Dissolving / Correcting Dermal Fillers Under Ultrasound

Dissolution of Dermal Fillers Using Ultrasound

Facial aesthetics is a rapidly growing industry, with dermal fillers being the preferred method for skin rejuvenation and facial enhancement. These injectable substances have a gel-like consistency and plump up the skin by adding volume, smoothing out wrinkles and aging lines, and reducing the appearance of scars.

Fillers are typically used in areas like the lips, cheeks, chin, and under the eyes. Dermal fillers come in different categories based on their ingredients, such as hyaluronic acid fillers, calcium hydroxylapatite fillers, poly-L-lactic acid fillers, and polymethylmethacrylate (PMMA) fillers. Hyaluronic acid is the most popular category, as it has a hydrating effect and few side effects.


  • Length of Treatment:
    • vary depending on the number of areas being treated and the amount of filler being dissolved. Typically, it takes between 30 minutes to an hour
  • Recovery Time:
    • Most people can resume normal activities immediately after treatment
  • Onset of Action:
    • Immediate
  • Cost of botox or neuromodulator:
    • vary depending on the type of filler being dissolved and the amount of filler being treated
  • Results:
    • The longevity of the results depends on the type of filler being dissolved, but typically last from several months to a year or more
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Undesirable Outcomes of Dermal Fillers

Sometimes, the results of dermal fillers turn out quite opposite to the expectations. Some of  the complications during or after injecting the filler are:

Migration of dermal filler

The migration of dermal fillers is a very undesirable complication. Facial anatomy shows slight variations from individual to individual. In some, more muscle laxity results in the formation of dependent pockets. These pockets provide the space for injected dermal fillers to migrate and produce unacceptable results.

Clinically, lip filler migrations are the most common ones. The filler is injected into lips near the junction of the pink and white border between the lips and skin. From here the filler can migrate to the undesired area above or below the lips. Here it makes the lips look puffy and swollen.

The lip filler migrations are usually noted by the patients themselves. It gives a shelf-like appearance of the lips and is named duck lips.

It can occur due to faulty administration and overfilling by the inexperienced practitioner.

Involvement of vessels

While injecting the fillers, there is a high chance of entering the vessels and blocking the blood flow. This can result in tissue death called necrosis. 

Misplacement of filler

Faulty administration of fillers disturbs the whole facial symmetry and results in notable facial imbalance.

Lumps or nodules

Sometimes, filler injections result in the formation of lumps or nodules. It may be due to the hard nature of filler or the excess amount of filler injected. Whatever the underlying cause may be, these lumps indicate complete failure of the procedure.

Poor outcomes and unsatisfactory results

Dermal fillers are all about enhancing facial beauty and boost confidence. But, sometimes the final look fails to make an impression and the patient is dissatisfied and wants to undo the procedure.

Solution is dissolution

Despite the high percentage of successful filler injections, the complications and undesirable outcomes of fillers raise major concerns. Fortunately, dermal fillers are not permanent and can be reversed when required. 

Normally dermal fillers are absorbed by the body over time. But in the case of vascular compromise or filler migration, emergency reversal of fillers is necessary. Reversal is also done in case of unsatisfied results. This is done by dissolving the dermal fillers with proper techniques and expertise.

doctors use ulreasound for filler injection at SparrowMD vancouver
Filler injection with hands Vancouver

How can the dermal fillers be dissolved?

The dissolution of dermal fillers is a low-risk procedure. The enzymes are injected into the filler sites. These enzymes metabolize the filler and convert it into smaller permeable particles which are then absorbed and cleared by the body’s natural processes.In daily clinical practice, hyaluronic acid fillers are the most common ones. Hyaluronic acid fillers are dissolved by using the enzyme called hyaluronidase. These enzymes are injected in a calculated dose in the filler areas. It breaks down the bonding present between the filler molecules and converts the hyaluronic acid into smaller particles. These particles permeate out of the skin by diffusion and are eventually excreted from the body.

