Vaginal Filler · Patient guide

How Is Permanent or Non-Dissolvable Vaginal Filler Removed?

Permanent or non-dissolvable vaginal filler, including polylactic acid, PMMA, silicone and calcium-based products, is removed by surgical excision: the surgeon opens the vaginal wall over the deposit, lifts out the material together with the scar capsule around it, and then closes the wall in layers. At Somssi Women's Clinic in Gangnam, Seoul, Dr. Yoon Ho-joo performs this through the posterior wall with fine micro-scissors and reconstructs the tissue in the same operation.

Medically reviewed by Dr. Yoon Ho-joo, MD, PhD, OB/GYN specialist, Somssi Women's Clinic · Last updated October 2026

At a glance

Key facts

The essentials, based on how Somssi Women's Clinic performs this procedure or answers this question. Your plan is confirmed at consultation.

• Applies to: PLA, PMMA, liquid silicone, calcium hydroxylapatite, granulomas, encapsulated or migrated filler
• Method: surgical excision of the deposit with its capsule, through the posterior wall or opening
• Anesthesia: sedation plus long-acting local, or local alone
• Hospital stay: none; discharge the same day after urinating
• Sutures: absorbable, two-layer closure, dissolve in about a week
• Intercourse: about 7 to 8 weeks when reconstruction is included
• Performed by: Dr. Yoon Ho-joo, MD, PhD, OB/GYN specialist

Permanent and non-dissolvable vaginal fillers cannot be broken down by any injection; they are removed surgically, by cutting out the deposit together with the capsule of scar tissue the body has built around it, and then repairing the wall. Done well, this is a single same-day operation.

Which fillers count as non-dissolvable

Hyaluronic acid filler is the only kind that can be dissolved; see dissolving HA vaginal filler. If you are not sure which you have, the clinic can usually tell from ultrasound and a test dose.

How the body reacts to permanent filler

Any material the body cannot absorb is walled off by a capsule of collagen. Around a small, well-placed deposit that capsule may stay thin and quiet for years. Around larger or scattered deposits, or in tissue that moves and stretches as the vagina does, it can thicken, contract and become inflamed, producing a hard nodule, pain with intercourse, or a granuloma. Infection can take hold on the surface of the material as a biofilm that antibiotics cannot clear. These are the reasons the US FDA has not approved any dermal filler for vaginal use and has warned about unapproved uses of fillers in the body, and why mainstream gynecology does not recommend permanent fillers in the genital area at all.

How Somssi removes non-dissolvable filler

Somssi Women's Clinic is a surgical gynecology clinic in Gangnam, Seoul, founded in 2000 and led by Dr. Yoon Ho-joo, MD, PhD. Its revision program was built for women whose earlier procedures elsewhere, including filler and implant insertion, have caused problems, and the clinic's stated philosophy is to remove foreign material and restore the tissue with the patient's own.

1. Mapping the deposit

Before surgery, Dr. Yoon examines the lump and performs a pelvic ultrasound. Permanent fillers and granulomas appear as dense, bright areas, often with shadowing, which shows their size, depth and whether there is one deposit or several. This map decides where the incision goes and how much tissue is involved.

2. Anesthesia

The operation is done under sedation (sleep) anesthesia combined with a mixture of long-acting local anesthetics, so there is no painful memory and the first day is comfortable. Patients who prefer can have local anesthesia alone and talk with the doctor during the procedure.

3. Exposing the material

Working through the posterior (lower) wall or the opening, Dr. Yoon peels the mucosa over the deposit to under one millimeter using the ophthalmic micro-scissors he uses for all vaginal surgery. Peeling rather than cutting preserves blood supply and keeps the dissection shallow, which protects the rectum behind the posterior wall. The upper wall, against the bladder and urethra, is never operated on.

4. Excising the deposit and capsule

The filler is lifted out together with its capsule and any granulomatous tissue, because leaving the capsule behind invites recurrence. Where silicone or PMMA has scattered into many small droplets, every trace cannot be removed without destroying healthy tissue; in that case the deposits causing symptoms are removed and you are told clearly what remains. Removed tissue can be sent for histology, which also confirms what the material was.

