasound can give us additional information to develop a more thoughtful surgical plan and establish a more predictable baseline for the result.
Filler Dissolver FAQs
How long does it take for the filler to dissolve?
Hyaluronidase can effectively dissolve HA filler within 24 to 72 hours, resulting in significant volume reduction. Final results can still take 3 days to 2 weeks for residual filler to dissolve.
Are there any side effects?
Some swelling and bruising can occur at the injection sites, similar to when you had filler injected. These are typically limited to a few days and remain mild before resolving.
How many sessions will I need?
Using ultrasound-guided techniques helps us minimize the number of filler dissolver sessions patients need. In many cases, a single visit will be enough. In cases of complex filler distribution, patients may need 2 to 3 sessions.
Does hyaluronidase work on all fillers?
Hyaluronidase will effectively dissolve the majority of fillers available, as they are mostly HA fillers. Fillers that use PLLA (e.g., Sculptra) and some formulations of Radiesse are the most common fillers that are not HA based. Additionally, filler dissolvers do not work on autologous fat injections.
Schedule Your Consultation
If you need fillers dissolved for any reason, you can visit our center in Miami for ultrasound- guided filler dissolving. Schedule your consultation to work with a clinician who will build an individualized plan to break down unwanted filler.
Sarah Avila, MD
Board Certification:
Oculofacial Plastic Surgery
Specialization:
Eyelid Surgery & Aesthetics
Dr. Sarah Avila is a Double Board-Certified Oculofacial Plastic Surgeon in Miami, Florida. After completing medical school, Dr. Avila completed a residency in ophthalmology at the Mount Sinai Hospital, followed by a highly competitive two-year ASOPRS-accredited fellowship in reconstructive and cosmetic oculofacial surgery at Emory University.
