Non-Surgical · Hyaluronidase

Filler Dissolving

The enzyme that takes hyaluronic acid back out, and the judgement before it

Gangnam, Seoul | Board-certified plastic surgeon, Dr. Jonghwan Choi
KHIDI-registered for international patients · Apgujeong Rewind

Hyaluronidase Hyaluronidase Hyaluronidase Hyaluronidase Hyaluronidase Hyaluronidase 
Define

Filler dissolving

Filler dissolving: what hyaluronidase can actually break down

The short answer

Hyaluronidase is an enzyme that cuts hyaluronic acid into fragments the body clears on its own. Injected into a site that is holding hyaluronic acid filler, it collapses a gel that would otherwise sit there for many more months. It acts on hyaluronic acid and on nothing else, so a lump left by a collagen stimulator, by a semi-solid implant material or by scar tissue will still be there afterwards. Rewind lists this treatment by the area treated, which is also how it is charged.

There is no Korean treatment page at this clinic describing the enzyme itself, so anaesthesia, appointment length and the number of passes an area takes are left off this page deliberately. Those belong to the examination, and a figure invented to fill the gap would be a guess wearing the clothes of a fact.

People ask about dissolving for reasons that sound very different and turn out to be the same reason. A lip border that has crept outward over several top-ups. A hollow under the eye that went puffy and took on a bluish cast. A cheek that reads wide in photographs taken from the side. A jawline that feels firm to the fingertip. In each case the question underneath is whether the material sitting there is hyaluronic acid, and whether the shape complained about is caused by that material at all.

The second thing worth understanding early is that dissolving is not the mirror image of filling. The enzyme cannot be aimed only at the gel a syringe left behind: hyaluronic acid your own tissue holds in that area is broken down alongside it, and the body replaces that over a short period. So the area can look flatter for a while than it did before any filler was ever placed, which is unsettling if nobody warned you it happens.

Consultation room at Rewind Plastic Surgery, Apgujeong, Seoul
Fig. 01  What is being removed, and from which layer, is settled in this room first
Zones

Where it is asked for

The four areas patients most often want dissolved

Hyaluronic acid behaves differently depending on the pocket it sits in, and the complaints that bring people in follow that closely. The zones below are the ones raised most often at a dissolving consultation. What gets treated on the day is whatever the examination can identify as hyaluronic acid, in a plane the injector can reach with a graded dose.

zone 01
Lips and lip border
The commonest request. Gel that has spread beyond the vermilion outline, or a lip that has stopped moving the way the rest of the face does.
zone 02
Tear trough and under-eye
Puffiness that appeared weeks after the injection, or a bluish shadow under thin skin where gel was placed too superficially.
zone 03
Cheek and mid-face
Accumulated volume from repeated topping-up in the same pocket, which widens the face from an angle nobody looks at in a mirror.
zone 04
Chin, jawline and nose
Firm contour gel that reads hard to the touch, or a nasal dorsum where the outline has thickened since the material went in.

One category is deliberately off this map. A firm area that turns out to be a biostimulator nodule, fibrous tissue, fat or simple descent of the cheek will not answer to this enzyme, and injecting it anyway would cost you an appointment and tell you nothing. That is the reason the assessment comes before the booking and not after it.

Undo

Mechanism

Four stages of a hyaluronidase appointment, start to review

Almost everything that decides the outcome happens before the enzyme is drawn up. These four stages are what separates a planned correction from a gamble with a syringe.

01Identify

Establishing that the material is hyaluronic acid

History, dates, any product record you can bring, and what the area feels like under the fingers. A gel injected two months ago and a firm area of unknown origin from several years back are not the same problem. Where the material cannot be established as hyaluronic acid, the appointment stays an assessment and the enzyme is not used.

02Screen

Allergy history is taken before anything is drawn up

Hyaluronidase is a protein preparation, and hypersensitivity reactions to it are documented in the aesthetic literature. Previous exposure to the enzyme, and any history of reaction to insect venom, changes how cautiously the first dose is approached. This is a question you should expect to be asked, and a question worth answering fully.

03Graded dose

The enzyme is placed into the deposit in measured amounts

Small volumes are delivered into and around the gel that has been identified, then the area is reassessed. Undershooting can be corrected at a second visit. Overshooting cannot be corrected at all, because nothing puts native hyaluronic acid back on demand. That asymmetry is the whole argument for a conservative first pass.

