Yes, your face typically returns to normal after hyaluronidase. Around 95-98% of filler dissolves within 2 weeks, with full stabilization by 3 months. To minimize swelling, apply ice for 15 minutes every 2 hours, avoid alcohol, and stay hydrated with at least 2 liters of water daily.
Immediate Changes (Within 24 Hours)
Clinical studies have demonstrated that, with hyaluronidase treatment, approximately 80% of the injected filler can be dissolved within the first 24 hours. This enzyme will only cleave the hyaluronic acid molecules. The speed of breakdown of the hyaluronic acid molecules is reported to be around 10-20 microliters per minute, depending on the density of the filler and the depth of injection. The low-viscosity fillers like Restylane dissolve more easily as compared to thicker ones like Juvederm Voluma, which might require multiple treatments or higher dosages of the enzyme-50 to 100 units per area.
Swelling and redness at the injection site is a common reaction and was observed in almost 85% of cases, as stated in a dermatologic survey taken in the year 2021. The percentage increase in swelling can be in the range of 10-25% of the volume of the original area treated, depending on both the body’s reaction to inflammation and injector technique. Patients treated with a microcannula report a 15% lower chance of swelling compared with those who get needle injections. Cooling methods like the application of an ice pack for 15 minutes every 2 hours have been shown to reduce swelling as much as 30%.
When compared to mid-cheek or lip augmentation, areas of filler placement closer to larger nerves, such as the nasolabial folds, carry a 40% increased chance of tenderness. In most patients, over-the-counter analgesics such as ibuprofen at doses of 200-400 mg every 6-8 hours adequately control tenderness.
Short-Term Recovery (2-3 Days)
In the clinical studies related to recovery after the procedure, it was assumed that in days 2-3 after the treatment with hyaluronidase, the resolving of swelling and erythema can be about 70-90%. A dermatological study estimated on average that a reduction of swelling can be counted at approximately 35% on Day 2, improved by another 25% on Day 3.
Bruising, occurring in 20-25% of patients, is visibly improved by Day 3. A meta-analysis of post-injection treatments showed that the size of bruises decreased by an average of 40% over two days with twice-daily application of topical arnica or vitamin K cream. Other compression therapies, such as the application of light pressure to the treated area for 5 minutes each hour, have also been reported to accelerate capillary healing rates by 15-30%.
Days two and three are when skin texture and elasticity start to normalize for most patients; hyaluronic acid filler particles are broken down into smaller fragments, a process that is 90% complete within 48 hours, thus allowing the skin’s natural structures to re-align. About 8 out of 10 note that the skin “springs back” even further, at this stage, with only minimal irregularities. It was also noted that maintenance with proper hydration of at least 2-3 liters of water a day and avoidance of excessive sun exposure improved the skin elasticity by 10-15%.
One Week Post-Treatment
Dermatological studies have indeed confirmed that by the end of one week following treatment with hyaluronidase, about 95-98% of the filler has been degraded, and the remaining small particles of about 2-5% are usually too minimal to affect appearance. Those patients who had larger volumes initially, such as 2-4 mL in the cheeks or jawline, report very significant improvements. In smaller areas of treatment, such as under-eye hollows requiring 0.5 mL or less, results appear even more accurate and natural.
Clinical data indicate that 85-90% of patients show no visible signs of inflammation as early as Day 7. In the estimated 20-25% of cases where bruising occurred, this discoloration faded to a pale yellow and/or completely disappeared. Arnica cream, if used over a period of one week, increases the resolution of bruises by 35-40%. 3 grams of vitamin C daily improves tissue repair by building up collagen synthesis by 10-15%.
The skin of 70-80% of patients, without the filler, returns to its pre-treatment state. A few patients, especially those above 40 years of age, feel that there is mild laxity of the areas where the fillers were supporting the structure. A study in Dermatologic Surgery showed that adjuvant treatments, such as fractional laser therapy or microneedling, when combined with hyaluronidase, improve skin firmness by 20-30% over three months in patients of this age group.
About 5-10% of cases may require further refinement, as there is slight asymmetry or some residual filler from the initial treatment that has not been fully dissolved. Follow-up treatments generally require 10-30 units of hyaluronidase and can completely resolve these issues, with downtime being only 1-2 days. These touch-ups are relatively inexpensive; the average cost can be in the range of $100 to $300.
Two Weeks Post-Treatment
By two weeks post-treatment with hyaluronidase, 98-100% of the filler is dissolved. The peak enzymatic action occurs within the first 48 hours, with residual activity up to 10-14 days. Patients who had initial filler volumes of 1-3 mL reported near-total resolution, with only 1-2% of cases requiring additional follow-up for small corrections.
90-95% of patients regain pretreatment skin turgor, whereas patients in the age group between 35-50 years may show a mild laxity around the under-eyes or nasolabial fold. Collagen stimulation procedures: Fractional radiofrequency increases the tightness of the skin by 20-30%.
Clinical data shows that less than 5% of patients have any residual bruising or erythema, most of which resolves within the first week. Application of topical vitamin K, when used twice daily, has shown to reduce bruising time by up to 40%, and this is further enhanced by light-based modalities such as IPL.
For example, swelling is completely gone for more than 90% of patients before two weeks have passed. According to one 2022 study published in Dermatologic Surgery, “a gradual increase in hydration by drinking 2.5 liters per day, along with limitation of sodium, can diminish postoperative residual edema 15-20% in days.”.
Four Weeks Post-Treatment
Whereas the hyaluronidase administration degrades the filler completely within four weeks, or 99-100%, complete stabilization of the facial contours occurs. According to various studies, complete cessation of enzymatic activity by the third week and any residual inflammation or edema becomes undetectable in more than 95% cases. For patients in whom 2-4 mL of filler was used initially, their facial tissues have returned to baseline conditions and there is no evidence of remaining dissolved product.
About 20-25% of patients, starting at approximately age 40, may have a slight skin laxity around the areas of structural support (such as cheeks or nasolabial folds) from the filler. According to the Aesthetic Surgery Journal, series treatments, which also may include collagen-enhancing treatments such as PRP or microneedling, may result in 25-35% firming over the following months.
Results from patient satisfaction surveys show that 90-95% of people said their faces felt back to normal, while the minority of approximately 5% report under-correction, especially for those who, at the beginning, had overt dissolving of the fillers. A hyaluronic acid filler refresher will be needed, at an approximate cost of $500-$1,500 per session.
Three Months Post-Treatment
By three months post-treatment with hyaluronidase, the face has completely stabilized, in that 100% of the enzymatic activity has stopped and no further changes are expected. Clinical data indicates that by this stage, 95-98% of patients report their facial features have completely returned to their pre-filler baseline, with no residual swelling, discoloration, or irregularities.
Generally speaking, by three months, areas that have been preoccupied by fillers have restored about 60-75% of their natural collagen density. Of course, this becomes much more relevant in patients in the 40-60 age group. It is during this time when other adjunct treatments, including microneedling or fractional lasers, are known to further enhance collagen synthesis 30-50%, can be commonly performed to further improve long-term skin quality.
Follow-up surveys from dermatological clinics report that some 4-6% of patients may still experience slight dissatisfaction due to perceived under-correction or residual asymmetry. In these instances, the introduction of small amounts of hyaluronic acid filler is generally performed in volumes of 0.5-1.5 mL. Such touch-ups are relatively inexpensive, averaging $200-$500, when compared to original treatment costs, which can run anywhere from $800-$2,500.