Face · Abu Dhabi & Dubai
Permanent Filler Removal
Medically reviewed by Dr. Paulo Michels, Board-Certified Plastic Surgeon· Updated 19 July 2026
Permanent fillers — biopolymer, liquid silicone and PMMA — cannot be dissolved; they can only be surgically removed. Dr. Paulo Michels excises the encapsulated filler and granulomas under general anaesthesia at Elyzee Hospital in Abu Dhabi, aiming to remove as much material as is safe, relieve pain and inflammation, and restore a natural contour — sometimes with staged reconstruction.
Permanent fillers cannot be dissolved — they can only be surgically removed. For patients living with migrated biopolymer, hardening, granulomas, pain or deformity, surgical excision removes the material and relieves the symptoms. This is corrective, reconstructive surgery — not a cosmetic injection reversed — and Dr. Paulo Michels approaches it with careful planning and complete honesty about what can and cannot be achieved in each case.
What are permanent fillers — and why do they cause problems?
Permanent fillers — biopolymer, liquid injectable silicone, PMMA (Metacrill) and old semi-permanent products — were injected to add volume, most often to the buttocks, but also the face and body. Unlike hyaluronic acid, they cannot be dissolved. Over months or years many cause migration, hardening, lumps, chronic inflammation, pain and distortion of the shape.
Different materials behave differently in the tissue, but all of the permanent ones share the same problem: they must be taken out.
| Material | How it behaves |
|---|---|
| Biopolymer & liquid silicone | The most problematic. Frequently injected into the buttocks; migrates, hardens and causes chronic inflammation and pain, sometimes years later. |
| PMMA (Metacrill and similar) | Becomes fixed and encapsulated in the tissue; can form nodules and irregularities. Excised surgically where it causes symptoms or deformity. |
| Old or semi-permanent products | Older long-lasting fillers that have encapsulated or caused lumps and inflammation are removed surgically when they can no longer be managed conservatively. |
Why can’t permanent filler be dissolved?
Hyaluronic acid fillers can be dissolved with an enzyme. Permanent fillers cannot — and that single fact changes everything about how they must be treated.
Biopolymer and liquid silicone do not stay where they are injected: they spread along tissue planes, migrate, and trigger chronic inflammation, forming hard granulomas. PMMA and old products become fixed and encapsulated. Because none of them can be dissolved away, the material has to be physically excised — the affected tissue and granulomas removed surgically. That is why permanent filler removal is a reconstructive operation, not a quick office treatment.
How is the filler removed?
The only real treatment is surgical removal: the encapsulated filler and the granulomas (inflammatory nodules) it forms are carefully excised under general anaesthesia. The goals are to take out as much of the material as can safely be removed, relieve the symptoms, and restore a more natural contour.
The treatment is planned in two stages:
- Stage 1 — Removal. The encapsulated filler and granulomas are excised. Drains and a compression garment are often used, depending on the extent removed.
- Stage 2 — Reconstruction. Once the tissue has fully recovered, the planned second stage restores the shape — the aesthetic reconstruction, such as fat grafting or a lift, where needed.
Can all of it be removed?
Honestly: not always completely. When biopolymer or liquid silicone has spread widely through the tissue, removing every last trace is not possible without damaging healthy structures. Anyone who promises 100% removal in every case is not being truthful.
What surgery can reliably do is remove as much of the material as is safe, take out the worst granulomas, and relieve the pain, inflammation and deformity. For most patients that is a profound improvement. Dr. Paulo Michels will tell you honestly, after examining you, how much can realistically be achieved in your case — before anything is decided.
What is the recovery like?
Recovery depends on how much material is removed and from where — typically two to four weeks.
- Swelling, bruising and tenderness settle over about two to four weeks
- Pain from the old inflammation often eases noticeably once the material is out
- The tissue recovers and softens over the following months, supported by compression
- Reconstruction, where planned, follows as a second stage once the tissue has fully recovered
Should I consider removal?
- You have permanent filler (biopolymer, silicone, PMMA) causing lumps, hardening or migration
- Pain, chronic inflammation, infection episodes or distortion of the shape
- Filler placed elsewhere — abroad or unregulated — that you were told was “permanent”
- You want an honest surgical assessment rather than another injection
- You are in good enough general health for reconstructive surgery
You do not need to know the exact product that was injected: part of the assessment is examining the area — sometimes with imaging — to understand what is there and how it behaves.
Why choose Dr. Paulo Michels?
Permanent filler removal demands an experienced plastic surgeon, careful planning and honesty. Dr. Paulo Michels performs the surgery at Elyzee Hospital in Abu Dhabi, where patients from Dubai and across the UAE are seen for consultation and surgery. His body contouring work was recognised with the Gold Medal, Best Body Contouring — World Plastic Surgery Olympiads 2025 (ISAPS, Singapore) — expertise that matters when the removal is followed by staged aesthetic reconstruction of the contour.
Questions, answered
Permanent Filler Removal in Abu Dhabi — your questions
Can permanent filler be dissolved?+
No. Only hyaluronic acid filler can be dissolved, with an enzyme. Permanent fillers — biopolymer, liquid silicone, PMMA and old semi-permanent products — cannot be dissolved and must be surgically removed.
What is biopolymer, and why is it a problem?+
Biopolymer usually means injectable silicone or similar permanent substances, often injected into the buttocks. Over time it migrates, hardens and causes chronic inflammation, granulomas, pain and distortion of the shape — which is why removal is so often needed.
Can all of the filler be removed?+
Not always completely. When biopolymer or silicone has spread widely through the tissue, removing every trace safely is not possible. The realistic goals are to remove as much as is safe, take out the worst granulomas, and relieve the symptoms — and Dr. Paulo Michels tells you honestly what your case allows before anything is decided.
How is the filler removed?+
By surgical excision — the encapsulated filler and the inflammatory granulomas are carefully cut out under general anaesthesia. It is reconstructive surgery, planned individually for the area and the material involved.
Which areas are treated most?+
Most often the buttocks, where biopolymer and silicone injections are common, as well as the face and other areas of the body where permanent filler has caused problems.
Will my shape be restored?+
The first priority is removing the material and relieving symptoms. Where volume or contour is lost, restoration — such as fat grafting or a lift — is planned as a second stage once the tissue has healed.
Is the pain and inflammation likely to improve?+
For most patients, removing the material and the granulomas significantly relieves the chronic pain and inflammation it was causing. The degree of improvement depends on how much can be removed.
I had filler abroad and don't know what it was — can you help?+
Yes. Part of the assessment is examining the area — sometimes with imaging — to understand what is there and how it behaves, then planning removal accordingly. You do not need to know the exact product to be assessed.
Is permanent filler dangerous to health?+
Beyond lumps and deformity, permanent fillers can cause recurring infections and chronic inflammation, and are associated with longer-term immune reactions. This is a further reason many patients choose to have them removed — assessed individually at consultation.
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