04Interval

A settling window before anything is placed there again

Residual enzyme activity in a treated pocket will work on fresh gel just as willingly as it worked on the old. Refilling the same site the following week wastes the new syringe. The interval before any refill is agreed at the review appointment, once the area has stopped changing.

Dr. Jonghwan Choi assessing a patient at Rewind Plastic Surgery
Fig. 02  Stage one carries more weight than stage three
Rewind

Judgement

Why a surgeon assesses what is being dissolved

Dissolving looks like the simplest injectable on any price list. It is the one where the decision carries most of the risk, because the decision is a diagnosis: is this shape made of gel, of tissue, or of gravity.

01Diagnosis

Heaviness and filler look alike in a mirror

A mid-face that has descended and a mid-face carrying old gel both read as fullness low on the cheek. Dr. Choi operates in those planes, so the person deciding whether the enzyme will help is someone who knows what the tissue does when the gel is gone. Patients are sometimes told that dissolving will not address what is bothering them.

02Restraint

A graded first pass is a deliberate choice, not caution for its own sake

Flooding an area clears the gel in one appointment and takes native hyaluronic acid with it, leaving a hollow that has to be waited out. Starting below the dose that would clear everything, then looking again, is slower for the patient and slower for the clinic. It is also the version that leaves you with options.

03Emergency

The same enzyme is the emergency answer to a blocked vessel

Vascular occlusion after a hyaluronic acid injection is rare and it is an emergency, with published consensus placing high-dose hyaluronidase at the centre of management. Anyone developing severe pain, blanching or mottled skin in the hours or days after a filler appointment should present for care immediately and should not wait for a scheduled follow-up.

Dr. Jonghwan Choi, board-certified plastic surgeon and medical director of Rewind
Fig. 03  The same surgeon assesses the area and injects it
Room

On the day

A dissolving appointment at the Apgujeong clinic

Treatment floor at Rewind Plastic Surgery, Gangnam, Seoul

Fig. 04  Treatment floor, Richro Building

Recovery area at Rewind Plastic Surgery

Fig. 05  Where the area is looked at again before you leave

The consultation happens first, and what is being treated is marked out in front of you, together with a note of what is deliberately being left alone. Bring whatever record of the original injection you still have, including the date and any product paperwork, because it changes what the injector expects to find. Ask for the packaging to be opened where you can see it: that is the only check a patient ever gets on what ends up in the syringe, and staff here treat the question as routine. Appointments are held on the fourth and fifth floors of the Richro Building in Gangnam, Seoul; the clinic works by appointment, Monday, Tuesday, Wednesday and Friday from 10:00 to 19:00 and on Saturday from 10:00 to 16:00.

Enzyme preparation, hyaluronidase
Acts on hyaluronic acid only
Quoted and charged per treated area
No incision and no suture
Assessed and injected by Dr. Jonghwan Choi
Refill interval agreed at review

What this page does not do is reprint promotional artwork. A claim printed on a marketing card is not something a patient can verify, and translating it into English would only lend it weight it has not earned. The material, the plane, the charging unit and the published literature are reproduced here. Everything with a number attached to it waits for the examination.

Record

Case photography

Dissolving photographs: frames this clinic has not filled

All of the case pairs Rewind has published to date come from its surgical list, and none exists for this enzyme. Filling these frames with photographs this clinic did not take would tell you something untrue about it, so they stay blank until Rewind has a consented series of its own.

Hyaluronidase  case pairs

BEFORE PHOTO
AFTER PHOTO
BEFOREAFTER
case  hyaluronic acid removal
Filler dissolving
Individual results may vary.
BEFORE PHOTO
AFTER PHOTO
BEFOREAFTER
case  hyaluronic acid removal
Filler dissolving
Individual results may vary.
BEFORE PHOTO
AFTER PHOTO
BEFOREAFTER
case  hyaluronic acid removal
Filler dissolving
Individual results may vary.
BEFORE PHOTO
AFTER PHOTO
BEFOREAFTER
case  hyaluronic acid removal
Filler dissolving
Individual results may vary.