5. Reconstructing the wall

Removing a deposit leaves a defect, and the laxity the filler was meant to treat is still there. Dr. Yoon therefore closes the wall in two layers: the pelvic floor muscles on either side are gathered and sutured toward the center first, then the mucosa is closed over them, with absorbable sutures that dissolve in about a week. Where the whole canal is loose, the reconstruction extends from the front of the cervix to the opening, as in the clinic's posterior colporrhaphy; where the uterus has descended, a hysteropexy lifts and fixes it. No mesh, implant or new filler is placed.

6. Same-day discharge

You walk out of the operating room, rest, and are discharged once you have urinated. Desk work is possible the next day, golf after about a week, vigorous exercise and bathing after about six weeks, and intercourse after about seven to eight weeks. The recovery guide sets this out week by week.

What makes removal harder

• Scattered silicone: the most difficult, because droplets spread through tissue planes.
• Long-standing granulomas: involve more tissue and heal with more firmness.
• Active infection: must be drained and treated before definitive excision.
• Previous removal attempts: scar tissue from earlier surgery makes planes harder to find.
• Filler in the upper wall: close to the urethra and bladder, where removal has to be especially conservative.

Risks

Surgical removal carries the risks of any posterior vaginal surgery: bleeding, infection, wound separation, incomplete removal, scarring, asymmetry, altered sensation and, rarely, rectal or cul-de-sac injury, plus the small risks of sedation. Our guide on the safety of filler removal discusses each and how it is managed.

Bottom line

Permanent and non-dissolvable vaginal filler is removed by surgical excision of the deposit and its capsule, and the result is only as good as the reconstruction that follows. Somssi combines both in one same-day operation using the patient's own tissue. Read the full vaginal filler removal page, or contact the clinic with your history and any records of the product.

Questions patients ask

Frequently asked questions

Short, honest answers. For anything personal, a consultation is the right place to ask.

See the full FAQ →

Can permanent vaginal filler be removed without surgery?

No. There is no injection, laser or device that breaks down PMMA, silicone, calcium or polylactic acid in the body. Steroid injections can shrink the inflammation around a granuloma for a time but leave the material in place. Surgical excision is the only way to remove it.

Will all of the PMMA or silicone come out?

A single well-defined deposit can usually be removed completely with its capsule. Material that has spread into many small droplets cannot all be removed without damaging healthy tissue, so the surgeon removes the symptomatic deposits and explains what remains. Most patients are comfortable afterward even with a trace left.

How do I know whether my filler is permanent?

Ask the clinic that injected it for the product name. If that is not possible, ultrasound appearance and a test dose of hyaluronidase usually settle it: HA softens within a day or two, permanent filler does not. Histology of removed tissue gives a final answer.

Is removal of PLA filler such as Embofill the same as PMMA removal?

The surgical principle is the same, but PLA particles resorb over one to two years and often leave only a collagen deposit, which can be smaller and softer than a PMMA capsule. The HA portion of a blend can be dissolved first to define what is left. Each case is mapped on ultrasound before deciding how much to remove.

Why is reconstruction done at the same time as removal?

Removal leaves a gap and does nothing for the looseness that led to the filler. Rebuilding the wall and pelvic floor in the same operation fills the defect with your own tissue, restores support, and avoids a second anesthetic and a second recovery, which matters especially for patients traveling from abroad.

Keep reading

Related treatments and guides

• Vaginal Filler Removal — the full procedure page
• Vagina Filler Removal — who needs it and what to expect at Somssi
• Can Vaginal Filler Be Removed? — overview of all filler types and methods
• Vaginal Filler Removal vs Dissolving: Which Do I Need? — how the two routes compare
• Vaginal Filler Lumps and Nodules: What Causes Them? — why permanent filler forms nodules
• Vaginal Mesh Complication Revision — removal of another foreign material using the same principles

Sources and medical review

• US Food and Drug Administration, safety communications on dermal fillers and unapproved uses in the body
• Te Linde's Operative Gynecology, chapters on posterior vaginal wall repair and vaginal surgery
• American College of Obstetricians and Gynecologists (ACOG), guidance on elective female genital cosmetic procedures

Next step

A consultation first. A decision only when you are ready.

Tell us what you are experiencing and what you hope to change. Dr. Yoon examines, measures and explains the options, including when no surgery is the right answer. International patients can start with an online consultation before travelling to Seoul.