{"id":11866,"date":"2026-09-10T13:24:19","date_gmt":"2026-09-10T04:24:19","guid":{"rendered":"https:\/\/kojihifu.com\/english\/?p=11866"},"modified":"2026-09-10T13:24:20","modified_gmt":"2026-09-10T04:24:20","slug":"when-to-dissolve-ha-filler","status":"publish","type":"post","link":"https:\/\/kojihifu.com\/english\/when-to-dissolve-ha-filler\/","title":{"rendered":"When to Dissolve HA Filler: Signs You Need Hyaluronidase"},"content":{"rendered":"<p><script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"MedicalWebPage\",\"@id\":\"https:\/\/kojihifu.com\/english\/when-to-dissolve-ha-filler\/#webpage\",\"url\":\"https:\/\/kojihifu.com\/english\/when-to-dissolve-ha-filler\/\",\"name\":\"When to Dissolve HA Filler: Signs You Need Hyaluronidase\",\"inLanguage\":\"en\",\"isPartOf\":{\"@id\":\"https:\/\/kojihifu.com\/english\/#website\"},\"about\":{\"@id\":\"https:\/\/kojihifu.com\/english\/#clinic-biotope\"},\"reviewedBy\":{\"@id\":\"https:\/\/kojihifu.com\/english\/#physician-karibe\"},\"lastReviewed\":\"2026-09-10\"},{\"@type\":[\"Article\",\"MedicalWebPage\"],\"@id\":\"https:\/\/kojihifu.com\/english\/when-to-dissolve-ha-filler\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/kojihifu.com\/english\/when-to-dissolve-ha-filler\/#webpage\"},\"headline\":\"When to Dissolve HA Filler: Signs You Need Hyaluronidase\",\"url\":\"https:\/\/kojihifu.com\/english\/when-to-dissolve-ha-filler\/\",\"inLanguage\":\"en\",\"author\":{\"@id\":\"https:\/\/kojihifu.com\/english\/#physician-karibe\"},\"reviewedBy\":{\"@id\":\"https:\/\/kojihifu.com\/english\/#physician-karibe\"},\"publisher\":{\"@id\":\"https:\/\/kojihifu.com\/english\/#organization\"},\"mainEntityOfPage\":{\"@id\":\"https:\/\/kojihifu.com\/english\/when-to-dissolve-ha-filler\/#webpage\"},\"description\":\"When to dissolve HA filler: learn the signs you need a hyaluronidase injection, from lumps and Tyndall to emergencies. Book a review with our Tokyo team.\",\"datePublished\":\"2026-09-10\",\"dateModified\":\"2026-09-10\",\"lastReviewed\":\"2026-09-10\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/kojihifu.com\/english\/when-to-dissolve-ha-filler\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/kojihifu.com\/english\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Skin & Dermatology\",\"item\":\"https:\/\/kojihifu.com\/english\/column\/skin-dermatology\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"When to Dissolve HA Filler: Signs You Need Hyaluronidase\",\"item\":\"https:\/\/kojihifu.com\/english\/when-to-dissolve-ha-filler\/\"}]}]}<\/script><br \/>\n<script type=\"application\/ld+json\">{\"@context\": \"https:\/\/schema.org\", \"@type\": \"FAQPage\", \"mainEntity\": [{\"@type\": \"Question\", \"name\": \"How quickly does hyaluronidase work?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"The enzyme acts immediately, and laboratory work has shown complete dissolution of biphasic filler within one to two hours at doses of 600\u2013750 units. Visually, however, swelling from the injection can mask the result, so most clinics reassess after about 48 hours.\"}}, {\"@type\": \"Question\", \"name\": \"Will dissolving filler leave my skin loose or saggy?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"The area often looks temporarily flat because the enzyme also degrades your own hyaluronic acid, but published guidance indicates the body restores native HA within roughly 15 to 20 hours. Any longer-term laxity usually reflects the tissue changes that led you to have filler in the first place, rather than damage from the enzyme.\"}}, {\"@type\": \"Question\", \"name\": \"Can filler from several years ago still be dissolved?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"Often yes. Imaging reports document HA deposits persisting well beyond the commonly quoted six-to-eighteen-month window, so old filler remains a plausible target \u2014 though heavily cross-linked, layered deposits may need more than one session.\"}}, {\"@type\": \"Question\", \"name\": \"What should I do if I suspect vascular occlusion after filler?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"Contact the treating clinic immediately, or seek emergency care if you cannot reach them. Severe pain, blanching or mottled purple skin, and especially any vision change, are treated as urgent \u2014 review data suggest hyaluronidase is best given within about four hours.