I had 2ml's of Perlane injected into my nose just over 3 years ago but can still feel some volume in the left side where a significant amount was injected and I'm unsure if this is still the Perlane or if this is scar tissue. My question is should I try and dissolve the "Perlane" with hyaluronidase? and if it is scar tissue will using hyaluronidase dissolve some of my natural tissue? I would really like to remove the volume that was created as a result of the Perlane Thank you :)
Is There Filler Still in my Nose or is It Scar Tissue?
Doctor Answers 4
Is there filler still in my nose or is it scar tissue
Generally HA fillers last about a year max. But in places like the nose, which just don't move that much, I have seen them last longer. Consult with a doctor in person for an evaluation. But you can easily have a small amount of hyaluronidase injected there. If it goes down, you'll know there is some filler in there. If not, it could be scar tissue. Hyaluronidase won't affect your natural tissue.
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Unwanted Perlane in the Nose
I have seen residual hyaluronic acid after 2-3 years, but it is unlikely. A physician familiar with Vytrase, could inject a very small amount (.05 to .1). If Perlane is evident in a small amount, it will probably resolve with this amount without side effect. If this is bothering you, there are limited risks to injecting an enzyme to correct. Thank you.
Filler versus scar tissue in the nose 3 years post-op
In the studies that have looked at filler longevity, the longest time that I have seen these hyaluronic acid fillers last in the tissues is on the order of 22 - 24 months. Thus, at 3 years, you are on the long end of the spectrum, and even if you did still have some hyaluronic acid filler present, one would wonder exactly how much and if it would even be relevant clinically, i.e., would it show? What does happen with these fillers too, though, is that the body forms some collagen scar tissue around them, and this I can see lasting for 3 years and giving some persistent fullness to the area. It would be very easy to see if there is treatable filler still present by placing a small amount of hyaluronidase directly into the area of maximum unwanted fullness and seeing what happens. This should not cause problems with your native tissues, and in fact, if there is scar tissue, it won't even affect that. I would start slowly and work up to the desired effect. If this doesn't work, then you probably have scar tissue/collagen in the area, and you would need to have it either removed surgically or injected with steroid and 5 flourouracil to decrease the size. One should be very cautious with this, especially on the nose, as it would be quite easy to overshoot the mark. You should only see an experienced injector for this treatment. Good luck.
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Perlane and longevity
I would consult with a well-trained and informed injector to determine your best route at this point. Perlane won't affect the tissue by causing scar tissue, but have someone evaluate the area and make sure you are a good candidate for removal. Sometimes dermal fillers last a long time in areas of less activity.