Will Dissolving My Filler Ruin My Face?

There’s a worrying narrative spreading online about filler dissolving, with some women claiming the procedure has “ruined” their faces or “destroyed” their natural collagen. Headlines warn of permanent damage, and social media is flooded with before-and-after photos showing dramatic and often distressing changes.

But is dissolving filler really as risky as these stories suggest? Let’s separate fact from fiction with some top-level expert input.

For as long as hyaluronic acid fillers have been used in aesthetic medicine, practitioners have been dissolving them with hyaluronidase – an enzyme that breaks down hyaluronic acid gel. It’s considered a safety net for the industry. If fillers are placed incorrectly, cause complications, or simply don’t give the desired result, dissolving offers a way out.

So why are we suddenly hearing horror stories about dissolving ruining faces?

Dissolving filler – the psychological impact 

Gillian Murray, a clinical prescribing pharmacist, aesthetic injector and educator who specialises in aesthetic complications, explains that much of the distress patients experience relates to psychological adjustment rather than physical damage.

“Most of us seek filler because we’re unhappy with something—maybe a small indentation, volume loss, or a sign of ageing,” she says. “Filler works incredibly well at softening those things, but once the change becomes part of our everyday appearance, our original features can be forgotten.”

This creates a perfect storm when fillers are eventually dissolved. “Over time, we not only adapt to our new appearance, but we also continue to age. If filler is removed years down the line, what’s revealed isn’t just our original face—it’s a face that’s changed over time, and that can be hard to reconcile.”

Gillian Murray emphasises that this emotional aspect of dissolving is rarely discussed properly. “Dissolving filler can be incredibly confronting—especially in areas like the under eye or midface, where subtle volume changes have such a big impact. This aspect of aesthetic treatment isn’t spoken about enough, but it can be emotionally very tough for patients.”

The science behind post-dissolving blues

Miss Caroline Wilde, a consultant ophthalmologist and oculoplastic surgeon at The Ezra Clinic in London, has been researching this dissolving-disaster phenomenon along with oculoplastic surgeon Professor Daniel Ezra.   The study on “Post-Hyalase syndrome” (Hyalase is the brand of hyaluronidase that’s most-used in the UK) investigated why some patients are so badly affected by the results of dissolving, and  recently won the “Aesthetic Disruptor” Award at a major industry conference.

After reviewing 90 patients who had undergone filler dissolution, Caroline Wilde discovered some fascinating patterns. Contrary to what you might expect, the concentration of hyaluronidase used made no difference to the outcome. What did matter was the amount of filler patients had accumulated over time.

“Patients who have had large amounts of filler, which had been in their face for a long time, are most at risk of distressing results,” she notes. Part of the problem, she adds, is that most patients have no idea how much filler they actually have in their faces. We now know that filler can last much longer than the year or two previously thought, and if people have had their filler topped up a good deal over the years, a lot of it may still be in place.

Another factor is that filler expands once injected as it absorbs water. When removed, the face loses both the volume of the filler and its hydrating properties, creating a more dramatic change than patients might expect.

Does Hyaluronidase destroy your natural collagen?

This is one of the more persistent myths circulating online – that hyaluronidase somehow “eats away” at your natural collagen, permanently damaging your skin.

Miss Wilde is clear: hyaluronidase cannot dissolve collagen. It may temporarily affect naturally occurring hyaluronic acid in your face, but your body replaces this within 24 hours, so it doesn’t significantly impact your appearance.

“From my experience, it does seem once you’ve dissolved, there is an immediate deflation, but that does tend to bounce back in a week or two,” she says, “so there is some effect but it’s not long lasting.”

Interestingly, hyaluronidase has been used safely in other medical contexts for years. “Hyalase is also used in anaesthetics for local blocks to enhance the spread and diffusion of the anaesthetic through tissue,” Wilde points out, “yet it’s only in aesthetics it has been picked up as an issue.”

A cautionary tale

What all this concern about dissolving does reveals is that filler and dissolving is not something to be taken lightly. Gillian Murray warns that “dermal filler treatment should not be approached with the idea that it can simply be reversed without consequence.”

Both the placement and removal of filler require expertise and careful consideration. “It should be carried out by practitioners who understand the nuance of treatment —facial anatomy, tissue behaviour, and the appropriate use of the dissolving enzyme,” Murray emphasises.

Caroline Wilde routinely dissolves filler before eye surgery, in order to see the true contours of the eyelid and prevent post-surgical swelling (since filler attracts water) – and talks this through carefully with patients beforehand, just so they know what might happen.  This, she says, “gives patients time to get used to their own face and know its true contours” before surgery – a kind of psychological adjustment period.

What’s the takeaway on dissolving?

Dissolving filler won’t physically “ruin” your face or destroy your collagen. But removing significant amounts of filler that have been in place for years can be emotionally challenging and might show up changes in your face that have happened naturally while the filler was masking them.

If you’re considering dissolving, work with an experienced practitioner who can guide you through both the physical and emotional aspects of the process.