In short
- Nothing dissolves these materials. Hyaluronidase breaks down hyaluronic acid and has no effect at all on them: they are chemically different.
- Nor are they removed by massage, radiofrequency, lymphatic drainage or any aesthetic treatment.
- 🔑 There are treatments that act on the inflammation, and that is a different thing: they improve symptoms without emptying the deposit.
- Systemic medical treatment — minocycline is the most used — achieved in the available review 20% complete responses and 60% partial responses.
- There are minimally invasive techniques described — intralesional laser with aspiration — with series of their own, but they are procedures, not creams.
- Shock waves have been used to make surgery easier, not to replace it.
- The evidence across this whole field is limited: case series and a single cohort study.
- ⚠️ Be wary of anyone offering to “remove biopolymers without surgery”. It does not exist.
The short answer is the one you will already have read: there is nothing that dissolves biopolymers. It is true, it is important and it bears repeating.
But the short answer leaves out what the person searching for this really wants to know, which is usually someone who has been told they need surgery and is looking for a way out. So this page gives the long answer: what has actually been tried in the medical literature, what each thing achieved and why none of it is “removing biopolymers without an operation”.
And the distinction that orders everything, which almost nobody explains: controlling the inflammation is not the same as removing the material.
The surgical process and the full assessment are in the guide to biopolymer removal. If the question is whether to have surgery or wait, it is in remove or monitor.
What does not exist, and is worth saying first
There is no solvent. It is the most frequent confusion and the most dangerous, because it comes from something real: hyaluronic acid does dissolve, with an enzyme called hyaluronidase. Many people assume that if it exists for one, it will exist for the other.
It does not. Hyaluronidase breaks the chains of hyaluronic acid and does not act on silicone, methacrylate or polyalkylimide, because they have nothing to do with it chemically. It is explained in detail in the page on hyaluronidase.
Nor is it removed by massage, lymphatic drainage, radiofrequency, cavitation or any aesthetic device. They may change how the area looks for a while; they do not remove material.
What has been tried, and what it achieved
This is where the long answer adds something. A systematic review published in 2023 on the management of silicone granuloma screened 901 studies and brought together 93 papers with 227 patients. These are the figures that came out of it and out of other series.
Systemic medical treatment
It was 10.2% of the treatments analysed, with minocycline as the commonest drug. The results: 20% complete responses and 60% partial responses.
It is a useful figure with one essential qualification: what improves is the inflammatory reaction, not the presence of the material. It is above all useful for patients who cannot have surgery. The authors themselves note that many of the patients reviewed were not candidates for surgery, because of contraindications or lack of access, and that medical management — though little studied — frequently achieves partial responses.
Intralesional corticosteroid and aspiration
They are used, and sometimes they help. But in refractory cases their performance is poor: in a case published in 2026 of multiple inflammatory nodules after successive injections of different materials, the lesions responded badly to intralesional corticosteroid and aspiration, and image-guided excision had to be resorted to.
Intralesional laser with aspiration
It is the technique that comes closest to “without surgery”, and it deserves explaining properly. A 2018 series treated 81 patients over twelve years with intralesional Nd:YAG laser combined with aspiration, for adverse reactions to methacrylate. The authors describe how granulomas and lumps could be removed by a minimally invasive procedure under tumescent anaesthesia, in most cases in a single session, with 86.4% of patients satisfied and no adverse effects attributed to the laser.
It is a good result. And even so, read it precisely: it is a procedure under anaesthetic, not a treatment-room treatment; it was done for one specific material; and it is a series from a single team.
Acoustic shock waves
They have been used in complications from methacrylate, but it is worth knowing in what role. In a 2025 series of 9 patients, shock waves were used alongside surgical excision, and what they contributed was making the material easier to remove and reducing the surrounding fibrosis. It is an adjunct to surgery, not an alternative to it.
The sentence that sums it all up
Controlling ≠ removing.
There are treatments that reduce inflammation, calm the flare-ups and improve how you feel. They are legitimate, they are described and for some people — those who cannot have surgery — they are the right option.
None of them makes the material disappear. It is still there, and it is still the underlying reason.
Anyone offering you both at once — removing it without operating — either does not know what they are saying or knows perfectly well what they are doing.
How much all this evidence is worth
Rather less than it appears, and saying so is part of informing you properly.
The 2023 systematic review concludes that the evidence is limited to case series and a single cohort study. There are no comparative trials saying what works better. The series we have cited come from particular teams, with their own patients and their own criteria.
That does not invalidate the figures. It means they are used to guide an individual decision, not as a guarantee.
