Atlanta (Buckhead)
3833 Roswell Rd NE, Tuxedo Atrium, Suite 108Atlanta, GA 30342
Floor 1 of the Tuxedo Atrium
Monday to Friday 8:30 AM to 5 PM; Saturday 8:30 AM to 2:30 PM
Dermal fillers
Dissolving Filler (Hyaluronidase) in Buckhead and Cumming
Dissolving filler means injecting hyaluronidase, an enzyme that breaks down hyaluronic acid (HA) filler. This use is off-label; the approved labels list other uses. People use it for lumps, overfilled areas, a bluish tint or unwanted results, and when HA filler blocks a blood vessel. A 2024 JMIR Dermatology review lists poly-L-lactic acid and calcium hydroxylapatite fillers (Sculptra, Radiesse) among those hyaluronidase cannot dissolve. Results vary, and it can remove more filler than you intended.
- 608 Google reviews, rated 4.9 and 5.0
- Board-certified physician who treats every patient herself
Treated by Dr. PaymanBuckhead and Cumming
What it treats
What is dissolving filler, and how does hyaluronidase work?
Hyaluronidase is an enzyme that breaks down hyaluronic acid (HA), a gel used in many fillers. A 2024 review in JMIR Dermatology says it acts immediately and works for 24 to 48 hours. It also breaks down some of your own HA, but the review says the body restores its native HA within about 15 to 20 hours.
The enzyme acts on hyaluronic acid, and the same review lists poly-L-lactic acid (Sculptra), calcium hydroxylapatite (Radiesse) and polymethylmethacrylate among fillers that hyaluronidase cannot dissolve, and the FDA warns that fillers not made of materials such as HA can be difficult or impossible to remove. Even among HA fillers, the review says a higher HA concentration, larger particles and more cross-linking make a filler harder to dissolve.
In aesthetics this is an off-label use. The label of an FDA-approved hyaluronidase product, Hylenex, lists other uses, such as helping fluids and other injected drugs absorb under the skin. The evidence for facial filler is also thin: a 2024 scoping review found five randomized trials, with 53 people in all, done on forearm, upper arm and back skin, and no trials or case-control studies on facial skin. Its search ended in May 2022 and looked only for trials and case-control studies.
Results
How fast does it work, and how many sessions will you need?
The enzyme acts right away, and for a bluish tint the review says resolution often comes within 24 hours, though a second treatment is sometimes needed. The number of sessions varies with the filler, the area and how much needs to go. Larger, longer-lasting or highly cross-linked fillers often take more, and many experts treat in small steps.
The evidence in detail
No source gives one fixed number of visits. The scoping review's five randomized trials used protocols from a single injection to three weekly injections, with a dose-dependent response for most fillers. With no trials or case-control studies on facial skin in that review, your plan rests on clinical judgment and on how your own filler responds.
Expect some local effects. The 2024 review lists itching, burning, swelling, redness and bruising at the injection site. Because swelling is one of them, ask Dr. Payman when you can fairly judge the result and when to plan new filler, if you want it.
Is it right for you?
Why do people dissolve filler, and who is it for?
People dissolve HA filler for lumps, overfilled or uneven areas, a bluish tint from filler placed too shallowly, an allergic or inflammatory reaction, or a result they dislike. It is used on HA filler; the review lists the materials in Sculptra and Radiesse among those it cannot dissolve. It is a poor fit for anyone with a known hypersensitivity to hyaluronidase. The Hylenex label also says not to inject into or around an infected or acutely inflamed area, so treating an inflamed lump is a judgment call at the exam.
The 2024 review lists the Tyndall effect (a bluish discoloration from filler placed too superficially), non-inflamed nodules from overcorrection or misplacement, inflammatory nodules, and allergic or immune reactions to the filler. It adds that hyaluronidase may be used at any time, citing one report of an effect 63 months after the HA injection.
Tell the office about allergies and medicines. The review says allergy to bee or wasp stings carries a significant risk of cross-reactivity, and the Hylenex label lists hypersensitivity to hyaluronidase as a contraindication and notes there are no adequate studies in pregnant women and no information on breastfeeding. For its approved dispersing use, it also says large doses of salicylates, cortisone, ACTH, estrogens or antihistamines may make tissue partly resistant to the enzyme.
608
Google reviews across both officesWho treats you
Arshia Payman, MD
Board-certified physician with 13+ years in aesthetic medicine. Dr. Payman is the only provider at Derm Clinic MD, and she personally treats every patient. Every plan starts with a consultation, so it is made around your face and your goals.
