Austin Hyaluronidase doctors

	Louis W. Apostolakis, MD Austin Facial Plastic Surgeon 5656 Bee Caves Road Suite E-201, Austin		1 answer
	Edward Buckingham, MD Austin Facial Plastic Surgeon 2745 Bee Caves Road Suite 101, Austin		1 answer
	Thomas T. Jeneby, MD San Antonio Plastic Surgeon 7272 Wurzbach Unit 801 801, San Antonio
	Adam Bryce Weinfeld, MD Austin Plastic Surgeon 1400 North IH-35 Suite 320, Austin
	Sean M. Blaydon, MD Austin Oculoplastic Surgeon 3705 Medical Parkway Suite 120, Austin

Recent Answers

Does Hylaronidase Dissolve Some Natural Hyaluronic Acid?
I had fat transfer under the eyes a few years ago that left all sorts of bumps but have finally been successful with bringing it down to an acceptable level with Kenalog. There were some little bumps that I can live with but thought I would just smooth it all out with Juvederm so I gave it a try.

I had Juvederm injected under eyes a week ago and it is definitely too much and placed lower than it should have been. It looks like I had something injected and I really need it to all just go away – it was fine before. The doctor has not used hylaronidase before and our question is would hylaronidase dissolve some of the natural hyaluronic acid thus leaving me less plump than before (or other possible side effects) and if so would this correct itself?

Could regular massaging make it go away in a few weeks; is there any danger with hylaronidase or should we just do it?

Appreciate your expertise.
Thank you,
Katie

A: Hyaluronidase Dissolves All Hyaluronic Acid, but not to worry

Hyaluronidase dissolves hyaluronic acid regardless of its origin. For decades the drug has been used to assist in tissue separation during surgery because of that. It was uncommonly used prior to Restylane and Juvederm coming to market and in fact was hard to find a decade ago.

Your body makes hyaluronic acid constantly and dissolves it just as fast. Naturally occurring hyaluronic acid is in constant flow as it is produced and then hours later dissolved. So within hours, or at worst days, your body will reestablish the natural balance present prior to your Juvederm. Juvederm and Restylane differ from the natural product primarily in that they have been cross-linked. The purpose of the cross-linking is to protect it from your natural dissolving mechanism. Cross-linking does not protect it from the effects of Hyaluronidase so it can still be dissolved that way.

Louis W. Apostolakis, MD

Austin Facial Plastic Surgeon

Double Bags After Attempt to Dissolve Juvederm I had juvederm injected under my eyes three weeks ago. The results were poor and it looked like I had big bags under my eyes. I went back to the doctor (who I found out is actually a physician's assistant), and she injected Vitrase/Hyaluronidase for dissolving the Juvederm about 24 hours ago. Now, the results are even worse! I look like I have double bags now. She advised me to come back today, but she said she will not issue even a partial refund. She also told me to be "patient" since the Vitrase/Hyaluronidase may need days to work. Is this true? Can Vitrase/Hyaluronidase make the bags worse before they get better, or is it possible that she didn't inject it in the right spot which caused further damage? What should I do now?

A: Don't worry about further damage with Juvederm under eyes

The great thing about hyaluronic acid fillers such as Juvederm is that they are reversible. It is not something that needs to be done often, but it is nice when needed. You do not need to be concerned about the vitrase causing further damage. It will take some time for the filler to resolve and you can expect some swelling. You may even need a second injection of Vitrase depending on how much was given the first time. Rest assured however that you will return to baseling. Don't be too dicouraged with fillers for that purpose either. Hyaluronic acid filler done correctly is very reliable and produces great results for tear troughs.

Edward Buckingham, MD

Austin Facial Plastic Surgeon