\"}}]}<\/script><\/p>\n<h2>When to Dissolve HA Filler: Signs You May Need a Hyaluronidase Injection<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"When to dissolve HA filler: signs you need hyaluro \u2014 When to Dissolve HA Filler: Signs You May Need a Hyaluronida\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/09\/pexels_7581583_1789010558.webp\" alt=\"When to dissolve HA filler: signs you need hyaluro \u2014 When to Dissolve HA Filler: Signs You May Need a Hyaluronida\" \/><\/figure>\n<p>If you are looking in the mirror and your filler <strong>no longer looks like you<\/strong> \u2014 a puffy under-eye, a lump that will not settle, a bluish shadow that was not there before<\/p>\n<p>\u2014 that worry is completely understandable, and it is one of the most common reasons people book a corrective consultation.<\/p>\n<p>Hyaluronic acid (HA) filler is one of the few aesthetic injectables that can be partially reversed, using an enzyme called hyaluronidase.<\/p>\n<p>This article explains which signs genuinely warrant a hyaluronidase injection, which are emergencies that need treatment within hours, and what reversal can and cannot realistically achieve.<\/p>\n<p><strong>What you&#8217;ll learn in this article:<\/strong><\/p>\n<ul>\n<li>The emergency warning signs of vascular occlusion \u2014 and why the first few hours matter<\/li>\n<li>The non-urgent cosmetic signs (lumps, Tyndall effect, migration, overfilling) that justify dissolving<\/li>\n<li>What hyaluronidase actually does to filler, and why &#8220;dissolving&#8221; is a slightly misleading word<\/li>\n<li>Realistic cost in Tokyo, downtime, and the waiting period before re-injecting<\/li>\n<li>Who is a good candidate \u2014 and who should be cautious<\/li>\n<\/ul>\n<div class=\"kjmc-en-booking-inline\" style=\"background: #f7fbf7; border: 1px solid #d5e6d8; border-radius: 10px; padding: 16px 20px; margin: 26px 0; text-align: center;\">\n<p style=\"margin: 0 0 12px; color: #1a3a1f; font-size: 0.95em; line-height: 1.65;\"><strong>Have a question about this treatment?<\/strong><br \/>\nMessage us on LINE or WhatsApp \u2014 our English-speaking team usually replies the same day.<\/p>\n<p style=\"margin: 0; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; gap: 8px; background: #06C755; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/line.me\/R\/ti\/p\/@710uitns?ts=05311801&amp;oat_content=url#~\" target=\"_blank\" rel=\"noopener noreferrer\">Book via LINE<\/a><br \/>\n<a style=\"display: inline-flex; align-items: center; gap: 8px; background: #25D366; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/whatsapp.com\/channel\/0029VbCA1v85K3zY4MLX2a1h\" target=\"_blank\" rel=\"noopener noreferrer\">Message on WhatsApp<\/a><\/p>\n<\/div>\n<h2>What Hyaluronidase Is \u2014 and What &#8220;Dissolving Filler&#8221; Really Means<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"When to dissolve HA filler: signs you need hyaluro \u2014 What Hyaluronidase Is \u2014 and What \" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/09\/pexels_4586709_1789010559.webp\" alt=\"When to dissolve HA filler: signs you need hyaluro \u2014 What Hyaluronidase Is \u2014 and What \" \/><\/figure>\n<p><strong>Hyaluronidase<\/strong> is an enzyme that breaks the bonds holding hyaluronic acid molecules together, allowing the gel to fragment and be reabsorbed by the body. It is injected directly into or around the filler deposit with a fine needle or cannula.<\/p>\n<p>It is worth knowing that reversing filler is an off-label use of this enzyme everywhere it is practised.<\/p>\n<p>The US FDA label for recombinant human hyaluronidase (Hylenex, 150 USP units\/mL, revised January 2024) lists only three approved indications: as an adjuvant in subcutaneous fluid administration for hydration, to increase the dispersion and absorption of other injected drugs, and in subcutaneous urography. Filler reversal appears nowhere on it.<\/p>\n<p>Two practical points follow. First, the enzyme is not selective \u2014 it degrades your own naturally occurring HA alongside the filler, although published guidance indicates the body restores native HA within roughly 15 to 20 hours. Second, dosing is judged clinically rather than read off a label; the UK CMAC guideline states plainly that &#8220;treat to effect is more reliable than specific doses.