- Medical schoolGeorge Washington University, Washington, D.C., where she also earned her undergraduate degree summa cum laude and was accepted to the early selection medical program in her sophomore year
- Hospital trainingFour hospitals in the Washington, D.C. area, including the National Institutes of Health and George Washington University Hospital
- ResidencyCompleted in 2008 at George Washington University
- Academic medicineOutpatient internal medicine at Emory University in Atlanta, as an instructor in clinical medicine who taught medical students
Georgia medical license 61513 (NPI registry).
Read Dr. Payman's full bioYour visit
What happens at a dissolving filler visit?
Every treatment starts with an in-person consultation. Dr. Payman reviews what filler you had and where, examines the area, asks about allergies and medicines, and agrees a plan with you before treating. The office will explain what to expect for your area.
- ConsultationBring any records or photos of your earlier filler, including the product name if you know it, and list your allergies and medicines.
- ExaminationDr. Payman checks whether what you feel or see is likely HA filler, a reaction or something else, and photos are taken so change can be tracked.
- Consent and planYou decide together whether to aim at the whole area or only part, knowing that the review says at least partial loss of the filler effect should be discussed first.
- TreatmentHyaluronidase is injected where the filler sits. Many experts treat in small steps and reassess, to avoid removing more than needed.
- Follow-upFor a bluish tint, the review suggests checking in after 3 to 4 days to see whether more is needed. Follow your written aftercare instructions.
Cost
How much does dissolving filler cost?
Derm Clinic MD lists dissolving filler as starting at $100. Your total depends on how much filler needs to be dissolved, where it is, what type it is and how many sessions you need, so the office quotes your cost at the consultation after the plan is made.
A single figure is hard to give because, per the 2024 review, the dose needed depends on the indication, location, volume and properties of the filler and on patient factors. See pricing and membership for how the office prices treatments. If a filler result is bothering you, you can book a consultation at Buckhead or Cumming.
Your exact cost
Your total depends on your plan: the areas, the product and how many visits you need. Dr. Payman gives you the full cost at your consultation, before anything is done.
Gold members get 10% off other services and skincare. About the membership.
Good to know
Is dissolving filler also the emergency treatment for a blocked blood vessel?
Yes, when the filler is hyaluronic acid, though it can fall short. If filler blocks or compresses a blood vessel, the 2024 review says hyaluronidase should be given as soon as possible, optimally within 4 hours, and in higher doses than for routine dissolving. The FDA tells patients to seek immediate medical attention for unusual pain, vision changes, white, gray or blue skin near the injection site, or any sign of a stroke.
Results are mixed. The review notes there is no consensus protocol, that in a systematic review it did not remove large areas of necrosis but played a moderate role in earlier recovery in limited necrosis, and that no accepted standard exists for vision loss. A 2025 American Academy of Ophthalmology review of 198 cases of vision loss after filler found that treatments, including hyaluronidase, were usually not effective in reversing it; vision improved in 28% of the 196 cases with follow-up.
The review says aesthetic practitioners should be versed in using hyaluronidase, so it is reasonable to ask any injector what their plan is if a vessel is blocked. It also says skin testing is not warranted in this emergency, because the risk of delay outweighs the benefit.
Safety
What are the risks of dissolving filler, including allergy?
Most effects are local: itching, burning, swelling, redness and bruising at the injection site. Allergic reactions to hyaluronidase are uncommon in aesthetics but can be serious. The Hylenex label, which covers its approved uses rather than filler dissolving, reports allergic reactions (hives or angioedema) in less than 0.1% of patients receiving hyaluronidase and says allergic and anaphylactic-like reactions have been reported rarely. The filler can also be over-dissolved.
Full safety details
A 2024 review of 106 reported patients with hyaluronidase allergy suggested that earlier hyaluronidase injections and sensitization to insect or wasp venom might be the main factors, and found that steroids with or without antihistamines rapidly and mostly completely reversed the symptoms. The JMIR review adds that products come from bovine, ovine or recombinant human sources, and that the recombinant type is thought to cause fewer allergic reactions, though long-term data are lacking.
The other main risk is losing too much filler. In a 20-patient series of lower eyelid swelling cited by the review, hyaluronidase worked without recurrence, but in 2 people all of the injected HA was degraded and the effect was lost. Call the office about worsening swelling or signs of infection, and get emergency care for trouble breathing or swelling of the face or throat; the FDA lists severe allergic reaction among rare filler risks.
Patient reviews
In patients’ words
“She is very kind and pays attention to my requests for minimal treatment”
“I only trust this clinic with my Botox and fillers.”