Time required to see the full effects

This technique takes about 24 - 48 hrs to show full results. This is because the swelling develops as a reaction to the dissolving substance. And the change in size and shape of the face can be noted only when the swelling subsides.

What type of dermal fillers can be dissolved?

The biggest limitation in the dissolving techniques is that only hyaluronic acid fillers can be removed using hyaluronidase.

The fillers like Sculptra stimulate the natural production of collagen and are non-dissolvable.

Is it safe to dissolve the injected dermal fillers?

People are usually concerned about the harmful consequences of dissolving the dermal fillers. Dermal filler dissolution, if performed with proper instruments and expertise, is a low-risk procedure. Bruising and swelling may occur but they usually resolve within few days.

Ultrasound use in the field of facial aesthetics

Practitioners has started to use ultrasound techniques in the field of facial aesthetics in the latest years. As stated in the 2021 article, ultrasound has proved its importance in cosmetics procedures by helping in filler injection and dissolution in the daily routine.

Ultrasound use in injecting the dissolving substance

High definition ultrasound has enabled plastic surgeons not only to inject the dermal filler without complications but also in dissolving them. Important clinical uses of ultrasound are in:

Locating the filler and complications

Ultrasound provides the exact map of facial anatomy as well as shows the presence of dermal filler and their complications like filler migration, misplacement, etc.

Finding the types based on the appearance of fillers on ultrasound

The unique advantage of ultrasound in filler dissolving is that each type of filler shows a characteristic shape on the image.

Finding the area and extent of migration

In the case of filler migration, ultrasound images can be used to find the area and extent to which filler has migrated and the involvement of important facial structures.

Avoiding over dissolution

If the excess filler dissolution is done, the facial volume is lost and it results in facial disfigurement. Using ultrasound imaging while injecting the dissolving substance can help surgeons avoid the over dissolution of filler.

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Who Is Not A Good Candidate For Dissolution of Dermal Fillers Using Ultrasound?

Those who are pregnant, breastfeeding, or have a neurological disease should not use Botox®. Request a complimentary consultation and find the best alternative for you.



We understand that any treatment to your face requires trust. We also know that, for some people, needles and neuromodulators such as Botox™ can seem a bit intimidating.

Sparrow MD knows you have many options. We are honoured to be your choice, and we are committed to delivering safe, evidence-based, and natural results.

For this very reason, unlike the other options out there, our trained and College of Physicians certified Medical Doctors directly administer all neuromodulator treatment in our clinic. 

Our doctors will address all your questions and concerns and guide you every step of the way. In becoming a growing Sparrow MD family member, we are excited to help you achieve beautiful, natural-looking results. Our goal, every day, is to assist you in looking like how you feel - to promote positive ageing. 

To learn about the best treatment options for you, book a complimentary consultation today.

There is no preparation needed for neuromodulator injections; however, we recommend you schedule a complimentary consultation from our Medical Doctors. This is to evaluate if neuromodulators or another treatment is the best option to achieve your desired goals. 

All treatments begin with a consultation where our medical doctors who specialize in medical aesthetics will address your concerns. During this consult, a customized treatment plan will be tailored to your needs. This process involves taking your medical history, including understanding any past aesthetics procedures you may have had, along with your satisfaction with these past treatments. Next, your concerns are explored, and any solutions provided by neuromodulators are outlined in detail.

Our injectors will carefully inject neuromodulators at specific anatomical points in your face with a tiny needle during the treatment itself. Most people feel at most a quick pinch from the injection. If requested, the doctor can apply a local anesthetic to minimize any discomfort. When this option is used, the pinch is nearly indistinguishable from the gentle pressure of a light touch. In most cases, cosmetic neuromodulator treatments can easily be completed in under thirty minutes.

Neuromodulators have very minimal to no downtime. At most, one can expect some localized swelling and/or redness for a few hours following. Otherwise, this procedure requires no recovery time.

Immediately following a neuromodulator treatment, you may return to nearly all normal activities with no issues. You may have some slight redness or swelling at the injection site, but this usually resolves spontaneously within a few hours.