&#8221;<\/p>\n<h3>How much is needed<\/h3>\n<p>Laboratory work published in the <em>Journal of Cosmetic Dermatology<\/em> in 2025 suggests that biphasic (particulate) fillers need approximately 500 units of hyaluronidase per 1 mL of filler, while monophasic, more heavily cross-linked gels often require up to 750 units per 1 mL. In that work, complete dissolution was observed within one to two hours when 600\u2013750 units were applied, and direct injection into the filler mass outperformed surface application.<\/p>\n<p>Clinical reports also note that the enzyme&#8217;s half-life is only about two minutes, with a duration of action of roughly 24 to 48 hours \u2014 which is why results are reassessed a day or two later rather than judged on the spot.<\/p>\n<h2>Signs You May Need a Hyaluronidase Injection<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"When to dissolve HA filler: signs you need hyaluro \u2014 Signs You May Need a Hyaluronidase Injection\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/09\/pexels_16131210_1789010560.webp\" alt=\"When to dissolve HA filler: signs you need hyaluro \u2014 Signs You May Need a Hyaluronidase Injection\" \/><\/figure>\n<h3>1. Emergency signs: suspected vascular occlusion<\/h3>\n<p><strong>Vascular occlusion<\/strong> happens when filler enters or compresses a blood vessel and blocks blood flow. The CMAC vascular occlusion guideline describes the key warning signs as sudden, escalating pain during or after treatment \u2014 either at the injection site or somewhere distant \u2014 along with skin that looks pale or dusky, a delayed capillary refill time of more than two seconds, and a mottled, reticulated purple pattern (livedo reticularis).<\/p>\n<p>Timing is not always immediate. The same guideline notes these changes can appear &#8220;instantly or within a few hours,&#8221; with delayed presentations days later also possible. Any sudden vision change, drooping eyelid, or eye pain after facial filler is a medical emergency.<\/p>\n<p>Why the urgency: published guidance cites evidence that the retina can tolerate roughly 97 minutes of hypoxia before damage becomes irreversible, and that retinal infarction can occur within 12 to 15 minutes. Review data suggest hyaluronidase treatment for vascular occlusion is optimally administered within about four hours, using high total doses in the region of 450\u20131,500 units delivered across the affected area in up to four cycles.<\/p>\n<p>A literature review and meta-analysis of 93 published cases of vascular complications after facial filler (reported between 2004 and 2016) found blindness in 61 percent of those cases, with partial or total recovery in only 28 percent. Retinal artery occlusions most often followed glabella (between-the-brows) injections, and ophthalmic artery occlusions most often followed nasal injections. These are published case reports, so they over-represent severe outcomes \u2014 but they explain why injectors treat these two zones with particular caution.<\/p>\n<h3>2. Cosmetic signs: the filler simply looks wrong<\/h3>\n<p>Far more commonly, dissolving is elective. Reasonable indications include visible lumps or nodules, asymmetry, overcorrection that reads as puffiness rather than volume, filler that has migrated away from where it was placed, and the Tyndall effect \u2014 a bluish-grey discolouration that occurs when HA is placed too superficially and scatters short-wavelength light.<\/p>\n<p>Doses here are dramatically smaller than in an emergency. Published dosage guidance suggests roughly 30\u201375 units for the Tyndall effect (with 10\u201320 units sometimes sufficient), 5\u201315 units as a starting dose for non-inflamed nodules with reassessment at one week, and as little as 1.5\u20133 units in thin-skinned eyelid areas.<\/p>\n<h3>3. Delayed signs: nodules appearing months later<\/h3>\n<p>Firm or inflamed nodules that appear months after treatment are a separate category. Guidance indicates inflammatory nodules are generally managed first with oral antibiotics for two weeks or more, with hyaluronidase added if they do not settle \u2014 dissolving is not automatically the first move.