COSMEDOCS
    Harley Street Doctors • Since 2007

    Medically reviewed by Dr Ahmed Haq, Medical Director, Cosmedocs Harley StreetGMC 6078057Last reviewed

    Doctor-led · Hyalase

    Dissolving tear trough filler — elective and emergency.

    Old under-eye filler is the most common reason patients come to us looking 'tired'. We dissolve, reset, and — only if appropriate — re-treat. We also accept emergency Hyalase referrals from other clinics.

    See examples of corrected cases. Tear trough before & after gallery — including dissolving and re-treatment cases.

    When dissolving is the right answer

    Migration into the cheek

    Old or over-volumised tear trough filler can drift outward and downward, creating a permanent 'puffy' or 'baggy' look that the patient mistakes for a worsening eye bag.

    Tyndall effect (blue tint)

    Filler placed too superficially shows blue through the thin under-eye skin. Hyalase reverses it in minutes.

    Lumps or asymmetry

    Small visible nodules that didn't soften by week 4–6, or a clear left-vs-right difference, can be selectively dissolved.

    Vascular event (emergency)

    Sudden blanching, severe pain or vision change after injection requires hyaluronidase within hours. We carry it on-site at every clinic and we accept emergency referrals.

    Vascular emergency? If you have sudden severe pain, blanching, mottled skin or any vision change after a recent filler appointment, contact us or attend A&E immediately. We hold emergency Hyalase appointments daily at our Harley Street clinic.
    Reset, then refine

    Book a dissolving consultation

    Book dissolving consult Tear trough main page →Aftercare & recovery →

    Common dissolving questions

    Yes. Hyaluronidase (Hyalase) breaks down hyaluronic-acid filler within 24–48 hours. Some patients need a second pass at two weeks for stubborn deposits, particularly older filler that has fibrosed.

    Initially the area can look hollow for 2–3 days while the saline carrier and natural HA clear. By day 7 the under-eye returns to its true baseline — which is often better than the over-filled state.

    From £250 per session at Cosmedocs. A patch test is mandatory before the dissolving session. Two sessions are sometimes needed for older or thicker filler.

    We wait a minimum of 2 weeks before re-treating, so all the original filler and any residual hyaluronidase have cleared. Six weeks is ideal if there is no time pressure.

    Hyaluronidase is licensed and has been used for decades. The main risk is allergy (~1 in 1,000), which is why we patch test. It does not affect your own natural hyaluronic acid in any lasting way — your tissue replaces it within days.

    Those cannot be dissolved with hyaluronidase. We assess case-by-case — sometimes intralesional steroid or surgical removal is required. We will tell you honestly if dissolving is not the right route.