July 01, 2026 | Uncategorized
A patient came in recently and set her phone on my desk, open to a photo of herself from five years earlier. “I want to look like that again,” she said. “Not younger. Just like me.” She had been adding filler for years, and somewhere along the way the additions had stopped giving her back her own face.
That conversation is becoming common. A growing number of people come to see me to have material removed, not added. Migrated filler. Old filler that puffed up under the eyes and never left. Permanent lip biopolymers causing asymmetry and firmness years after the fact. Often, “I want it out” is exactly the right instinct.
These answers come straight from my consultations, anonymized.
Can You Remove Biopolymers From My Lips?
Yes. Biopolymers are permanent injectable materials, and over time the skin stretches around them and you get those little bags. I make an incision right where the wet and dry parts of the lip meet (the line you would color to just inside), then remove the affected tissue and whatever I find inside.
It goes all the way across, because doing it in spots leaves little dog ears, which are puckered bunches of tissue at the edges. Placed where it is, you will not see it. It heals fast, around five days, and the scar keeps improving for about two months. If you look closely you will see the line, but no one else will.
Will You Cut My Lip Muscle?
No. Some of the material sits deeper, in the muscle, but I do not remove muscle, because I do not want your motion or expression affected. Your body is already trying to push the material out, which is part of why you see those bumps.
Could It Come Back?
It can, and I want you to know that up front. Once I remove what is at the surface, your body may keep pushing more up, and sometimes about six months later you notice it again and we go back and remove more.
That happens roughly forty percent of the time, and we apply a discount when it does. Honesty here matters more to me than a perfect-sounding promise.
What About Migrated Filler in My Face?
Old filler often does not fully dissolve. It migrates, meaning it drifts away from where it was placed. If you are having a facelift, I can place medication during the procedure to dissolve some of it, so we are left with just your natural tissues and we do not over-inflate an area like the high cheekbones. I am genuinely cautious about stacking more filler on top of filler.
My Under-Eye Filler Has Been Puffy for Years
That is one of the most common things I see. Filler placed under the eyes can hold water and stay swollen for a very long time. Dissolving it is usually the first step, and it can take more than one treatment, especially if it has been there a while or earlier attempts to dissolve it did not work.
Once your own tissue is back to baseline, fat grafting, which uses your own fat to restore volume, is a safer way to address true hollowing than more product.
How Long Does Dissolving Take, and Why More Than Once?
Patients often expect one visit to undo years of filler. Sometimes it is that simple. Often it is not. Hyaluronic acid fillers can be dissolved with an enzyme, but old, deeply placed, or partially scarred filler can resist the first round. So we may dissolve, let things settle for a couple of weeks, then assess what is still holding water and treat again.
I would rather under-promise here and surprise you on the good side than tell you it is one and done and leave you frustrated. The goal is not to strip your face. It is to get you back to your own baseline so we can see what is really there.
What Recovery From Removal Looks Like
For lip biopolymer removal, the incision heals in about five days, and the scar keeps improving for roughly two months. You will be swollen at first, which is normal, and I will tell you what is expected versus what would be a reason to call.
For dissolving filler, there is essentially no downtime beyond a little swelling or bruising at the injection points. For fat grafting later, recovery is gentle, with some swelling that settles over a few weeks. None of this is dramatic, but I want you to know what to plan around before you book.
What Will My Lips Look Like Afterward?
This is the question I hear most, and the honest answer is that they will look like your lips, just without the foreign material distorting them. Once the biopolymer and the affected tissue are out, the shape settles toward your natural anatomy.
If you have lost true volume over the years and want a little back, we can talk about that later, once everything has healed and we can see your actual baseline. I will not rebuild volume in the same visit I remove material, because the swelling makes it impossible to judge the result honestly. Patience here protects you from chasing a moving target.
Is Removal Riskier Than Placement?
It is more involved, yes. Putting material in takes minutes. Taking it out, especially permanent biopolymers, is more delicate and sometimes staged across more than one visit. I will be straight with you about what can be fully reversed and what cannot. But for a lot of people, getting the foreign material out is the right call.
Why I Take This Seriously
I am double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, a Fellow of the American College of Surgeons, and I completed my plastic surgery fellowship at the Mayo Clinic. I have strong feelings about the filler-everything era, because I am the one who sees the cleanup. Removing material thoughtfully, and being honest about recurrence, is its own skill.
Ready to Talk?
If you are tired of chasing one filler with another, or you want a biopolymer out, come talk to me. For the surgeon’s editorial take, see the companion essay on drworldwide.com. For the facial-aesthetics menu, see the version on swplasticsurgery.com.
Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com. #StayBeautiful.
@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
