The "Natural Look" Era: Why Filler Dissolving Became Common

One of the clearest trends of recent times is the reversal of an approach applied for years: instead of adding volume, taking back what was added.

This is a trend that has changed the direction of both patients and practitioners, and it arose from several separate developments coming together.

What changed?

1. The overfilled look became recognisable

Filler use has grown at a very high rate worldwide since the 2000s. Use on that scale inevitably also made the excessive results visible.

Over time the "has had filler" look became recognisable, and that reversed the original aim — looking better without it being noticed.

2. It became clear that filler does not always disappear completely

For a long time people acted on the assumption that "it dissolves anyway". But imaging studies are challenging that assumption.

In a study published in Plastic and Reconstructive Surgery — Global Open in 2024, 33 people who had had filler in the mid-face were examined with MRI. Filler was still visible in all thirty-three at the end of two years ; complete disappearance was found in none of them. Twelve of the participants had not had a treatment for more than five years, and in one person the filler could still be imaged fifteen years later. The study covers 33 people — a small group of selected patients; even so, it shows that the general assumption of "three to twelve months" does not hold for every product and every area.

This means that it is not the individual treatments but the sum of the years that has to be assessed.

3. It became clear that the problem was not volume

This is the most important shift. Putting filler into sagging does not correct the sagging; as volume is added the face becomes heavier and a "full but low" appearance emerges.

When the right distinction is not made — sagging, volume loss or skin quality — every millilitre added makes the problem bigger.

Dissolving filler: how does it work?

Hyaluronic acid fillers can be broken down with an enzyme called hyaluronidase. This is the most important safety feature of this product group and is vital in emergencies.

Dissolving for aesthetic reasons, however, is a different decision and calls for care. This should also be known: a scoping review published in Aesthetic Plastic Surgery reports that there is no randomised trial, clinical trial or retrospective controlled study on the use of hyaluronidase to reverse filler in the face ; all five randomised trials available were carried out on the skin of the arm, forearm and back. So the practice is widespread, but the evidence base for its use in the face is weak.

• The enzyme can affect not only the filler but also the natural hyaluronic acid in the tissue
• After dissolving, the area may temporarily look emptier than it is
• You need to wait a few weeks to judge the result
• It may not all dissolve in a single session
• For permanent or non-dissolvable fillers this option does not exist

Tip — Deciding to dissolve is also a treatment decision and deserves the same care. The thought "it can be reversed anyway" should not be a reason to take the first treatment lightly.

The new direction: improving instead of adding

Moving away from the volume-adding approach left the space to other approaches:

• Regenerative injections. Treatments that target tissue quality instead of adding volume.
• More measured filler use. Regional, in small amounts, keeping an eye on the yearly total.
• Turning to surgery earlier. If the problem is sagging, choosing the right procedure instead of postponing it for years with filler.
• Investing in skin quality. Sun protection and treatments aimed at tissue quality.

How healthy is this trend?

On the whole a positive direction. But two cautions are needed:

First: "natural result" can itself become a fashion and produce the same mistake in the opposite direction. In someone with marked volume loss, doing nothing may not be the right decision either.

Second: the decision to dissolve is itself a treatment. Dissolving done by looking at a social-media trend may be no more thought through than the filler that was done.

The same principle applies in both directions: the decision should rest on your own findings, not on a trend.

Questions to ask

• Is my problem volume loss, sagging or skin quality?
• How do the treatments I have had before affect the picture today?
• Adding, dissolving or doing nothing — what is the reasoning behind each of the three?
• Is the product used dissolvable?
• How will we assess the picture a year from now?

References

1. Master M, Azizeddin A, Master V. Hyaluronic Acid Filler Longevity in the Mid-face: A Review of 33 Magnetic Resonance Imaging Studies. Plast Reconstr Surg Glob Open. 2024;12(7):e5934. PMID 39015357
2. Borzabadi-Farahani A, Mosahebi A, Zargaran D. A Scoping Review of Hyaluronidase Use in Managing the Complications of Aesthetic Interventions. Aesthetic Plast Surg. 2024;48(6):1193–1209. PMID 36536092
3. Yi KH, Wan J, Yoon SE. Considerations for Proper Use of Hyaluronidase in the Management of Hyaluronic Acid Fillers. Plast Reconstr Surg Glob Open. 2025;13(3):e6566. PMID 40040950

About the Author

Op. Dr. Yasemin Aydınlı is a graduate of the English Medical Faculty of Hacettepe University. She completed her specialist training in Plastic, Reconstructive and Aesthetic Surgery at Ankara University Faculty of Medicine. She works in the field of aesthetic and reconstructive surgery in İstanbul.

Frequently Asked Questions

This content is for general information only and does not replace medical advice. Every person is different; suitability and the process can only be determined by a personal examination and consultation.

Op. Dr. Yasemin Aydınlı

Plastic, Reconstructive and Aesthetic Surgeon

Offers personalized aesthetic solutions with a priority on naturalness and balance.