If You Can Live with Your Filler Results, Don't Go for Hyaluronidase

I had hyaluronidase after an "overfill"...

I had hyaluronidase after an "overfill" of Restylane that left my undereyes kind of baggy (never had a problem before, it's always looked great in the past). Mind you, it was an "OK" result, just not great. So I went in for the hyaluronidase -- had to go to a plastic surgeon as my derm said he didn't believe in doing it because it can dissolve your own tissue along with the Restylane.

Anyway, the plastic surgeon said this was a myth and that it would improve. I insisted on a very small amount of the Vitrase (he wanted to inject more). Within minutes it started to dissolve. Problem was, it really only dissolved the area of the tear trough itself -- NOT where the Vitrase was placed, as I am positive he did not place it in the tear trough (just two quick injections where the Restylane filler was too bulky). Within days I had two rather narrow and VERY DEEP "troughs" that were more like creases. I did not even recognize myself. They were dark because of my own pigmentation but also because of how deep they were.

I went back to the plastic surgeon and had to pay AGAIN for Restylane filler. The total of this nightmare was over $1,000 for adding more, less, etc. I am ALMOST at a good result, although I still have a faint trace of the crease below my right eye -- at any rate, it's much improved, but this was a nightmare, and I think the docs are very cavalier in insisting that there's no risk at all with Vitrase.

My plastic surgeon was surprised by my poor result, as was his nurse, and when I gave him the names of a few very well known surgeons who don't advise hyaluronidase he was surprised and promised to look into it. So, unless you feel you are horribly disfigured I recommend patience. The creases I have from the Vitrase that are underlying the filler I just had to replace are, I guess, permanent.

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I had botox for my crow feet and yes it got rid of those, but now I have new ones just below the center of my eyes, and these look WORSE!!!! Also I have darker circles under my eyes. Think twice before geting fillers!!
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Hi... I had Hyalurondase to remove filler in my top lip line, I feel it has reuined my lips I have indents in the place where the filler once was, and the skin above my top lip as shagged. I do want to add that I noticed a small indent before I decided to have Hyalurondise. The body of my lips feel like empty sacks when I press down on it seems like it lost its bounce. I'm really worried the skin won't ever restore itself. This have left me depressed.

I asked friends and family they seem to think it looks normal as it was before the filler, but I can see the difference. I also went to the doctors and she thinks my lips look fine. My friend think am mentally scared by the whole thing and yes I think I am.