You will begin to see results from neuromodulators within a few days (3-4 on average), with most of the results appearing within a week. It is important to note that the results are a very natural-looking expression rather than the common misunderstanding of a “frozen” face. You will notice a change. Most people describe this charge as appearing well-rested, refreshed, or softened. 

Botox® and other neuromodulators like Xeomin®, Dysport® or Nuceiva® are all injectable neuromodulators approved for minimizing fine lines and wrinkles. Probably the biggest myth around this topic is that the other brands are simply a cheap and generic version of Botox™.

All Health Canada-approved neuromodulators are effective in eliminating lines and wrinkles that occur due to repetitious muscle contractions involved in everyday facial movements. They work by the same mechanism of relaxing facial muscles. They differ by the formulation of the active ingredient. For example, Xeomin® contains only a single active protein ingredient, whereas the formulation of Botox™ includes various protective proteins clustered around this same active molecule. 

Though similar, different neuromodulators will have different personalities when it comes to results after injection. Our expert injectors will analyze your current facial anatomy, medical history, and desired results to determine the best course of treatment given your concerns. We will choose the right treatment options with you based on your experience and patient journey. 

The cost of a neuromodulator treatment varies with each person based on the area treated, their current anatomy, and their desired results. These factors determine how many injections and what doses of neuromodulator are necessary or whether other treatments or procedures should be performed as part of the overall treatment plan. During your consultation, the cost, as well as payment options, are thoroughly reviewed. We accept cash, credit cards and debt.

This is variable and completely up to the patient. In our experience, the age that one should start using Botox™ depends more on anatomy, genetics, and environmental exposure than it is about age. In the world of Botox, age is truly just a number. Some clients start in their early 20’s and they already have wrinkles and lines whereas some start in their 40’s and don’t have as many lines.

Botox can be used preventatively to prevent wrinkles from forming in the first place or to soften lines and wrinkles once they develop. It has been well studied and proven to be safe long-term for over twenty years. So the ideal age to start Botox is truly a very personal decision.

Everyone is different, so the answer varies from patient to patient. In general, the results can be seen within three to seven days, and they last for three to six months with no downtime and minimal discomfort. Most of our patients enjoy results from maintenance treatments every three months, whereas some will wait a little longer between treatments.

Yes and no. A cosmetically elegant result will leave you looking refreshed, more cheerful and perhaps younger. We are careful to preserve natural movements so that patients continue to look themselves and completely natural.

Often there are signs that someone recently had wrinkle relaxing treatments, such as a smooth and shiny forehead or reduced crow’s feet. These effects can be tailored depending on personal preferences. It is also important to keep in mind that as long as you are happy with the results, it shouldn’t matter if your friends, family, or strangers can tell the difference. As we say to our family and friends at Sparrow MD, share the love!

Absolutely. Botox™ and other neuromodulators, like Xeomin™, Dysport™ or Nuceiva™, are highly purified proteins that work to reduce muscle contractions that cause frown lines, forehead lines, and crow’s feet.

Without the injection, these same muscles contract hundreds of times a day and eventually etch deeper lines and wrinkles in the skin. When Botox is injected, it relaxes the muscles underneath the skin, slows down the excess facial expression, allowing the lines and wrinkles to diminish over time. It can prevent the frown lines from forming between the eyebrows, lift corners of the mouth which often go downwards with age, smooth out the “pincushion” appearance in the chin, soften barcode lines around the lips, and soften vertical neck bands. 

Optimized neuromodulator treatments should keep you looking refreshed and natural. Our treatment plan is designed to soften lines from excessive facial expressions such as frowning, squinting and raising eyebrows. It does not affect the nerves of sensation or make you feel or look "frozen."

Treatments at Sparrow MD are performed by experienced medical professionals that understand anatomy and can assess the strength of your muscles to decide how much Botox™ or neuromodulator treatment you actually need. Please book a consultation today with one of our medical doctors to further discuss your questions and needs.