Staged Removal Means at Least Two Trips
The question I get most from people writing from abroad is, "Can it all be done in one go?" Honestly, for many lumps it can't. With Ellansé, Sculptra nodules or silicone, the first session usually removes about 30–50%. Most fillers take two to three sessions to reach about 80–90%, and it is never 100%. The sessions are about 3 months apart.
So if you live outside Taiwan, start with the right expectation: staged removal means flying in at least twice. This article covers how the two trips are planned, what to do in the three months between them, and how your local doctor takes over once you are home. Airport transport and visas have their own pages, linked below.
Why removal is not done all at once, and why the gap is 3 months, is explained in the second half of Why Hyaluronidase Fails: 7 Reasons. Here I only deal with the travel.
First, Who Doesn't Need to Fly In
Not every lump is worth an international trip. In these situations I usually suggest treating it or watching it at home first:
- Soft swelling in the first days or weeks after an injection: the product and the tissue are still settling, so wait and see.
- A lump confirmed as hyaluronic acid, not encapsulated and not migrated: a local doctor injecting hyaluronidase precisely under ultrasound may well resolve it.
- Small calcium hydroxylapatite deposits you can feel but not see, with no inflammation: many fade on their own.
The opposite case is too urgent to wait for a flight. If the injected area suddenly turns red, swollen, hot and painful, with fever or pus, or if the skin turns pale or purple or your vision changes right after an injection, that is an emergency. Go to a local emergency department first, not to a booking site.
Key Insight: The cases worth flying in for are the ones that have already been dissolved or injected with steroids at home, where the lump is still there and ultrasound suggests it needs extraction. If it can be solved locally, I will tell you plainly that you don't need to come.
Remote Assessment: What to Send, and What It Can Tell Us
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| What to prepare | Why we need it |
|---|---|
| Injection history: what was injected, when, how many times, and where | The material decides whether it can be dissolved and how it can be removed |
| Photos: front, both sides and both 45-degree angles, in natural light, no make-up; add a smiling photo if expression makes the problem more obvious | To see the extent, the contours and any asymmetry |
| A local ultrasound report or images, if you have them | The closest thing to what we actually need to see |
| Treatments already tried: hyaluronidase, steroids, antibiotics, with how many times and when | So we know which routes have already been tried |
| Current medication and allergies | For safety |
Once everything is in, we usually reply within 48–72 hours.
Remotely, we can judge the general picture: roughly what the problem is, whether you need to come, how many sessions it may take, and about how long the first stay should be. What we cannot judge is the deep detail, such as where the material has actually spread, how thick a capsule is, and how close it sits to blood vessels and nerves. Those only count once you have been scanned in Taiwan, so the remote conclusion is provisional and the plan may change on the day you arrive. The full online assessment process is described in Overseas Filler Rescue: Online Evaluation.
The Two Trips at a Glance
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| First trip | Between trips (about 3 months) | Second trip | |
|---|---|---|---|
| Main purpose | Consultation, full-face ultrasound, first stage of extraction | Let the tissue recover; send photos if anything changes | Repeat ultrasound and treat what remains |
| Days in Taiwan | Usually 3–5, or 5–7 for larger or multiple areas | At home | Depends on the extent that time |
| Keep in mind | Wait at least 48 hours after the procedure before flying | Avoid extra hyaluronidase or steroid injections | Some people no longer need further removal by now |
The First Trip: Assessment, Ultrasound, First-Stage Extraction
On the first day you have a consultation and a full-face ultrasound to confirm the material, its extent and its depth, and then we decide what to remove this time. Extraction is done under local anesthesia plus gentle pain-relief anesthesia, with no incision, through a pinhole of about 2 mm. The first session usually removes about 30–50%.
The pinhole is small, but this is an extraction, so swelling and bruising will happen: they settle in about 2–3 weeks, the pinhole heals in about 2 weeks, and the final result takes about 3 months. You will probably still see it when you fly home, so plan work and important events around that. Wait at least 48 hours after the procedure before flying.
There is a follow-up visit about 14 days after the procedure. If you can stay in Taiwan until then, come back in person; if you can't, send us photos instead, and we will settle the plan together at your consultation. Until your treatment plan is confirmed, please don't book a return flight you cannot change.
The Three Months Between: What to Do, What to Hold Off On
The roughly 3-month gap lets the swelling settle and the tissue stabilise, so the next ultrasound can show clearly how much is left and where. You will be back in your own country during this time. If anything changes, send us photos.
What your local doctor can help with: normal wound care, antibiotics if there is a genuine infection, and an ultrasound scan when needed.
