Reversing Facial Fillers: Where, How and How Often?

There are a large number of facial fillers on the market and they are becoming immensely popular. Although, not quite as popular as Botox, they are quickly becoming the "next biggest thing." Although there are millions of women and men doing this, for those that are newer to this, you are probably wondering the following:

Should I do this? Who should I let do the injection? What are the risks? And if I hate it, can I reverse it?

Let me preface my comments by saying that I have always done all of my own injections for fillers and Botox for my patients. I know many places use estheticians and other doctors that are not plastic surgeons (even dentists). Most of the time, this is probably fine but there is a lot to be said for having an experienced plastic surgeon do your injections. But ultimately, that is your decision, based on your comfort level.

Not all facial fillers are reversible. Only those that are made from hyaluronic acid can be reversed. The good news is that all the facial fillers that I use are made from hyaluronic acid: namely Juvaderm and Voluma, and their associated families of products. This also applies to Restylane and Perlane and that entire family of fillers. This does not apply to Radiesse or Sculptra, which are made from a completely different material.

When a filler is injected, I always tell my patients to massage any firm areas that they may notice during the first week. You can certainly ice an area after an injection, but it is not required. Also, if you are happy with the look after the injection, it will almost certainly stay that way. Everyone gets some water absorption and slight swelling after the filler is injected. I strongly advise everyone to wait 2 weeks after the filler before considering making any changes. Since people sometimes examine the area injected very critically, it is important to realize that there may be subtle differences between the areas injected and along the areas injected (eg the two sides of the lip) that may be noticeable to you at day 2 or 3, but will be fine by day 14. The important thing to note here is to not be in a rush to make changes in the first two weeks!

I believe the main advantage of knowing that your filler is reversible is having peace of mind that you are not "stuck" for many months or years with the filler if you end up not really liking it. The practical side is that you are very unlikely to even need it reversed. You should also know that if you inject the reversing agent, it may dissolve ALL of the filler injected into that area, which you may not want. It is not an exact science and we cannot control exactly how much of the filler will melt away with the reversing agent.

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