How to spot an offer that does not stand up
Signs to be wary of:
- A promise to “remove biopolymers without surgery” or to “dissolve them”.
- Talk of a product or enzyme that breaks them down.
- A guarantee of removing 100% of the material, with or without surgery.
- A treatment-room procedure offered with no prior medical assessment or imaging.
- No risk mentioned at all.
- Pressure to hurry and a discount.
What it is reasonable to expect from a serious consultation: that you are examined, that imaging is used to assess how much there is and where, that you are told what can and cannot be achieved, and that the possibility of not operating is considered.
Book an appointment
You can book your own appointment. Pick the day and time from the free slots in the diary, in a panel that opens right here, without leaving this page.
Frequently asked questions
Does hyaluronidase work on biopolymers?
No. It dissolves hyaluronic acid and has no effect on silicone, methacrylate or polyalkylimide. It is the commonest confusion in this whole subject.
And massage, radiofrequency or lymphatic drainage?
They do not remove material. They may temporarily change the look of the area, but the deposit stays where it is.
So medical treatment is no use at all?
It is of use, but for something else: for controlling the inflammation. In the available review, systemic treatment achieved 20% complete responses and 60% partial ones. It is especially relevant for anyone who cannot have surgery.
Is there a laser that removes them?
There is a described technique of intralesional laser combined with aspiration, with a series of 81 patients and 86.4% satisfaction, used for reactions to methacrylate. It is a procedure under anaesthetic, not an aesthetic treatment, and it is not equivalent to complete removal.
And shock waves?
They have been used as an adjunct to surgery, to make the material easier to remove and to reduce fibrosis. They do not replace excision.
If I do not have surgery, can I do anything in the meantime?
Yes: follow-up, control of flare-ups and treatment of complications when they appear. That is not “doing nothing”, but it is not an alternative to removing the material either.
Why do some clinics offer it?
Because there is demand and because the word “dissolve” sells. It is why this page exists.
And if I have already had one of those treatments?
There is no harm in having tried, and it does not invalidate anything that comes afterwards. The current state of the area is assessed and the decision is taken from there.
Sources
- Mustin DE, Barrett DL, Gangal A, White MS, Yeung H. Management of silicone granuloma: A systematic review. JAAD Int. 2023;11. Of 901 studies screened, 93 were included, with 227 participants; surgical excision accounted for 66.2% of treatments, with 48% complete and 50% partial responses; systemic monotherapy accounted for 10.2%, with minocycline as the commonest drug, and achieved 20% complete and 60% partial responses; overall, 41.8% complete and 51.6% partial responses. The authors note that many patients were not candidates for surgery because of contraindications or barriers to access, and that the evidence is limited to case series and a single cohort study. https://pubmed.ncbi.nlm.nih.gov/36865613/
- Goldman A, Wollina U. Intralesional Neodymium YAG Laser to Treat Complications of Polymethylmethacrylate. Open Access Maced J Med Sci. 2018. Eighty-one patients treated over twelve years with intralesional Nd:YAG laser combined with aspiration for adverse reactions to methacrylate; granulomas and lumps could be removed by a minimally invasive procedure under tumescent anaesthesia, most in a single session; 86.4% of patients satisfied and no adverse effects attributed to the laser. https://pubmed.ncbi.nlm.nih.gov/30337979/
- Goisis M, Zecchetto S, Veronese S, et al. Extracorporeal Acoustic Shock Waves to Treat Complications of Polymethylmethacrylate. Aesthetic Plast Surg. 2025. Nine patients treated with acoustic shock waves alongside surgical excision; the waves made the methacrylate easier to remove and reduced the surrounding fibrosis. https://pubmed.ncbi.nlm.nih.gov/39681689/
- Wang H, Lo C, Wang Z, Huang PP, Qiu H. Refractory craniofacial soft-tissue foreign-body granulomas after sequential multi-material filler injections. J Craniomaxillofac Surg. 2026. Late inflammatory nodules with a poor response to intralesional corticosteroid and aspiration, which required surgical excision guided by high-frequency ultrasound and MRI. https://pubmed.ncbi.nlm.nih.gov/42551060/
Book your consultation
If you have come here looking for a way of avoiding theatre, the assessment is still worth having: it establishes how much material there is and where, allows whatever can be treated to be treated, and lets you decide on data rather than on fear.
And if someone has offered to dissolve them, bring it to the consultation and we will talk it through. It is useful information.
Clinical confirmation by the surgeon
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Last reviewed: 6 September 2026. This content is for information only and does not replace an individual assessment by a healthcare professional.