Two things to hold off on: hyaluronidase injected without ultrasound confirmation, and further steroid injections. Repeated injections around the lump make the surrounding tissue messier and the next extraction harder. Don't have any filler injected into the same area either; whether to add volume after extraction is decided at the follow-up about 3 months later.
If the area suddenly becomes red, swollen, hot and painful, you develop a fever or pus, or the area grows clearly within a few days, go to a local emergency department. Don't wait for the second trip.
Key Insight: These three months are recovery time. Until the second trip, your job is to look after the wound and send photos if anything changes. Leave any further treatment for now.
The Second Trip: When and What
The second trip is about 3 months after the first. Before you set off, send recent photos so we can confirm it is still needed. On arrival you have another ultrasound and we treat what remains; for most fillers, two to three sessions remove about 80–90%, and it is still not 100%.
Some people are satisfied after the first session, or feel the amount left is not worth another round of swelling and a long flight. Then there is no need to come back. Whether to make the second trip depends on the ultrasound and on how you feel, and we decide it together.
Back Home: You, Us and Your Local Doctor
When you go home you can take a treatment summary for your local doctor, stating what was removed, what remains and what to watch for. If your local doctor has questions about the details later, they can check with us, so all three of us are working from the same information and you are not left caught in the middle.
Follow-up after you return home is online: send us photos at about 14 days, 1 month, 3 months and 6 months after the procedure, with no need to fly back for a check-up. If you have questions or notice changes in between, send photos any time.
Visas and Entry
- Every time you enter Taiwan, fill in the online Arrival Card (TWAC) within the 7 days before you land; two trips means filling it in twice.
- We are not a member of the Ministry of Health and Welfare's medical-services internationalisation programme, so our documents cannot be used to apply for a medical visa.
- Visa-free stays cannot be extended, so each trip has to fit inside your allowed stay.
Visa-free stays, TAC and official links by nationality are collected on Visa and entry. The Bureau of Consular Affairs notices always take precedence.
From the Airport to the Clinic
- Taipei Xinyi (Main) and Taipei Tonghua: from Taoyuan Airport, take the Airport MRT Express to Taipei Main Station, then the Tamsui–Xinyi Line toward Guangci/Fengtian Temple to Xinyi Anhe, about 70–90 minutes in all; from Songshan Airport, about 25–35 minutes by metro.
- Kaohsiung Wenkang: from Kaohsiung International Airport, the Kaohsiung Metro Red Line runs straight to Ecological District station, about 25 minutes on the train.
Fares, last trains and the exits with lifts for luggage are on Airport to clinic. For food nearby, see Where to eat nearby; skip alcohol for about one week after an extraction, while seafood and spicy food are fine.
Where to Start
If you live abroad and your lump is still there after dissolving or steroid injections, start by sending us your injection history and photos. Our overall approach to filler removal is on Filler Repair, and other arrangements for international patients are in our international patient guide.
Frequently Asked Questions
Can everything be removed in one session so I only fly once?
It depends on the material and how far it has spread. A small lump with clear edges can sometimes be treated to your satisfaction in one session. But with Ellansé, Sculptra nodules or silicone, the first session usually removes about 30–50%, and most fillers take two to three sessions to reach about 80–90%. Removing too much at once risks a hollow or an uneven surface, so most cases are staged. The remote assessment will give you an idea of how many sessions to expect.
Do the two trips really need to be 3 months apart?
About 3 months lets the swelling settle and the tissue stabilise, so the ultrasound can show clearly what is left. The actual timing depends on how you recover and is decided after we see your photos or you at a follow-up. Going back in too early means scanning through swelling, which makes the picture less clear.
How long should the first stay in Taiwan be?
Usually 3–5 days, or 5–7 days for larger or multiple areas. Wait at least 48 hours after the procedure before flying. There is a follow-up about 14 days after the procedure; if you cannot stay that long, you can send us photos instead. Don't book a return flight you cannot change until your treatment plan is confirmed.
What can my local doctor do for me once I'm home?
Normal wound care, antibiotics if there is an infection, and an ultrasound scan when needed. Hold off on hyaluronidase without ultrasound confirmation and on further steroid injections. Your local doctor is welcome to check details with us.
Can I use your documents to apply for a medical visa?
No. A medical visa requires a provider that is a member of the Ministry of Health and Welfare's medical-services internationalisation programme, and we are not a member. If your nationality can enter visa-free or with TAC, follow those rules; if you need a visa, apply for an ordinary visitor visa at the Taiwan office in your country. Details by nationality are on Visa and entry.
