Complication Management
Complication Management & Hyaluronidase Treatment
Dr Martyn King | Cosmedic Skin Clinic | Staffordshire
Dermal filler treatments are widely used for facial rejuvenation and volume restoration. While generally safe when performed correctly, complications can occasionally occur, ranging from aesthetic concerns such as overfilling or asymmetry to more urgent vascular-related complications.
At Cosmedic Skin Clinic, we provide a specialist service for filler complication management and hyaluronidase-based filler dissolving. This includes the assessment and treatment of unwanted, misplaced, or problematic dermal filler, as well as the management of more complex or urgent aesthetic complications.
Dr Martyn King is recognised as an expert in this field, with extensive clinical experience and a leading role in the development of complication management protocols within aesthetic medicine. He is also Medical Director of the Aesthetic Complications Expert Group (ACE Group), contributing to widely adopted clinical guidance used across the industry.
Summary
- Procedure time: 30–60 minutes (initial assessment may be longer)
- Downtime: Minimal to moderate depending on severity
- Discomfort: Mild to moderate (injection-based treatment)
- Anaesthetic: Topical or local anaesthetic may be used
- Onset of results: Immediate to 24–48 hours
- Peak/final results: 2–7 days depending on filler type and amount
- Duration: Permanent removal of hyaluronic acid filler once dissolved
- Maintenance: May require 1–3 sessions depending on complexity
Pricing
- Consultation & complication assessment: From £150
- Hyaluronidase treatment (small area): From £150
- Emergency complication management: Priced according to urgency and complexity
💡 All cases require clinical assessment prior to treatment. Emergency cases are prioritised where clinically indicated.
How it works
Hyaluronidase is an enzyme that breaks down hyaluronic acid-based dermal fillers. It works by rapidly dissolving filler material, allowing the body to naturally clear it from the treated area.
Treatment involves:
- Detailed clinical assessment of the concern
- Identification of filler type, location, and depth where possible
- Risk assessment for vascular or inflammatory complications
- Targeted injection of hyaluronidase into affected areas
- Careful monitoring of response
- Follow-up review and additional treatment if required
In cases of urgent vascular compromise or suspected vascular occlusion, immediate treatment may be required.
What areas can be treated
Aesthetic Concerns
- Overfilled or overcorrected areas
- Lumps or irregularities
- Asymmetry following filler treatment
- Migration of filler
- Tyndall effect (blue-grey discolouration under the skin)
- Unwanted or outdated filler results
Medical & Urgent Complications
- Suspected vascular occlusion
- Skin blanching or compromised blood flow following filler
- Severe pain following filler injection
- Inflammatory reactions to filler
- Delayed-onset nodules (where clinically appropriate)
Am I suitable?
You may be suitable if you:
- Have hyaluronic acid dermal filler that requires correction or removal
- Are experiencing complications following filler treatment
- Have asymmetry or aesthetic dissatisfaction
- Require urgent assessment following a filler procedure
- Have been advised to seek specialist complication management
You may not be suitable if you:
- Have filler types that are not responsive to hyaluronidase (non-HA fillers)
- Require surgical management for unrelated conditions
- Have untreated infection requiring prior medical management
- Are unable to provide relevant treatment history where required (may affect planning)
- Have an allergy to wasp or bee stings
A full clinical assessment is essential before treatment.
Pre-treatment advice
Before treatment:
- Provide full details of previous filler treatments where possible
- Inform the clinic of all medications and medical history
- Avoid alcohol for 24 hours prior if possible
- Attend as soon as possible if a vascular complication is suspected
- Do not massage or manipulate the area prior to assessment unless advised
Urgent cases should be assessed immediately.
Post-treatment advice
After treatment:
- Expect some swelling and tenderness
- Avoid touching or massaging the area unless instructed
- Avoid strenuous exercise for 24–48 hours
- Avoid heat exposure (saunas, steam rooms) for 48 hours
- Follow all personalised aftercare instructions
- Attend follow-up review if required
- Multiple treatments may be needed in complex cases.
Side-effects & complications
Hyaluronidase treatment is widely used and generally safe when performed by experienced clinicians.
Common (temporary):
- Swelling
- Bruising
- Redness
- Mild tenderness
- Temporary asymmetry during resolution
Less common:
- Overcorrection (excess breakdown of filler and natural hyaluronic acid)
- Allergic reaction (rare but possible)
- Localised irritation
- Temporary skin texture changes
Rare:
- Significant allergic reaction (anaphylaxis)
- Infection
- Unexpected tissue response
- Incomplete filler dissolution requiring repeat treatment
All patients are carefully assessed to minimise risk and ensure appropriate treatment planning.
Benefits
- Safe removal of unwanted dermal filler
- Correction of overfilled or uneven results
- Specialist management of complications
- Rapid intervention in urgent cases
- Restoration of natural facial appearance
- Expert-led assessment and treatment planning
- High-level clinical expertise in aesthetic complications
- Evidence-based approach to patient safety
Advice from Dr Martyn King
Dr Martyn King, Cosmedic Skin Clinic, Staffordshire
"Filler complications require careful assessment, accurate diagnosis, and prompt, evidence-based treatment. Hyaluronidase is a highly effective tool when used correctly, but its use must always be guided by clinical judgement and an understanding of facial anatomy. My focus is always on patient safety, restoring natural appearance, and ensuring the best possible clinical outcome in every case."
