Patients often come to Dr. Rokhsar, who is a double board-certified cosmetic dermatologist, asking him to correct fillers that were wrongly injected by other practitioners. Dr. Rokhsar is a trainer and educator for Allergan, Galderma, and Merz. Additionally, his offices have been named Centers of Excellence by Radiesse1, and he has worked extensively with a wide range of injectables.
Moreover, Dr. Rokhsar has helped many patients throughout Manhattan, Long Island, and the greater NYC area to dissolve fillers, create facial balance and restore a natural look.
While dermal fillers are safe and an effective way to combat the signs of aging, and good results are expected, it is possible for the treatment to go wrong. And in most cases, this occurs when the treatment doesn’t match expectations. So if for instance, the wrong technique is used, injectables are placed into the wrong layer or area, or the wrong types are used, results could be less than expected.
These problems may2 include:
When injections are carefully performed by a board-certified and experienced dermatologist, you can get natural results without bumps, lumpiness, or discoloration, with minimal bruising, risks, and complications.
Various factors will impact the best approach to “un-do” the botched procedure. And these factors may include the type of dermal filler used and the injection site.
If you can’t wait for the filler to naturally dissolve, Dr. Rokhsar can typically reverse4 the botched results in one of the following ways:
First, Dr. Rokhsar will discuss the options available to you after he has performed a complete examination of the botched area. Next, he will also ensure that you are well informed of any possible risks and side effects of filler reversal treatment.
For the best results from facial fillers, do your research and find a provider who is experienced, board-certified, and specializes in cosmetic dermatology. In addition, you should ask for before and after photos and be sure to have realistic expectations. When selecting a provider, all of these factors are equally important. You should not go into this blindly, as doing so, may result in long-lasting negative outcomes in severe cases.
When visiting our offices in LI and Manhattan, you will be in the care of a world-renowned cosmetic surgeon and dermatologist. Dr. Rokhsar is a sought-after trainer and speaker who consistently delivers aesthetically pleasing results with his dermal filler reversal treatments.
Dr. Rokhsar has reversed and fixed many botched filler jobs and suggests to those considering correction, to choose their service provider carefully. Schedule your appointment with his Manhattan or Long Island office today.
* Results May Vary
The effects of tear trough fillers are more long-lasting than any other anatomic areas. Fillers placed in the right plane can last 1-2 years. Fillers placed in the wrong plane which is above the muscle can last much longer. This is very problematic when the filler is placed in the wrong place because it shows up as lumps of blue material. These lumps often become more swollen in the morning time, or during sickness as the filler holds onto tissue fluid. Other factors that can influence how long the treatment lasts include age, metabolism, and the type of filler used. Repeated treatments are necessary to maintain long-term results.
The longevity of the filler may vary from person to person and the type of filler used. Hyaluronic acid fillers like Restylane in the tear trough can last 1-2 years. Juvederm, although a great filler, should never be used in the tear trough as it absorbs too much fluid and often looks very swollen. Another food filler for the tear trough is Vollure. Vollure gives very natural results with minimal swelling compared to other fillers. The FDA has allowed Allergan, the maker of Vollure to claim that this filler lasts for 18 months. In some people, Vollure when injected in the tear trough can last for 2 years. RH fillers including RH2 RH3 and RH4 fillers are relatively new. There is not a whole lot of experience to ascertain the look of these fillers in the tear trough. RH2 and RH3 fillers should be avoided in the tear trough as they are relatively heavy fillers. Volbella injections in the tear trough should be avoided as they have a high incidence of nodule formation. Voluma is also a very dense filler and should be avoided in the tear trough. Volux is also a relatively new filler and should be avoided in the tear trough. Belotero, although a soft and not so dense filler, and is used commonly in the tear trough by many doctors, has the disadvantage of lasting only a few months and therefore is not a preferred filler in the tear trough. Radiesse should only be used in patients with a very thick skin in the tear trough and be only used by a very experienced doctor like Dr. Rokhsar. Although Dr. Rokhsar, can dissolve Radiesse with injections of sodium thiosulfate, multiple sessions are required to dissolve Radiesse. Permanent fillers like Bellafill, and silicone are not recommended for use in the under-eye area due to the risk of complications such as allergic reactions, nodule formation, and persistent swelling. These are permanent fillers and cannot be reversed. Bellafill and Silicone have been associated with a high incidence of nodule formation and inflammatory granulomas.