This treatment is unusually easy to photograph dishonestly. Swelling on the day, a different lens distance, a head turned two degrees further, and an area looks corrected when nothing has been corrected at all. When Rewind publishes pairs for the enzyme they will be its own patients, photographed at a matched distance in matched light on both dates, uncropped, consented, and captioned with the interval between the two dates. Nothing here promises you a particular outcome, and individual results may vary.

Rates

Pricing

What dissolving costs per area in Gangnam, Seoul

The enzyme is charged by the area treated, so the arithmetic is simple and worth doing out loud before you book: two areas is two charges, and a deposit that needs a second pass is charged again at the second visit. The two rows beneath it are the clinic's hyaluronic acid rates, listed here because most people asking about removal are also asking, quietly, what a replacement would come to.

Hyaluronidase  per treated areaEnzyme preparation. Each area assessed and charged separately
₩80,000
Hyaluronic acid filler, domestic  1ccReference: what refilling the same site is quoted at
₩200,000
Hyaluronic acid filler, imported  1ccReference: the imported gel on the same sheet
₩500,000

Rates are read from the clinic's list and VAT is charged on top of them, so your receipt sits above the figures here. The numbing preparation used during an injectable session is already counted inside the rate. No multi-area plan is quoted before the examination, and whatever figure is read out to you at the desk comes off the list printed above.

Fit

Suitability

When dissolving is the right answer, and when it is refused

Usually a reasonable request

  • Hyaluronic acid placed at an earlier appointment that has stayed firm or visible well past the life you were told to expect
  • A lip border that has widened across several top-ups in the same site
  • Puffiness or a bluish cast under the eye that began after gel went into that hollow
  • Side-to-side asymmetry you can point at in a photograph of yourself
  • A patient planning surgery on the same area, where the plane needs to be clear before the operation is planned

Reasons the doctor holds off

  • A firm area nobody can establish as hyaluronic acid, since the enzyme has no effect on any other material
  • Known hypersensitivity to hyaluronidase, or a reaction history that needs assessing before a dose is considered
  • Active infection or inflamed skin over the target site
  • An expectation that the area will return exactly to its pre-filler state, when laxity that the gel was masking becomes visible again
  • Pregnancy, breastfeeding, or a fixed date within weeks, since swelling and then a flatter interval both need room
After

Recovery

The days after hyaluronidase, and the weeks after that

This treatment moves fast at the start and then asks you to wait, which is the opposite rhythm to the injection that put the gel there. Most of the disappointment people report about dissolving comes from reading the first evening as the finished answer.

Day of
Swollen and flat at once
The area can look puffy from the injection and emptied of contour underneath it. Both impressions are true and neither is the outcome. Nothing should be judged from a photograph taken that evening.
First days
The clinic's injectable instruction
Rewind's written guidance for injectable appointments asks for a first day without strenuous exercise, alcohol or sauna, and for the site to be left unpressed. A cold compress helps bruising settle faster.
Following weeks
Native tissue catches up
Hyaluronic acid your own tissue holds in the area is replaced over a short period, and the flatness of the first days lifts with it. This is the stretch during which nothing new should be injected.
Review
Second pass, refill, or neither
The area is looked at again once it has stopped changing. Sometimes a second pass is needed. Sometimes the answer is that the original complaint was never the gel.

The risks belong on the page and not in a leaflet handed over at the desk. Swelling, bruising and tenderness at the site are common in the first days. Allergic reaction to the enzyme is the specific concern for this product, ranging from local response to systemic reactions that are rare and serious. More volume than intended can be lost, leaving asymmetry or a hollow that has to be waited out. Infection is uncommon. The complaint that prompted the original filler returns once the gel is gone, and no removal treats the volume loss underneath it. Increasing pain, spreading redness, breathing difficulty or any change in vision should be reported to the clinic or to emergency care at once.

Doctor

Professional

At Rewind, one board-certified plastic surgeon carries every case — from the first consultation to the final follow-up. Because a face is a story, and a story deserves a single author.

Dr. Jonghwan Choi, board-certified plastic surgeonRewind,
Dr. Jonghwan Choi presenting at an academic session
Fig. 06  Academic presentation, thread-lifting session

Rewind's Doctor

Dr. Jonghwan Choi Medical Director

One surgeon, from the first
consultation to the last follow-up.

A board-certified plastic surgeon devoted to anti-aging lifting — with the precision and restraint built through years of craniofacial practice.