<\/p>\n<table style=\"border-collapse: collapse; width: 100%; margin: 20px 0; font-size: 0.95em; border: 1px solid #ccc;\">\n<thead>\n<tr>\n<th style=\"border: 1px solid #ccc; padding: 10px 12px; background: #f1faf3; text-align: left; font-weight: bold;\">Situation<\/th>\n<th style=\"border: 1px solid #ccc; padding: 10px 12px; background: #f1faf3; text-align: left; font-weight: bold;\">Typical signs<\/th>\n<th style=\"border: 1px solid #ccc; padding: 10px 12px; background: #f1faf3; text-align: left; font-weight: bold;\">Urgency<\/th>\n<th style=\"border: 1px solid #ccc; padding: 10px 12px; background: #f1faf3; text-align: left; font-weight: bold;\">Typical enzyme dose range reported<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Vascular occlusion<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Severe pain, blanching, dusky or mottled purple skin, delayed capillary refill, vision change<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Emergency \u2014 same day, ideally within hours<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">450\u20131,500 units total, repeated cycles<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Tyndall effect<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Bluish-grey shadow, usually under the eyes or lips<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Elective<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Approx. 10\u201375 units<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Non-inflamed lump or migration<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Palpable or visible lump, filler sitting outside the intended area<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Elective<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Approx. 5\u201315 units initially, higher if needed<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Overcorrection or asymmetry<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Puffiness, heaviness, uneven result<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Elective<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Up to approx. 225 units reported<\/td>\n<\/tr>\n<tr>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Delayed inflammatory nodule<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Red, tender, swollen lump months later<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Assess first \u2014 antibiotics often precede enzyme<\/td>\n<td style=\"border: 1px solid #ccc; padding: 10px 12px; vertical-align: top;\">Variable; per clinical judgement<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2>What People Often Get Wrong About Dissolving Filler<\/h2>\n<p><strong>Misconception 1: &#8220;Old filler is gone, so there is nothing to dissolve.&#8221;<\/strong><\/p>\n<p>Imaging evidence increasingly contradicts the familiar six-to-eighteen-month figure. A 2026 clinical report in the <em>Journal of Cosmetic Dermatology<\/em> documents that complete disappearance within traditionally cited timelines &#8220;is not universal,&#8221; with MRI showing well-demarcated deposits corresponding to old injection sites years after treatment. If a lump appeared long after your last syringe, filler may still be a plausible cause.<\/p>\n<p><strong>Misconception 2: &#8220;One session erases everything.&#8221;<\/strong><\/p>\n<p>The same report notes that limited diffusion of the enzyme or insufficient dosing may contribute to incomplete degradation \u2014 particularly with heavily cross-linked gels and repeated layering in the same anatomical plane. Reversal is often staged, with reassessment at around 48 hours and further sessions if needed, rather than a single guaranteed clean slate.<\/p>\n<h2>Cost of Hyaluronidase in Tokyo<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"When to dissolve HA filler: signs you need hyaluro \u2014 Cost of Hyaluronidase in Tokyo\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/09\/pexels_7581577_1789010561.webp\" alt=\"When to dissolve HA filler: signs you need hyaluro \u2014 Cost of Hyaluronidase in Tokyo\" \/><\/figure>\n<p>Filler reversal is a self-pay (non-insured) cosmetic treatment in Japan, so pricing is set by each clinic. On our group&#8217;s published cosmetic price list (dated 1 October 2023), hyaluronidase is listed at \u00a544,000 per 1 mL, tax included, and \u00a588,000 per 1 mL where the original filler was injected at another clinic. The initial and follow-up consultation fee is listed at \u00a55,500.<\/p>\n<p>Total cost depends on how much filler is present, how heavily cross-linked it is, and how many areas are treated \u2014 a small Tyndall correction and a full mid-face reversal are not comparable. Please see the clinic&#8217;s official price page or contact us for a current quote, as published prices are subject to revision.<\/p>\n<p>One note specific to Japan: PMDA states that some medicines used in cosmetic medical procedures are not covered by the national relief system for adverse drug reactions. It is reasonable to ask your clinic which hyaluronidase product is used and what its regulatory status is before consenting.