What is Hyaluronidase?

Hyaluronidase is a naturally occurring enzyme which is commonly found in the body. Cosmetic surgeons use Hyaluronidase as a means of correcting mistakes with filler injections, usually where there is asymmetry or too much filler having been injected into the patient’s skin. The substance is derived from bovine or porcine (cow or pig). Prior to being used, it is thoroughly cleaned to remove animal substances. Common brand names for Hyaluronidase include Amphadase, Hydase, Vitrase and Hylenex.

Why is Hyaluronidase Used?

These days, filler injections are extremely popular for treating facial aging and wrinkles. Unfortunately, there are doctors who lack proper skill and judgment with these injections. A novice physician performing such treatments can over treat a patient, requiring corrective measures.

When a doctor incorrectly injects filler or injects too much filler into a treatment area, this can create unsightly and unintended results. If filler is injected in excessive quantities, the area can appear swollen and out of proportion to the rest of the face. Fillers can also be injected into the wrong place. For example, for treating wrinkles around the eye, if injected above the orbicularis oculi muscle then the patient can experience lumping and significant bruising and swelling.

Some areas require more technical injection techniques such as the fan-like distribution technique. If the physician does not administer these injections correctly, then unpleasant results can occur. Hyaluronidase can be used in these circumstances in order to dissolve hyaluronic acid based fillers. It provides very fast relief for the patient, reducing the swelling or lumpiness almost overnight.

Which Fillers can Hyaluronidase Dissolve?

Hyaluronidase injections are used to dissipate injectable fillers which are hyaluronic acid (HA) based. This includes popular products such as Juvederm, Restylane, Perlane, Hylaform and Captique. HA is a natural occurring sugar in the body and once injected it can stay in the body for up to one year. This is beneficial if the correct amount is injected. However if there is an over treatment or asymmetry, then having the product last in your facial region for a year is not acceptable. Hyaluronidase will dissolve hyaluronic acid from these fillers in a rapid manner.

What Wrinkles can be Treated with Hyaluronidase?

Doctors these days can treat many areas for aging and provide significant wrinkle reduction. Primary areas which are treated include lips, smile lines, nasolabial folds (lines run from the nose to the corners of the mouth), under eye areas, crow’s feet and also forehead lines. They can also fill in tear troughs which are the grooves under the eye and just above the cheek. If any of these areas are over enhanced, Hyaluronidase can be used to provide an efficient means of reversing the effects of a HA filler.

Is Hyaluronidase Safe?

Hyaluronidase has been used for many years for other medical purposes such as being combined with local anesthetic in order to improve its spread through the body. However, since it’s derived from animal tissue as opposed to your own human tissue, an allergy test is required prior to injection of Hyaluronidase.

The test is commonly carried out by injecting a small volume into the inner surface of the forearm. Doctors will usually require you to wait 10 to 15 minutes to see if there’s any adverse reaction. There is a small risk of Hyaluronidase causing significant hypersensitivity reaction; however the possibility is quite minimal. Since dissolving injectable fillers is not urgent medical treatment, skin allergy testing is a compulsory prerequisite for all corrections with Hyaluronidase injections.

How Long Does Hyaluronidase Take To Correct Over Treatment?

Typically patients will see results within 24 hours. About 90% of the HA filler product is dissolved by the next day. The remaining filler dissolves over the next several days. Patients can be given a follow up visit approximately 7 to 9 days after Hyaluronidase injections in order to see whether any further Hyaluronidase is required to disperse any remaining filler.

Injectable fillers are becoming increasingly accepted for anti-aging and wrinkle reduction. Unfortunately in some circumstances cosmetic surgeons can incorrectly place the filler or over enhance a certain area. Luckily, with Hyaluronic acid based fillers, Hyaluronidase injections can be used to reverse the mistakes. However, doctors warn of simply thinking of Hyaluronidase as a simple remedy for HA filler blunders. In order to have fillers dissolved, you should consult an experienced cosmetic surgeon who has extensive experience with and understanding of injection techniques. It is important that the Hyaluronidase solution is injected into the correct place and in the right manner. You may wish to seek an alternative doctor for this purpose.