Hyaluronidase · Ultrasound first · Staged doses

Filler Dissolving Singapore

How hyaluronidase works, and what it cannot do

Hyaluronidase breaks down hyaluronic acid filler, and nothing else. Dr Sin Yong scans the area first, places a small dose into the filler he can see, reviews it, and adds more only where filler remains.

Book a ConsultationLearn More
Hyaluronic acid
The only filler it dissolves
Skin test
Before any planned dose
Small dose
Then review at 48 hours
2 weeks
Before any refilling

In Brief

Filler dissolving uses hyaluronidase, an enzyme that breaks down hyaluronic acid filler. It does not act on Sculptra, Ellansé, Radiesse or fat. Dr Sin Yong does a skin test, scans the area with ultrasound, places a small dose into the filler he can see, and reviews it at about 48 hours before adding more.

At a Glance: Filler Dissolving Singapore

What dissolvesHyaluronic acid filler, broken down by the enzyme hyaluronidase.
What does notPoly-L-lactic acid, polycaprolactone, calcium hydroxylapatite, fat and permanent fillers.
UltrasoundShows the depth and size of the filler and nearby vessels, and whether it looks like hyaluronic acid.
Allergy checkEarlier reactions and bee or wasp sting allergy are asked about, and a skin test is done first.
DosingA small first dose, a review at about 48 hours, and more only where filler remains.
RefillingNo sooner than two weeks, once swelling has settled.
EmergencyA blocked blood vessel is treated with a separate protocol, urgently.

What the Research Shows: Filler Dissolving

  • Published guidance covers the use of hyaluronidase in dissolving filler, including a modified high-dose protocol for vascular occlusion. [1] [2]
  • A 2023 comparative case series of 39 patients with vascular events after filler reported a mean of 122.5 IU of hyaluronidase with ultrasound-guided targeting. Targeting followed flooding, at a mean of 1519.4 IU, that had brought little or no improvement. [3]
  • MRI found hyaluronic acid filler still visible in all 33 patients at least two years after injection, and in one case up to 15 years. It was a small, selected group. [4]
  • Polylactic acid and calcium hydroxylapatite are not broken down by the enzyme, and are cleared by other, slower processes. Non-absorbable fillers stay. [5]

Figures describe published study groups, which may have used other devices or protocols. They do not predict your result. Updated 6 November 2026.

Urgent: skin turning white, grey or mottled, or pain that is getting worse after filler, can mean a blocked blood vessel. Go to the doctor who injected you or to A&E now. A change in vision or eye pain after filler, difficulty breathing or swelling of the tongue or throat: call 995. See the warning signs.
About This Treatment

What hyaluronidase is

Hyaluronidase is an enzyme that breaks the long chains of hyaluronic acid into small fragments, which the body clears. Injected into hyaluronic acid filler, it softens and reduces the gel. It starts working soon after it is placed and keeps acting for a while afterwards.

The material decides everything. Hyaluronidase breaks down hyaluronic acid and nothing else, so the first question is what was injected. If you are not sure, ultrasound often helps to show it.

Where the filler cannot be dissolved, the plan is different. See filler correction for what each material needs.

Why the dose is not fixed

The dose is not a set number of units. For a non-urgent correction, Dr Sin Yong places a small dose directly into the excess, reviews it, and adds more only where filler remains. The aim is to avoid leaving the face hollow.

An emergency is different. A blocked blood vessel is treated with a separate high-dose protocol, and it is not booked as an appointment.

Why ultrasound comes first

Ultrasound shows where the filler sits, and it can suggest whether it is hyaluronic acid. [6] [7] It also shows how much of it there is, and nearby blood vessels. The enzyme can then be placed into the filler, not around it. In faces with years of filler, the scan often finds product that nobody remembered.

Dr Sin Yong performs the scan himself. If the scan shows something other than hyaluronic acid, the plan changes before anything is injected.

The visit, in order

01
History
What was injected and when, any earlier reactions, and any allergy to bee or wasp stings. Non-urgent dissolving is usually deferred in pregnancy and breastfeeding, and an infection or cold sore near the area is settled first.
02
Skin test
A small test is done first, and you are watched for a reaction.
03
Ultrasound
He scans the area to find the filler and measure it.
04
First dose
A small dose is placed into the filler he can see, in the area that needs it.
05
Review
At about 48 hours, once the enzyme has acted and the swelling has begun to settle.
06
Further dose
More is added only where filler remains. Refilling, if it is wanted at all, waits at least two weeks.

Dissolve, wait or do nothing

Dissolve

Hyaluronic acid that looks heavy, puffy, lumpy or has moved, where you want it gone.

Wait

Filler injected in the last few weeks, because swelling can look like excess. A blocked vessel is the exception.

Do nothing

Filler that bothers you little. Dissolving is a medical step, and leaving it can be a fair choice.

A different plan

Material the enzyme does not touch. See Ellansé and Sculptra lumps.

Filler dissolving by area

Lips

Lips often look lopsided at first and then settle. See lip filler.

Under the eye

Skin is thin here, so doses are small and placement matters. See tear trough.

Cheeks and mid-face

Layers are common here, and earlier filler often sits deep. See pillow face treatment.

Chin and jaw

Check what was used first, because these areas often hold calcium hydroxylapatite or other stimulators. See chin filler.

Nose

The area carries particular vascular risk, so it is mapped with care. See nose filler.

After filler dissolving

Swelling, redness, itch and small bruises at the injection points are common, and they usually settle over days. The area can look uneven before it settles. The result is first assessed at about 48 hours.