<\/p>\n<p>For an accurate quote, please book a consultation.<\/p>\n<div class=\"kjmc-en-booking-inline\" style=\"background: #f7fbf7; border: 1px solid #d5e6d8; border-radius: 10px; padding: 16px 20px; margin: 26px 0; text-align: center;\">\n<p style=\"margin: 0 0 12px; color: #1a3a1f; font-size: 0.95em; line-height: 1.65;\"><strong>Have a question about this treatment?<\/strong><br \/>\nMessage us on LINE or WhatsApp \u2014 our English-speaking team usually replies the same day.<\/p>\n<p style=\"margin: 0; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; gap: 8px; background: #06C755; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/line.me\/R\/ti\/p\/@710uitns?ts=05311801&amp;oat_content=url#~\" target=\"_blank\" rel=\"noopener noreferrer\">Book via LINE<\/a><br \/>\n<a style=\"display: inline-flex; align-items: center; gap: 8px; background: #25D366; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/whatsapp.com\/channel\/0029VbCA1v85K3zY4MLX2a1h\" target=\"_blank\" rel=\"noopener noreferrer\">Message on WhatsApp<\/a><\/p>\n<\/div>\n<h2>What to Expect, and Who Is a Good Candidate<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"When to dissolve HA filler: signs you need hyaluro \u2014 What to Expect, and Who Is a Good Candidate\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/09\/pexels_3985311_1789010563.webp\" alt=\"When to dissolve HA filler: signs you need hyaluro \u2014 What to Expect, and Who Is a Good Candidate\" \/><\/figure>\n<h3>Before<\/h3>\n<p>Bring your treatment records if you have them \u2014 the product name, volume, date and areas treated all change the dosing plan. Allergy history matters too: the CMAC guideline highlights cross-reactivity concerns in people with a history of anaphylaxis to wasp or bee stings, and describes intradermal skin testing using 15 units, while noting that no validated test concentration exists in routine practice.<\/p>\n<h3>During and after<\/h3>\n<p>The injection itself is quick. Expect swelling, redness and possible bruising for a few days; the treated area frequently looks flatter than your pre-filler baseline at first, because native HA is temporarily degraded as well. Guidance suggests reassessing the result at around 48 hours, and waiting a minimum of two weeks before re-injecting new filler.<\/p>\n<h3>Who should be cautious<\/h3>\n<p>Hyaluronidase is not appropriate for non-HA fillers such as calcium hydroxylapatite, poly-L-lactic acid or permanent silicone \u2014 the enzyme has no effect on them, so identifying the original product is essential. It is generally avoided in people with known hypersensitivity to the enzyme, and used with care in those with significant allergy histories. The FDA label states that allergic and anaphylactic-like reactions have been reported, rarely; review data put Type I hypersensitivity at approximately 0.1 percent at aesthetic doses.<\/p>\n<h2>Where to Get Filler Dissolving in Tokyo<\/h2>\n<figure style=\"margin: 1.5em 0;\"><img decoding=\"async\" style=\"width: 100%; max-width: 100%; height: auto; border-radius: 8px;\" title=\"When to dissolve HA filler: signs you need hyaluro \u2014 Where to Get Filler Dissolving in Tokyo\" src=\"https:\/\/kojihifu.com\/english\/wp-content\/uploads\/2026\/09\/pexels_27925589_1789010564.webp\" alt=\"When to dissolve HA filler: signs you need hyaluro \u2014 Where to Get Filler Dissolving in Tokyo\" \/><\/figure>\n<p>Within our clinic group, both BIOTOPE CLINIC (Shirokanedai, Minato-ku) and Kojimachi Dermatology &amp; Plastic Surgery Clinic (Ichigaya, Chiyoda-ku) offer English-language consultation with Dr. Jun Karibe&#8217;s team. Hyaluronidase injection for HA filler reversal is handled at BIOTOPE CLINIC in Shirokanedai. Bookings and enquiries in English: LINE or WhatsApp.<\/p>\n<p>At BIOTOPE CLINIC in Shirokanedai, a filler-reversal consultation begins with identifying the original product and mapping where it sits, since dosing depends on both. If you decide to re-treat afterwards, hyaluronic acid filler and Botox are both available there \u2014 feel free to ask about the timing during your consultation with Dr. Karibe.<\/p>\n<h2>Frequently Asked Questions<\/h2>\n<dl class=\"kj-faq\">\n<dt>Q. How quickly does hyaluronidase work?