What should I do to resolve hyaluronidase 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?"

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8 answers to “What should I do to resolve...”

A: Tear Troughs - A very unforgiving area

Harold J. Kaplan, MD

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... more

A: Hyaluronidase and swelling

Steven Wallach, MD

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. 

A: Hyaluronidase Allergy

Tanveer Janjua, MD

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... more

A: Hyaluronidase Side Effects After Juviderm in the Lower Eye Lids

Michael A. Persky, MD

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... more

A: Hyaluronidase side effects

Kenneth D. Steinsapir, MD

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... more

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

Joel Schlessinger, MD

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... more

A: It could be from the original problem

Mary Lupo, MD

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... more

A: See an Opthalmologic plastic surgeon

Arnold R. Oppenheim, MD

    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... more

Comments

tried but failed
341 posts
4 Jul 2009

Thank you so much for taking the time to answer my question Dr Oppenheim. I will make the appointment with the opthalmologic plastic surgeon as you have suggested. At the time of injection I asked about side effects of hyaluronidase. I was told there are none. I was not told that anyone has allergic reactions to hyaluronidase (or I would have just waited for the restylane to dissolve). Thanks again.

tried but failed
341 posts
4 Jul 2009

Please note that my review should be NOT worth it!

tried but failed
341 posts
6 Jul 2009

Thank you all for taking the time to reply. Much appreciated. However, I am confused as to why some of you have assumed that I had the filler put in by "the nurse at the local medispa". I have never been to a medispa and don't really know what that means. I assume the concept is not very common in Australia, at least not where I am from. The juvederm in Oct 08 and the top-up restylane in April 09 were appropriately timed at six months apart. The juvederm had broken down considerably by the end of six months. These two procedures and the refill with juvederm in June 09 were all done by a board certified doctor who is a specialist in this field. I was too embarrassed to tell this doctor (who is exceeding well-qualified and I also like personally) that I hated the restylane so I went elsewhere to have it dissolved. The person who dissolved it was a nurse, but I was unaware at the time that dissolving requires as much precision and care as filling. Following the dissolving of the filler, I intended to go back to my original doctor (who does not use hyaluronidase at all) and start again. I was told by a representative of Allergan that it would be okay to have the area refilled around a fortnight after dissolving. I now agree that it was too early after dissolving the restylane to have refilling with juvederm, but I have a high-profile job in the public eye and I looked absolutely dreadful. Further, I was not able to take time off work to recover. I am not a medical professional so I am not sure if it was an allergic reaction to hyaluronidase or the hyaluronidase solution was too concentrated or injected incorrectly. I believe it was an allergy. There was minimal bruising, although the hyaluronidase burned under the skin when injected, presumably from the chemical reaction of the enzyme working. The appearance I described as 'black' in respect of my lower eyelids was more of a reference to the shadows created by the large, bloated bags of fluid that appeared under my eyes almost immediately. In addition to the incredible swelling, the reaction also included photophobia, a burning sensation in my eyes and redness/welts on the skin of my lower eyelids. I was not self treating with the Advantan steroid cream. I was prescribed it by an opthalmologist. I only used it for three days as instructed by the doctor. It helped with the outer symptoms on the eyelids, but not very much with the swelling. I accept that I should have waited until the situation completely resolved before having more filler put in, but this was not possible given the public nature of my job. Thank you all again for your assistance and encouragement. I will let you know how long it takes for the situation to finally resolve because this was a question I and two other RealSelf members with similar experiences - kakie and ANAN - were very anxious to find out but we could not find an answer. I understand from Dr Persky's response that the eyelid edema may take some time to resolve completely. At least the refill of juvederm has made this bearable in the interim. Cheers.

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