“Once I met with Dr Arshia Paymen I never felt rushed, she took the time to listen to all my concerns and explained it all in a way that was easy to understand.”
Excerpts are quoted word for word from public Google reviews of Derm Clinic MD. Individual results vary.
Questions
Questions patients ask about dissolving filler
Short answers here. Your own plan, product and cost are set with Dr. Payman at your consultation.
Ask at a consultationDoes dissolving filler hurt?
Expect some discomfort. A 2024 review in JMIR Dermatology lists itching, a burning sensation, swelling and redness at the injection site as the main effects of hyaluronidase injections. Your injector will tell you what to expect and how comfort is managed. Unusual pain, vision changes or white, gray or blue skin after filler needs immediate medical attention.
Does hyaluronidase damage my own skin?
It breaks down some of your own HA as well, but a 2024 review in JMIR Dermatology says the body restores its native HA in about 15 to 20 hours and reasons from this that there are no detrimental long-term effects on skin quality. The practical risk is removing more filler than you wanted, which is why plans often go in small steps.
What if I do not know which filler I have?
Ask the provider who treated you for the product name or its patient labeling; the FDA says your doctor can provide the patient labeling for the specific filler you received. Bring any receipt, card or photos. If the product is not hyaluronic acid, such as Sculptra or Radiesse, a 2024 review in JMIR Dermatology lists those materials among fillers hyaluronidase cannot dissolve, and the FDA warns removal can be difficult or impossible.
Can old filler still be dissolved years later?
If it is still HA, yes in principle. A 2024 review in JMIR Dermatology says hyaluronidase may be used at any time and cites an effect 63 months after the original injection. But HA fillers also fade on their own: the FDA says their effects last approximately 6 to 12 months, so whether anything is left to dissolve is a question for your exam.
Can lip filler be dissolved?
If the lip filler is hyaluronic acid, yes. A 2024 review in JMIR Dermatology includes a case in which upper lip overfilling and swelling after HA filler resolved after treatment that included hyaluronidase. Because that review recommends small steps with reassessment to avoid removing too much, treatment may take more than one visit. See lip filler for the treatment itself.
Do I need an allergy test first?
It depends. A 2024 review in JMIR Dermatology says skin testing is optional for non-urgent problems such as overcorrection and is not required for recombinant hyaluronidase, though it may be considered for bovine, ovine or compounded products. Skin testing is not recommended in an emergency such as a blocked blood vessel, because delay is the bigger risk. Your injector will tell you which approach applies to you.
Two offices
Two offices. One physician.
Atlanta, GA 30342
Floor 1 of the Tuxedo Atrium
Cumming
425 Peachtree Parkway, Suite 345Cumming, GA 30041
In The Shoppes at Brannon Crossing
Monday to Friday 8:30 AM to 5 PM; Saturday 8:30 AM to 2:30 PM
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Your first step
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Sources (7)
- Hyaluronidase for Dermal Filler Complications: Review of Applications and Dosage Recommendations. JMIR Dermatology, 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC10836581/
- A Scoping Review of Hyaluronidase Use in Managing the Complications of Aesthetic Interventions. Aesthetic Plastic Surgery, 2024. https://pubmed.ncbi.nlm.nih.gov/36536092/
- Allergic Complications of Hyaluronidase Injection: Risk Factors, Treatment Strategies, and Recommendations for Management. Aesthetic Plastic Surgery, 2024. https://pubmed.ncbi.nlm.nih.gov/37145319/
- HYLENEX recombinant (hyaluronidase human injection): prescribing information, revised 11/2024. National Library of Medicine DailyMed, FDA-approved labeling, 2024. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3023cc56-ed4b-4e87-b3a1-81b20943f658
- Dermal Fillers (Soft Tissue Fillers). U.S. Food and Drug Administration, 2023. https://www.fda.gov/medical-devices/aesthetic-cosmetic-devices/dermal-fillers-soft-tissue-fillers
- FDA-Approved Dermal Fillers. U.S. Food and Drug Administration, 2020. https://www.fda.gov/medical-devices/aesthetic-cosmetic-devices/fda-approved-dermal-fillers
- Vision-Threatening Complications of Soft Tissue Fillers: A Report by the American Academy of Ophthalmology. Ophthalmology, 2025. https://pubmed.ncbi.nlm.nih.gov/40167411/
This page is general education and is not medical advice. It does not replace an in-person consultation. Whether a treatment suits you, and what result is realistic, depends on your health history and an examination. Results vary from person to person.
Derm Clinic MD · Last updated October 2026.