<\/dt>\n<dd>The enzyme acts immediately, and laboratory work has shown complete dissolution of biphasic filler within one to two hours at doses of 600\u2013750 units. Visually, however, swelling from the injection can mask the result, so most clinics reassess after about 48 hours.<\/dd>\n<dd><\/dd>\n<dt>Q. Will dissolving filler leave my skin loose or saggy?<\/dt>\n<dd>The area often looks temporarily flat because the enzyme also degrades your own hyaluronic acid, but published guidance indicates the body restores native HA within roughly 15 to 20 hours. Any longer-term laxity usually reflects the tissue changes that led you to have filler in the first place, rather than damage from the enzyme.<\/dd>\n<dd><\/dd>\n<dt>Q. Can filler from several years ago still be dissolved?<\/dt>\n<dd>Often yes. Imaging reports document HA deposits persisting well beyond the commonly quoted six-to-eighteen-month window, so old filler remains a plausible target \u2014 though heavily cross-linked, layered deposits may need more than one session.<\/dd>\n<dd><\/dd>\n<dt>Q. What should I do if I suspect vascular occlusion after filler?<\/dt>\n<dd>Contact the treating clinic immediately, or seek emergency care if you cannot reach them. Severe pain, blanching or mottled purple skin, and especially any vision change, are treated as urgent \u2014 review data suggest hyaluronidase is best given within about four hours.<\/dd>\n<\/dl>\n<div class=\"kjmc-en-booking-inline\" style=\"background: #f7fbf7; border: 1px solid #d5e6d8; border-radius: 10px; padding: 16px 20px; margin: 26px 0; text-align: center;\">\n<p style=\"margin: 0 0 12px; color: #1a3a1f; font-size: 0.95em; line-height: 1.65;\"><strong>Have a question about this treatment?<\/strong><br \/>\nMessage us on LINE or WhatsApp \u2014 our English-speaking team usually replies the same day.<\/p>\n<p style=\"margin: 0; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; gap: 8px; background: #06C755; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/line.me\/R\/ti\/p\/@710uitns?ts=05311801&amp;oat_content=url#~\" target=\"_blank\" rel=\"noopener noreferrer\">Book via LINE<\/a><br \/>\n<a style=\"display: inline-flex; align-items: center; gap: 8px; background: #25D366; color: #fff; padding: 10px 20px; border-radius: 8px; text-decoration: none; font-weight: bold; font-size: 0.92em; margin: 4px 6px; white-space: nowrap; vertical-align: middle;\" href=\"https:\/\/whatsapp.com\/channel\/0029VbCA1v85K3zY4MLX2a1h\" target=\"_blank\" rel=\"noopener noreferrer\">Message on WhatsApp<\/a><\/p>\n<\/div>\n<h2>Summary<\/h2>\n<p>There are two distinct reasons to <strong>dissolve HA filler<\/strong>.<\/p>\n<p>One is an emergency \u2014 suspected vascular occlusion, signalled by disproportionate pain, colour change, delayed capillary refill or visual symptoms, where treatment is measured in hours. The other is elective, covering lumps, Tyndall discolouration, migration and overcorrection, where small doses and staged reassessment are the norm.<\/p>\n<p>Reversal is realistic but not absolute: the enzyme is used off-label, it is non-selective, and heavily cross-linked or long-standing deposits may not clear completely in one session. An honest assessment of what is actually in your tissue is the most useful first step.<\/p>\n<p>If you have questions about when to dissolve HA filler and whether a hyaluronidase injection is appropriate for you, both <strong>BIOTOPE CLINIC<\/strong> (Shirokanedai, Minato-ku) and<strong> Kojimachi<\/strong> <strong>Dermatology &amp; Plastic Surgery Clinic<\/strong> (Ichigaya, Chiyoda-ku) offer English-language consultation with Dr. Karibe and his team. Hyaluronidase injection is primarily handled at BIOTOPE CLINIC. English enquiries: LINE or WhatsApp.<\/p>\n<div class=\"kjmc-en-booking-box\" style=\"background: linear-gradient(135deg,#f1faf3 0%,#e6f3ea 100%); border-radius: 14px; padding: 32px 24px; margin: 36px 0 24px; border: 1px solid #c5dccd; text-align: center;\">\n<h3 style=\"margin: 0 0 8px; color: #3a6e3a; border: none; padding: 0; font-size: 1.3em;\">24\/7 Consultation &amp; Booking<\/h3>\n<div style=\"width: 48px; height: 2px; background: #3a6e3a; margin: 0 auto 22px;\"><\/div>\n<p style=\"margin: 0 0 12px; color: #1a3a1f; font-size: 1.1em; font-weight: bold;\">Book a Consultation or Treatment<\/p>\n<p style=\"margin: 0 0 24px; color: #2c4a35; line-height: 1.75;\">Our English-speaking team responds via LINE or WhatsApp \u2014 usually the same day.