Hyaluronic acid fillers, which are the most commonly used type of fillers, are easier to dissolve than calcium-based fillers like Radiesse. When injected with Vitrase or Hylenex, the Hyaluronic Acid (HA) filler starts dissolving immediately. Dr. Rokhsar recommends that you wait at least 48 hours for the Vitrase or Hylenex to finish working. In some instances, with heavier fillers like Voluma or Juvederm, a second or third session of Vitrase injections may be needed to dissolve the botched filler. Calcium-based fillers like Radiesse, have to be injected with sodium thiosulfate. Dr. Rokhsar recommends weekly injections of sodium thiosulfate to dissolve Radiesse. One to four sessions of sodium thiosulfate injections may be needed to fully dissolve botched Radiesse injections. Massaging the area is highly recommended after Vitrase, Hylenex, or sodium thiosulfate injections to fix a botched filler job.
Different fillers in different anatomic areas last a different amount of time. For example, fillers, last the least in the lips due to high blood flow and constant movement of the lips. Fillers in general last longer in the cheeks and tear trough when placed in the appropriate plane. Dr. Rokhsar has years of experience dissolving botched filler injections and redoing your fillers by placing them in the right plane.
If you are looking to dissolve fillers faster, there are a few options available. One option is to receive injections of hyaluronidase, which is an enzyme that breaks down hyaluronic acid fillers. There are two forms of hyaluronidase available to Dr. Rokhsar. One is Hylenex and the other is Vitrase. These enzymes chew up the hyaluronic acid filler like Restylane and Juvederm. They start working almost immediately after the injection. Dr. Rokhsar recommends that you wait a full 48 hours for the hyaluronidase enzyme to finish dissolving your bad filler injection. These injections are usually fairly painless. Radiesse can be dissolved by injecting a solution called sodium thiosulfate. Since Sodium thiosulfate injections can sting or burn, Dr. Rokhsar always numbs the area of the botched filler injection with a numbing solution like lidocaine. Massaging the area after injections of Vitrase or sodium thiosulfate aids in the filler to dissolve faster. Dr. Rokhsar is an expert in dissolving botched filler injections and redoing them for you.
Dermal fillers can be naturally dissolved by the body over time, typically taking months to years to dissolve depending on the type of filler used, the plane it was injected the anatomic locations of the injections. However, if immediate removal is desired, hyaluronidase (Vitrase or Hylenex) can be injected by Dr. Rokhsar to rapidly dissolve HA-based fillers. These include fillers like Restylane, Juvederm, volume, Belotero, and RH family of fillers. Hyaluronidase is a soluble protein enzyme that breaks down the hyaluronic acid found in dermal fillers by breaking up the bonds that hold the HA molecules together and encourages the body to reabsorb those molecules in a natural process. Hyaluronidase can also be used to correct filler procedures that have gone wrong for any number of reasons. If Radiesse was injected, Dr. Rokhsar’s injection of choice is sodium thiosulfate. Multiple sessions may be necessary to fully dissolve botched Radiesse injections.
To dissolve lip fillers, the most effective method is to receive injections of hyaluronidase (Hyalenex or Vitrase). Hyaluronidase is a concentrated synthetic form of an enzyme that naturally occurs in the body and is used to break down hyaluronic acid, the main ingredient in most dermal fillers. This is a fast-acting and safe procedure with minimal side effects. However, only hyaluronic acid fillers can be dissolved using hyaluronidase injections. Other types of fillers, such as poly-L-lactic acid (Sculptra) and calcium hydroxylapatite, (Radiesse) are harder to dissolve. Radiesse can be dissolved by injecting sodium thiosulfate. Sculptra nodules can be dissolved by cortisone injections, cortisone and 5FU injections, or sometimes saline injections. Multiple injections may be necessary.
