Hyaluronidase Q&A
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Hyaluronidase Side Effects

asked 2 years ago by tried but failed in Australia
Latest answer by Chris Thiagarajah, MD
Question viewed 8,202 times
Tags: side effects

What should I do to resolve the puffiness and swelling in the lower eyelids? Will it resolve over time? If so, how long should I expect to wait? Or has the hyaluronidase done irreversible damage to the tissue of my lower eyelids and the edema is therefore permanent? There is not much information about hyaluronidase on the internet. I look ghastly. Please help.

Read my review "Hyaluronidase Nightmare - Permanent Damage to Lower Eyelid Tissue?"

9 answers to Hyaluronidase Side Effects

+4

It could be from the original problem

When hyaluronic acid fillers are over-injected, or injected into the incorrect plane, the tissues can swell even after the material is dissolved by hyaluronidase. Allergic reaction is also possible, especially if compounded hyaluronidase was use instead of Vitrase. If you are sleeping on your face or have a high sodium diet, this could increase the problem, so sleep on 2-3 pillows. I doubt the problem is permanent, but an evaluation by an oculoplastic surgeon would be reasonable to get it... more
Mary Lupo, MD

New Orleans Dermatologist
+3

First thing, get a second opinion from a board certified dermatologist or cosmetic surgeon

It sounds like you have really been through the ringer here and it doesn't sound like you have gotten better, despite multiple procedures. I'd get a second opinion from someone who is trusted in your area. Skip the medispas out there and go to a board certified dermatologist who does these sorts of procedures or a very fine cosmetic surgeon (plastic surgeon, oculoplastic, etc). Don't let other folks do more stuff on you until you get this second opinion as it seems like you have already... more
Joel Schlessinger, MD

Omaha Dermatologist
+3

See an Opthalmologic plastic surgeon

A visit to an opthalmologic plastic surgeon would be warrented. While not common, some people are allergic to hyalruonidase. You have not provided photographs, but it is possible that you are one of those people. You might need dilute coricosteroid injections, but I would urge you to let the opthalogic plastic surgeon make that judgment and if need be perform the injections. Good luck and I hope this helps.
Arnold R. Oppenheim, MD

Virginia Beach Dermatologist
+2

Hyaluronidase and swelling

Swelling after hyaluronidase injection to treat excess fillers is normal. This may take several weeks to months to improve. You just have to be a bit patient. 
Steven Wallach, MD

Manhattan Plastic Surgeon
+2

Hyaluronidase Allergy

It is important for you to know if it was a true allergy to hyaluronidase or just excessive bruising. You mention the word -black along with the swelling hours after hyaluronidase injection. Please tell me if you got a lot of bruising. If you did then it is possible that what you have described is prolonged lower lid edema after excessive ecchymoses (bruising). If you can describe the situation in more detail with some photos from after the hyaluronidase injection (same day) that would be... more
Tanveer Janjua, MD

Bedminster Facial Plastic Surgeon
+2

Hyaluronidase Side Effects After Juviderm in the Lower Eye Lids

Hi Tried Aussie, The puffiness and swelling will resolve with time. The edema is not permanent and the hyaluronidase has not done irreparable damage. I have treated a few patients with similar scenarios, and eventually their lower lids returned to normal. You do need to be patient. The most difficult thing to do is nothing. It may take weeks to months. Do follow the good doctor's advice here on RealSelf.com and see a board certified opthalmoplastic surgeon, facial plastic surgeon, or... more
Michael A. Persky, MD

Los Angeles Facial Plastic Surgeon
+1

Give it some time

The hyaluronidase doesnt do anything permanent. It is a temporary medication that gets absorbed. The swelling may be from the filler stretching the skin and creating some swelling in the area. I would give in a solid 6-8 weeks. Time should make it come back to normal.
Chris Thiagarajah, MD

Washington DC Oculoplastic Surgeon
+1

Tear Troughs - A very unforgiving area

All of the panel members offered a broad range of valuable feedback. However, in reading the original posting, it would appear that possibly the product was not placed under the muscle in the second treatment. Although hyaluronidase was used to dissolve the product, unless it was placed exactly where the filler was placed, it will not offer much benefit. This may account for why you are describing being able to still feel the filler product but have "bags" of fluid above it. You... more
Harold J. Kaplan, MD

Los Angeles Facial Plastic Surgeon
+1

Hyaluronidase side effects

Dear Tried I honestly don't think you can know whether you are coming or going. You have done so many things in such a short period of time. It is quite possible for example that you are in fact not allergic to the hyaluronidase. It sounds a bit like you are treating yourself. It is my opinion that if you are in fact allergic to hyaluronidase you should not be getting more filler to the lower eyelids which based on your description in your review you did. There is a simple way to know... more
Kenneth D. Steinsapir, MD

Los Angeles Oculoplastic Surgeon

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