<\/p>\n<p style=\"margin: 0 0 10px; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; justify-content: center; gap: 10px; background: #06C755; color: #fff; padding: 14px 32px; border-radius: 10px; text-decoration: none; font-weight: bold; font-size: 1.02em; box-shadow: 0 2px 8px rgba(6,199,85,0.25); min-width: 240px; white-space: nowrap;\" href=\"https:\/\/line.me\/R\/ti\/p\/@710uitns?ts=05311801&amp;oat_content=url#~\" target=\"_blank\" rel=\"noopener noreferrer\">Book via LINE<\/a><\/p>\n<p style=\"margin: 0; line-height: 1;\"><a style=\"display: inline-flex; align-items: center; justify-content: center; gap: 10px; background: #25D366; color: #fff; padding: 14px 32px; border-radius: 10px; text-decoration: none; font-weight: bold; font-size: 1.02em; box-shadow: 0 2px 8px rgba(37,211,102,0.25); min-width: 240px; white-space: nowrap;\" href=\"https:\/\/whatsapp.com\/channel\/0029VbCA1v85K3zY4MLX2a1h\" target=\"_blank\" rel=\"noopener noreferrer\">Message on WhatsApp<\/a><\/p>\n<\/div>\n<h2>References<\/h2>\n<ol>\n<li>Kroumpouzos G, Treacy P. Hyaluronidase for Dermal Filler Complications: Review of Applications and Dosage Recommendations. JMIR Dermatology. 2024;7(1):e50403.<\/li>\n<li>Hong GW, Hu H, Wan J, Chang K, Park Y, Vitale M, Damiani G, Yi KH. How Should We Use Hyaluronidase for Dissolving Hyaluronic Acid Fillers? Journal of Cosmetic Dermatology. 2025;24(1):e16783.<\/li>\n<li>Murray G, Convery C, Walker L, Davies E. Guideline for the Management of Hyaluronic Acid Filler-induced Vascular Occlusion. Journal of Clinical and Aesthetic Dermatology. 2021;14(5):E61\u2013E69.<\/li>\n<li>Murray G, Convery C, Walker L, Davies E. Guideline for the Safe Use of Hyaluronidase in Aesthetic Medicine, Including Modified High-dose Protocol. Journal of Clinical and Aesthetic Dermatology. 2021;14(8):E69\u2013E75.<\/li>\n<li>Sito G, Manzoni V, Sommariva R. Vascular Complications after Facial Filler Injection: A Literature Review and Meta-analysis. Journal of Clinical and Aesthetic Dermatology. 2019;12(6):E65\u2013E72.<\/li>\n<li>Prager M, Lusher J. Long-Term Persistence of Hyaluronic Acid Fillers: A Clinical Illustration and Implications for Practice. Journal of Cosmetic Dermatology. 2026;25:e70879.<\/li>\n<li>US Food and Drug Administration. HYLENEX recombinant (hyaluronidase human injection) prescribing information, revised January 2024. https:\/\/www.fda.gov\/<\/li>\n<\/ol>\n<h2>Related Articles<\/h2>\n<p>You may also find these articles useful.<\/p>\n<ul>\n<li><a href=\"https:\/\/kojihifu.com\/english\/under-eye-filler-tokyo-risks-benefits-3\/\" target=\"_blank\" rel=\"noopener\">Under Eye Filler Tokyo: Risks, Benefits &amp; Costs<\/a><\/li>\n<li><a href=\"https:\/\/kojihifu.com\/english\/dermal-filler-tokyo-price-guide-2\/\" target=\"_blank\" rel=\"noopener\">Dermal Filler Tokyo: Price Guide &amp; Clinic Selection Tips<\/a><\/li>\n<li><a href=\"https:\/\/kojihifu.com\/english\/ha-filler-tokyo-downtime-stay-flying\/\" target=\"_blank\" rel=\"noopener\">How Long Should You Stay in Tokyo for HA Filler? Downtime, Bruising &amp; Flying Guide<\/a><\/li>\n<li><a href=\"https:\/\/kojihifu.com\/english\/lip-filler-tokyo-cost-guide-3\/\" target=\"_blank\" rel=\"noopener\">Lip Filler Tokyo: Cost, Treatment &amp; Clinic Guide<\/a><\/li>\n<li><a href=\"https:\/\/kojihifu.com\/english\/volnewmer-jawline-cheeks-tokyo\/\" target=\"_blank\" rel=\"noopener\">Filler for Jawline and Cheeks Tokyo<\/a><\/li>\n<\/ul>\n<div style=\"margin: 2.5em 0 1em; padding: 1.5em; border: 1px solid #d5d5d5; border-radius: 10px; background: #fafafa; font-size: .9em;\">\n<p style=\"font-size: .72em; font-weight: bold; color: #888; margin: 0 0 1.2em; letter-spacing: .08em;\">SUPERVISED BY<\/p>\n<div style=\"display: flex; align-items: flex-start; gap: 1.2em; flex-wrap: wrap;\">\n<div style=\"flex-shrink: 0; text-align: center; min-width: 110px;\"><img decoding=\"async\" style=\"width: 100px; height: 100px; border-radius: 50%; object-fit: cover; object-position: top center; display: block; margin: 0 auto; border: 3px solid #e0e0e0;\" src=\"https:\/\/kojihifu.com\/hon\/wp-content\/uploads\/2022\/01\/photo-karibejun-400-3_re-300x300.jpg\" alt=\"Dr. Jun Karibe MD \u2014 Board-certified Plastic Surgeon, Director of Kojimachi Dermatology &amp; Plastic Surgery Clinic\" \/><\/p>\n<p style=\"margin: .6em 0 .1em; font-weight: bold; font-size: .95em; color: #222;\">Dr. Jun Karibe<\/p>\n<p style=\"margin: 0 0 .1em; font-size: .75em; color: #999;\">MD<\/p>\n<p style=\"margin: 0; font-size: .75em; color: #555; font-weight: bold;\">Director<\/p>\n<\/div>\n<div style=\"flex: 1; min-width: 200px;\">\n<div