Before the procedure, numbing cream is applied to the lips to dull the burning sensation that is often experienced during the injections. Then, hyaluronidase is injected into the lips with a series of tiny injections to dissolve the lip fillers.
In emergency situations where the filler is accidentally injected into an artery and causes vascular occlusion, hyaluronidase injections should be immediately administered to dissolve the filler.
It is recommended to seek a qualified medical professional like a board-certified dermatologist. Dr. Rokhsar is double board certified in dermatology and dermatologic surgery and is a graduate of Harvard and NYU.
The most common area that Dr. Rokhsar sees botched filler injections is the under-eye or the tear trough. This is a wonderful area to inject fillers. The results can be life-changing and dramatic. There are too many unqualified people who are injecting the undereye or the tear trough which often results in a terrible look with bumps, bluish bulges (Tyndall effect), persistent swelling, and many other issues. These complications happen when an inexperienced injector, injects the filler in the wrong anatomic area or when the wrong filler is injected in the tear trough. To dissolve under eye filler, hyaluronidase (Vitrase or Hylenex) injections are typically used, similar to the process for dissolving lip filler. Hyaluronidase is an enzyme that breaks down the hyaluronic acid molecules in the filler, allowing the body to naturally reabsorb it over time. The injection of hyaluronidase should only be performed by a qualified medical professional. Dr. Rokhsar is double board certified in Dermatology and Dermatologic surgery; he has many years of experience fixing botched tear trough injections. Many other doctors see Dr. Rokhsar for their tear trough injections because it involves a high degree of skill and experience. Dr. Rokhsar performed tear trough under eye filler injections live on the Rachel Ray show in 2008. Since then, he has treated thousands of happy patients performing his non-surgical eyelift in the tear trough. He has also helped hundreds of patients with botched tear trough or under-eye filler injections.
When dissolving under eye filler, the specific type of filler used is also important to consider. Some fillers are specifically formulated for use in the tear trough area. Restylane is an example of this filler. Restylane when injected properly in the tear trough or under eye gives great natural results. When botched, it can look terrible. The good news is the Restylane can be easily dissolved with Vitrase injections. Oftentimes, one session of Vitrase injections can fully dissolve botched Restylane undereye or tear trough injections. Juvederm may take two sessions to dissolve. Dr. Rokhsar is the most experienced doctor in fixing botched under-eye or tear trough filler injections in the New York area.
Upper East Side Manhattan Office
121 East 60th Street, Suite 8AB New York, NY 10022
(212) 285-1110
Long Island Office
901 Stewart Ave, Suite 240, Garden City, NY 11530
(516) 512-7616
References
Dr. Cameron Rokhsar, MD, FAAD, FAACS, is the founder and medical director of the New York Cosmetic, Skin, & Laser Surgery Center. Dr. Rokhsar is a graduate of Harvard College and NYU School of Medicine. Dr. Rokhsar is double board certified in dermatology and micrographic dermatologic surgery, being one of the few select dermatologists in the country who is also fellowship trained in laser surgery. A researcher and innovator, Dr. Rokhsar is the creator of the non-surgical nose job and has been instrumental in the research and development of laser systems such as the Fraxel, CO2, Mirady, Vbeam, Themitight, and Ulthera devices. An Associate Professor of Dermatology at Mount Sinai Hospital in NYC, Dr. Rokhsar actively teaches the cosmetic dermatology clinic to the resident at Mount Sinai. An expert injector of fillers, and a trainer for many companies, patients fly in from around the world to see Dr. Rokhsar in his Garden City and Manhattan offices in New York.
Dr. Rokhsar was chosen by
magazine as a top dermatologist in its Best Doctors 2017, 2018, 2019, 2020, 2021, 2022 and 2023 issues.
