There’s something inside your nose — firm, sometimes red or swollen, tender when you press it. You ask around and find out what you had injected years ago wasn’t hyaluronic acid. It was “Amazing Gel,” or “growth factor,” or something even you can’t quite name.

The next question is almost always the same: “Can we just dissolve it?”

Here’s the bottom line up front: this kind of material can’t be dissolved, there is no antidote, and leaving it in usually gets more troublesome the longer you wait. Let me explain why it ends up needing removal.

First, Know What These Actually Are

Let’s line up the names. The permanent fillers we run into inside the nose are usually one of a few things.

Amazing Gel — its proper name is polyacrylamide gel (PAAG for short), a gel that stays semi-permanently once it’s injected. Aquamid is the same family of PAAG. Then there’s PMMA (polymethyl methacrylate, a microsphere the body doesn’t absorb). And there are so-called “growth-factor injections,” which are mostly unregulated, of unknown origin.

These share one thing: most of them aren’t approved materials for facial filling — some were abandoned long ago, some never passed review for this use at all. They may have been described beautifully at the time, but the problems only surface later.

Why They Can’t Be Dissolved — There’s No Antidote

When hyaluronic acid goes wrong, there’s at least an exit: hyaluronidase, an enzyme that breaks it down. But PAAG and PMMA have no enzyme that can break them down at all. They aren’t materials the body recognizes and metabolizes — once injected, they’re a foreign body, just sitting there.

Here’s what to be careful about: some people try to “press it down” with steroids, even hyaluronidase. Let me put it plainly — that doesn’t work on these, and it can do harm. Hyaluronidase has no effect on PAAG or PMMA to begin with. Steroids may calm the inflammation for a while and make you think it’s gone, but the foreign material hasn’t been cleared — you’ve just covered the problem, not solved it. Once the drug wears off, it often comes back.

Key point: A hyaluronic acid problem can be “dissolved”; a permanent-filler problem can only be “removed.” Trying to injection your way out of it usually just suppresses the inflammation — the foreign body is still there, and that’s a different thing from clearing it.

What Happens If You Leave It In

A lot of people think: it doesn’t hurt, so why not leave it?

The problem is that your body doesn’t ignore foreign material inside it. It wraps a fibrous layer (a fibrous capsule) around it, which over time can become a palpable nodule; gel types (like PAAG) can also slowly migrate, drifting from the nose to a neighboring spot. In removal cases shared among colleagues, there have been instances of Aquamid gel migrating up to the forehead and adhering to the dermis.

Then there’s recurrent inflammation and infection. A biofilm tends to form on the surface of foreign material, and once it gets infected it’s stubborn — often flaring suddenly years, even a decade, later. With the nose stretched for that long and tissue pulled by repeated inflammation, the nasal shape can gradually distort and harden. Colleagues have also shared a case of someone in their early twenties, repeatedly injected with this kind of material in several areas, left with irreversible nodules and a deformed nose — and by the time it deforms, how much can be recovered is limited.

Key point: Trouble from this kind of filler doesn’t “fade with time” — more often it gets worse the longer you wait. When it isn’t hurting, that doesn’t mean it’s fine; it just hasn’t flared yet.

How It’s Removed — and the Part I’ll Be Honest About

Since it can’t be dissolved, the remaining route is physical removal. But in a place like the nose, the method is everything.

We don’t take the route of opening the nose with a large incision to go looking. Precise removal in reverse is what Liusmed has always done — go in through a small pinhole, deal with the surrounding fibrous capsule along with it, and aspirate and clear out the gel or microspheres piece by piece. This is also the consensus approach colleagues use for these permanent fillers: pinhole aspiration and handling the fibrous capsule, rather than a wide-open dissection.

But I won’t give you the pretty version. This kind of material can usually be removed at around 80 to 90 percent, not 100. Shallow, scattered deposits are the hardest to clear — force every last point out and the surface ends up uneven and deformed, which defeats the purpose. The shared nasal Aquamid removal cases describe the same thing: around 90 percent comes out, and trying to fully clear the shallow layer risks damaging the surface. This is usually reached over two or three sessions; the first typically removes about 30–50%.

So the goal of removal is to safely clear the troublesome bulk — the part that inflames and deforms — and let the nose look as natural as possible, not to chase down every last grain. How much can come out depends on which material you had, how much accumulated, how tightly it’s bound, and whether it migrated — that varies from person to person, and it takes a consultation plus imaging to know.

Key point: The goal of removal is to safely clear the troublemaking bulk, not to leave nothing behind. Being too aggressive leaves dents and deformity instead — and telling you honestly how much can come out matters more than a chest-thumping guarantee.

Common questions

Can Amazing Gel or PMMA be dissolved with an injection like hyaluronic acid?

No. The dissolving injection (hyaluronidase) only works on hyaluronic acid. It does nothing to Amazing Gel, Aquamid (both polyacrylamide gel, PAAG) or PMMA. Some people try steroids to calm it down, but that usually just suppresses the inflammation temporarily — the foreign material is still there, it often flares again once the drug wears off, and it can even do harm.

It doesn’t hurt — can I just leave it in?

Your body doesn’t ignore foreign material sitting inside it. It wraps a fibrous layer around it, can form a nodule, and gel types can migrate. Sometimes it sits quietly for years, even more than a decade, then suddenly inflames. Not hurting doesn’t mean nothing is wrong — it just hasn’t flared yet. Whether and when it flares varies from person to person, but it won’t fade on its own.

Will it all come out, or could removal deform my nose?

The goal is to safely clear the bulk that inflames and deforms — usually around 80 to 90 percent (usually built up over two or three sessions, with about 30 to 50 percent the first time), not 100. Shallow, scattered deposits are the hardest to clear, and forcing every last bit out can leave the surface uneven or deformed. So knowing where to stop matters as much as knowing how to remove, and that takes a consultation plus imaging to judge. How much can actually be removed varies from person to person.

I’m not sure what I was injected with years ago — what now?

Very common — many people have no record of it. At consultation we use ultrasound first to see which layer it’s in, whether it’s gel or microspheres, and whether it has migrated or calcified. That usually narrows down the material category, and from there we decide how to handle it. Get the material identified first, then the plan won’t go the wrong way.

Wrapping Up

If what’s in your nose is Amazing Gel, Aquamid, PMMA, or an unregulated growth-factor injection, hold onto a few things.

First, this material can’t be dissolved and has no antidote; an injection can only suppress the inflammation, not clear the foreign body. Second, leaving it in won’t make it fade — more often it worsens over time, with inflammation, migration, nodules, and nasal distortion. Third, the way to handle it is pinhole precise removal, and you should go in expecting around 80 to 90 percent (usually built up over two or three sessions, with about 30 to 50 percent the first time) out, not all of it.

If you’re not even sure what you were injected with, start with how to identify an unknown filler; for a fuller look at the inflammation and removal of permanent fillers like silicone and PAAG, see the inflammation and removal of early permanent fillers. If you’re planning to redo a rhinoplasty and there’s still old filler in the nose, the sequence is a separate question — I cover it in clearing old filler before rhinoplasty.

For a fuller picture of nasal filler residue and lumps, start from the nasal filler residue & lumps hub; for filler revision more broadly, see filler revision specialty. How it’s actually handled still depends on assessing your nose in person.