style=\"margin-bottom: .75em; background: #fff; border: 1px solid #ebebeb; border-radius: 6px; padding: .7em 1em;\">\n<p style=\"margin: 0 0 .35em; font-size: .78em; font-weight: bold; color: #666; border-bottom: 1px solid #f2f2f2; padding-bottom: .3em;\">Education &amp; Career<\/p>\n<div style=\"font-size: .82em; color: #444; line-height: 1.75;\">\n<div>Juntendo University School of Medicine<\/div>\n<div>Department of Plastic Surgery, University of Tokyo Hospital<\/div>\n<div>Assistant Professor, Plastic &amp; Cosmetic Surgery, Saitama Medical University<\/div>\n<div>Assistant Professor &amp; Chief Resident, Yamanashi University Hospital<\/div>\n<div>2019: Founded Kojimachi Dermatology &amp; Plastic Surgery Clinic (Ichigaya, Tokyo)<\/div>\n<div>2021: Founded BIOTOPE CLINIC Shirokanedai (Minato-ku, Tokyo)<\/div>\n<\/div>\n<\/div>\n<div style=\"margin-bottom: .75em; background: #fff; border: 1px solid #ebebeb; border-radius: 6px; padding: .7em 1em;\">\n<p style=\"margin: 0 0 .35em; font-size: .78em; font-weight: bold; color: #666; border-bottom: 1px solid #f2f2f2; padding-bottom: .3em;\">Certifications<\/p>\n<div style=\"font-size: .82em; color: #444; line-height: 1.75;\">\n<div>Board-certified Plastic Surgeon \u2014 Japan Society of Plastic and Reconstructive Surgery<\/div>\n<div>Specialist \u2014 Japan Society of Anti-Aging Medicine<\/div>\n<div>Certified Industrial Physician \u2014 Japan Medical Association<\/div>\n<div>Allergan VST-certified Injector (Botox &amp; Hyaluronic Acid)<\/div>\n<\/div>\n<\/div>\n<div style=\"background: #fff; border: 1px solid #ebebeb; border-radius: 6px; padding: .7em 1em;\">\n<p style=\"margin: 0 0 .35em; font-size: .78em; font-weight: bold; color: #666; border-bottom: 1px solid #f2f2f2; padding-bottom: .3em;\">Awards<\/p>\n<div style=\"font-size: .82em; color: #444; line-height: 1.75;\">\n<div>Best Presentation Award \u2014 Dept. of Plastic Surgery, University of Tokyo (2016)<\/div>\n<div>Excellence Award \u2014 Japan Society of Plastic and Reconstructive Surgery (2018)<\/div>\n<div>Featured Presentation \u2014 ASPS Annual Scientific Meeting, USA (2018)<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div style=\"margin-top: 1em; padding-top: .75em; border-top: 1px solid #e8e8e8; display: flex; flex-wrap: wrap; align-items: center; gap: .5em;\"><a style=\"display: inline-block; background: #e1306c; color: #fff; padding: .4em .9em; border-radius: 4px; text-decoration: none; font-size: .8em; font-weight: bold;\" href=\"https:\/\/www.instagram.com\/dr.jun_\/\" target=\"_blank\" rel=\"noopener noreferrer\">Instagram<\/a><\/p>\n<div style=\"margin-top: 1em; padding-top: .75em; border-top: 1px dashed #d5d5d5; font-size: .78em; color: #555; line-height: 1.7;\">\n<p style=\"margin: 0 0 .3em; font-size: .72em; font-weight: bold; color: #888; letter-spacing: .08em;\">MEDICAL REVIEW<\/p>\n<div><strong>Jun Karibe, MD<\/strong> \u2014 Board-certified Plastic Surgeon \u2014 Japan Society of Plastic and Reconstructive Surgery<\/div>\n<div>Medical Director, BIOTOPE CLINIC<\/div>\n<div>Last medically reviewed: 2026-09-10<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"When to dissolve HA filler: learn the signs you need a hyaluronidase injection, from lumps and Tyndall to emergencies. Book a review with our Tokyo team.","protected":false},"author":4,"featured_media":11865,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[20,21],"tags":[907,913,914,915,916,26],"class_list":["post-11866","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cosmetic-treatments","category-skin-dermatology","tag-filler-dissolving","tag-ha-filler","tag-tyndall-effect","tag-vascular-occlusion","tag-filler-migration","tag-tokyo-clinic"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/posts\/11866","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/comments?post=11866"}],"version-history":[{"count":1,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/posts\/11866\/revisions"}],"predecessor-version":[{"id":11886,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/posts\/11866\/revisions\/11886"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/media\/11865"}],"wp:attachment":[{"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/media?parent=11866"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/categories?post=11866"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kojihifu.com\/english\/wp-json\/wp\/v2\/tags?post=11866"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}