Board-certified plastic surgeon (Plastic Surgery)
10 peer-reviewed publications
Medical Director, Rewind Plastic Surgery
Korean Society of Plastic & Reconstructive Surgeons
Former chief director, Apgujeong Y&T Plastic Surgery
Korean Society for Aesthetic Plastic Surgery
J Craniofac Surg · JKMS · Arch Craniofac Surg
Korean Cleft Palate-Craniofacial Association
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Ask

Questions

Dissolving questions asked at the Gangnam consultation desk

Does hyaluronidase work on every kind of filler?
No. The enzyme cuts hyaluronic acid and leaves everything else where it is. Poly-L-lactic acid, polycaprolactone, calcium hydroxylapatite and the older non-absorbable materials do not respond to it. Establishing what was injected is the first job of the consultation, and it decides whether an appointment is booked at all.
How quickly does the shape start changing?
Much of the gel breaks down within a day or two, but swelling from the injection sits on top of that, so the area reads confusingly at first. A reliable look at what has actually gone comes around the two-week mark, and review appointments are set well after the session for that reason.
Will one session clear the whole deposit?
Often, but not always. A large volume, a heavily cross-linked gel or a deposit that has been in place for years can need a second pass. Because the enzyme is charged by area, a second visit is charged again, and that possibility is put on the table at the consultation and not after it.
Is an allergy test carried out beforehand?
The history comes first: earlier exposure to the enzyme, and any reaction to insect stings. Where that history suggests risk, a cautious test dose is the conventional approach in aesthetic practice. Hypersensitivity is the reaction this product is specifically watched for, so the question is asked in full at the consultation.
What happens to the hyaluronic acid my own skin holds?
It is broken down as well. The enzyme cannot tell injected gel from native tissue hyaluronic acid in the same pocket, so an area can look flatter for a while than it did before any filler existed. The body replaces its own supply over a short period, and the flatness lifts with it.
I do not know what was injected into my face. What then?
Bring any paperwork, product record or dated photograph you still have. Dr. Jonghwan Choi examines the area himself and, where the material cannot be established as hyaluronic acid, the appointment stays an assessment. Injecting an enzyme blindly into an unidentified firm area achieves nothing and removes the chance of learning what it is.
How long before the same area can be filled again?
An interval is set at the review and not on the day, because residual enzyme activity will break down fresh gel placed into the same pocket. Refilling too early costs you a syringe for nothing. The area is judged once it has stopped changing, and the refill decision is made then.
Does removing filler leave the skin looser?
It removes what was holding the tissue outward, so laxity that predated the injection becomes visible again. This is the single most common surprise reported after dissolving, and it is not damage caused by the enzyme. If that is what turns up, the conversation moves to tightening.
What does one area cost, and how is an area defined?
The current list rate per treated area appears in the pricing section above, with VAT charged separately. An area is the region being assessed and injected, so both lips together are counted differently from lips plus a chin, and the count is agreed with you before anything is drawn up.
My face became painful and pale after a filler injection. Is this the same treatment?
It uses the same enzyme, at a different urgency. Severe or increasing pain, blanching, mottled skin or any visual change after a hyaluronic acid injection can indicate a blocked vessel, which published consensus treats as an emergency managed with high-dose hyaluronidase. Present for care immediately; a routine appointment is the wrong route for it.
Can the area be re-treated with something else on the same day?
In the same site, normally no. The pocket is still holding enzyme activity and anything placed there is working against it. A different region of the face is a separate question, decided at the examination. See dermal filler for how a refill is planned once the interval has passed.
How should this be scheduled inside a short stay in Seoul?
Put the assessment at the start of the stay. That leaves room for the area to declare itself and for a second pass if one is needed, before you travel home. Bruising is common in the first days, and a long flight is more comfortable once it has faded. Interpreter-assisted consultation is arranged for international patients.
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Scientific evidence

Hyaluronidase and filler correction: what the literature records

These six papers cover the enzyme and the problems it is used for: how hyaluronidase has been used in aesthetic practice, how cross-linked hyaluronic acid is metabolised in tissue, how filler complications have been graded and managed by consensus panels, and which patient factors raise the odds of running into one. None of this work was carried out at Rewind Plastic Surgery or on patients treated here, none of it was funded by this clinic, and nothing in it forecasts how your own area will behave.