See a doctor the same day, or go to A&E if none can see you, for swelling that spreads or hives. Pain that is getting worse needs the doctor who injected you or A&E now. Difficulty breathing or swelling of the tongue or throat: call 995. See filler aftercare.

If dissolving did not seem to work

When filler seems to remain after hyaluronidase, there is usually a reason. The material may not be hyaluronic acid. The enzyme may not have reached a deep or dense deposit. A staged dose may not have been reviewed yet. Or the fullness may be swelling, fluid or your own tissue.

A second look starts with ultrasound, not with another dose. Having tried other treatments does not mean nothing more can be done. Read about a second opinion.

What dissolving cannot do

Dissolve other materials

It has no effect on PCL, PLLA, PDLLA, CaHA, fat or silicone.

Tighten skin

Skin that was stretched by filler does not tighten because the filler has gone.

Promise your earlier face

Ageing has carried on while the filler was there, and removing it can show that.

Choose exactly what goes

It can also act on your own hyaluronic acid, which is why doses are small.

Risks and side effects

Common

Swelling, redness, itch, bruising, and a temporary uneven look.

Allergy

Uncommon but can be serious. This is why history is taken and a skin test is done first.

Over-correction

An area can look hollower than you want, particularly if much is dissolved at once.

Infection and vessels

Any injection carries a small risk of infection, or of bruising from a vessel.

What affects the fee

Fees are not published here. They depend on the areas, the extent of ultrasound mapping, how much is dissolved and how many stages the plan has. A written quote follows the assessment.

Frequently Asked Questions

It is an enzyme that breaks down hyaluronic acid, including hyaluronic acid filler. Injected into the filler, it softens and reduces the gel, and your body clears the fragments. It keeps working for a while after it is placed, so the effect is judged at review and not on the day.
Only hyaluronic acid. That includes most lip and under-eye fillers and many cheek, chin and nose fillers. Sculptra, Ellansé, Radiesse, the PDLLA in Juvelook, grafted fat and permanent fillers are not dissolved by it, and they need a different plan.
It is a medical treatment with risks. Swelling, redness, itch and bruising are common. Allergic reactions are uncommon but can be serious, so your history is taken and a skin test is done first. Too much enzyme can also leave an area hollower than you want.
The enzyme starts acting soon after it is placed and keeps acting for a while, and injection swelling can hide the change at first. The area is reviewed at about 48 hours, and any further dose is decided then. The area can look uneven before it settles.
Yes, it comes first. Ultrasound shows where the filler sits, how much there is, and whether it looks like hyaluronic acid, so the enzyme can be placed into the filler and not around it. Dr Sin Yong scans the area himself before he treats it.
The enzyme can act on your own hyaluronic acid as well, but the body replaces it over time. This is one reason he starts with a small dose placed into the filler, reviews it, and adds more only where filler remains.
Not straight away. Refilling waits at least two weeks, until swelling has settled and the face can be read properly. Often the better question is whether more filler is needed at all, and many people decide that it is not.
The filler may not be hyaluronic acid, the enzyme may not have reached it, or the fullness may be swelling, fluid or your own tissue. A staged dose may also not have been reviewed yet. A second look starts with ultrasound, not with more enzyme.
No. A suspected blocked vessel is an emergency and has a separate high-dose protocol. Skin turning white, grey or mottled, or pain that is getting worse, needs the doctor who injected you or A&E now. A change in vision or eye pain: call 995.
SY
Dr Sin Yong
MBBS (NUS) · MRCS (Edinburgh)
MSc Aesthetic Medicine (QMUL) · MSc Practical Dermatology (Cardiff)
Aesthetic physician registered with the Singapore Medical Council.

Find out what can be dissolved

Dr Sin Yong will scan the area and explain what is there before anything is injected.

WhatsApp the Clinic

References

  1. King M, Convery C, Davies E. This Month's Guideline: The Use of Hyaluronidase in Aesthetic Practice (v2.4). J Clin Aesthet Dermatol. 2018;11(6):E61-E68. View source · PMID 29942426
  2. Murray G, Convery C, Walker L, Davies E. Guideline for the Safe Use of Hyaluronidase in Aesthetic Medicine, Including Modified High-dose Protocol. J Clin Aesthet Dermatol. 2021;14(8):E69-E75. View source · PMID 34840662
  3. Schelke LW, et al. Ultrasound-Guided Targeted vs Regional Flooding: A Comparative Study for Improving the Clinical Outcome in Soft Tissue Filler Vascular Adverse Event Management. Aesthet Surg J. 2023;43(1):86-96. View source · DOI · PMID 35951759
  4. Master M, Azizeddin A, Master V. Hyaluronic Acid Filler Longevity in the Mid-face: A Review of 33 Magnetic Resonance Imaging Studies. Plast Reconstr Surg Glob Open. 2024;12(7):e5934. View source · DOI · PMID 39015357
  5. Wollina U, Goldman A. Spontaneous and induced degradation of dermal fillers: A review. J Cutan Aesthet Surg. 2024;17(4):273-281. View source · DOI · PMID 39649762
  6. Wortsman X. Identification and Complications of Cosmetic Fillers: Sonography First. J Ultrasound Med. 2015;34(7):1163-72. View source · DOI · PMID 26112618
  7. Schelke L, Harris S, Cartier H, et al. Treating facial overfilled syndrome with impaired facial expression—Presenting clinical experience with ultrasound imaging. J Cosmet Dermatol. 2023;22(12):3252-3260. View source · DOI · PMID 37772766

Studies may involve other devices or protocols, and they do not predict your own result. See our evidence library and editorial policy.

Related Treatments

Last updated 6 November 2026. General information only. Results vary between individuals.