Please can anyone help me is it possible for the skin around and in my top lip improve in time I have read Hyaluronadase does not course permanent damage but yes temporary. I don't know what to believe I lost trust.
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Hi Kelly exactly the same thing has happened to my lips. It's been 3 months since I had hyalase and my lips and the skin above my lips are sagged. Have you seen improvement yet?
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UPDATE: Although I still think hyaluronidase is damaging (it left me with blue-purple lines and discoloration around the eye immediately after the treatment), I now know that my "bad filler" was actually herniated fat resulting from botox to the crows feet that I had concurrently with the restylane under the eye. NEVER get the two done at once. I strongly recommend having a plastic surgeon and not a dermatologist administer botox. Be very careful of the crows feet area; your eye muscle can easily be frozen if they inject you in the wrong place, resulting in my case in a festoon, a black eye effect, and herniated fat pads all around. I look horrific.
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Mirror image from Australia.
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I am 2 1/2 years post juvaderm to tear trough and botox to crows feet w/ same problem. Too scared for HA. i also believe it is muscle herniation. Have you come upon any treatment for that? I have been to 5 plastic surgeons including one specializing in ocular plastic surgery and no one has a fix except suggesting Hyaldronidase or more filler too diminsh appearance of a ridge. Very depressed
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Hi! Can you give me more information on the discolouration you got from the hyaluronidase?
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I think you are so right, tried but failed ... can't agree more. What you said about hyaluronidase being part of the "marketing package" of these fillers is a great point. It is hard for me to look in the mirror b/c I blame myself, and it has been hard to deal with this at work or meet my colleagues with confidence (b/c I am imagining they're thinking, What's with her black eye???). My only comfort in this is that anyone in her right mind reading this will look in the mirror, realize the filler while not ideal will slowly dissolve in a couple of months, and NOT go in for hyaluronidase. I also agree about not getting Resty and botox on the same visit. The added convenience is not worth it. Space these things a few months apart. Don't get filler on your doc's time frame. It's your face; get filler when your mirror tells you you need it. Based on my experience think very seriously if you want to get filler under the eyes because although in the past I've had excellent results with Restylane it's a tricky area and there's a risk of blindness. Docs are sometimes over confident in their ability to give you a good look. You want someone who informs you of the risks, and who, if anything, is skeptical of the results, not someone who is anxious to sell you another syringe of something!
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I had a thought on the way to work. I am a former Accutane user (about 10 years), which cured my cystic acne but did change the texture of my skin somewhat. I just wondered if there might be a correlation between the past use of Accutane and these problems with filler/hyaluronidase to inject filler. Just a thought.
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I think a very important thought! And I definitely think that is worth looking into further. I am pretty sure that I have also read something about a bad interaction between Botox and Accutane because of the permanent skin changes that occur with Accutane. I will have a look again and post anything I find that might be relevant. You raise an excellent point in general. When I read bad reports about various procedures on this website, I often wonder about the medical histories of these people and how the COMBINATION of different procedures affects results. For example, in respect of some of the shocking results with Fraxel and other lasers, I wonder if those people had Accutane in the past as both laser and Accutane change skin texture. I also wonder if those people had restylane/juvederm in their faces at the time of the laser treatment because hyaluronic acid dermal fillers are "hydrophilic" so the fillers attract/hold water and an ablative laser like Fraxel is attracted to water. Does this interact well? Possibly not. I wonder if those people with bad laser results had active botox at the time of the laser treatment because botox initially makes skin tight and then it loosens up again as it wears off. I am not a medical professional but I would think it is just common sense that no procedure and its outcome should be viewed in a vacuum. Surely the different procedures must impact each other and some combinations are just bad!
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How are you doing? I was reading some of your other posts because you'd asked me about whether I had botox in the crows feet at the same time. I did. I don't think I had any negative effects like you describe (he placed botox at the eye corner not under the eye), but thanks to your posts and Neena's I'll NEVER have botox anywhere near my eyes again, and I'll think very carefully about ever getting it again!! I see an oculoplastic surgeon (local, not Seckel in Boston) this Monday. Will let you know what he says ... From your posts you sound like such an amazing and smart woman. I wish we lived closer, I'd want to get together for coffee!! This is not my first beauty disaster. With Accutane I went through a hair shedding phase and at one point thought I would go permanently bald. This lasted for two years (horrible) and I feel in some ways I'm sort of reliving that with my "black eye" syndrome.
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What do you see Fraxel doing if there is a juvederm overfill? Reducing it or causing it to grab more water?
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Thank you so much for the compliment. Same to you and I am so glad you have joined this discussion!! Bloody hell (there's an Aussie expression for you), I also wish I lived closer to you then I could invite myself over to your house on a Saturday night so we could drink wine and commiserate over our faces. From what I can gather from the reviews on RealSelf, Botox is very hit and miss, especially around the eyes. And when it 'misses' it is can make you look like a monster, takes forever to wear off and I suspect (still hoping maybe not!) that it leaves residual damage. Lots of people report having used Botox for years and years only to eventually have a disaster. Cheek drop and festoon formation as two of the most appalling aesthetic outcomes of Botox/Dysport do not seem uncommon - there are at least 20 people on this website alone who got this awful result in one form or another (me, Beth F, Amaxy, Penelope, Learning, Shabbygirl, Uncool, Anny, AnotherBadBotox, Chipmunk Face, Petrified etc etc etc). Disturbingly, it would appear that Botox/Dysport in the forehead only can also cause bad results under the eyes. See for example the reviews from Happywithme and Chloerose. I receive emails from people at least every other day asking what on earth happened to their face after Botox/Dysport! I can try to explain what happened but sadly can offer no solution other than wait, wait, wait. On your previous Accutane/hair disaster. I can relate. In my early 20s I had 'cause unknown' alopecia which left me with a bald spot about the size of an Australian 20 cent piece (maybe like a US half dollar) and I was terrified I would go completely bald but I didn't thank goodness. However, the bald spot grew no hair for at least six months and when it finally grew back it was grey. Ugh! I am blonde and don't need to colour my hair even now, so I was lucky that the bald spot and grey regrowth are in a spot covered by the rest of my hair. For some people, disasters seem to be multiple events, me included!!
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I should also say that I have never written on a forum before about anything. I am not even on FaceBook! I started contributing to RealSelf to work out what went so wrong for me and then what to do to try to fix it (because I could not get any sensible answers or proper advice from anyone in the medical profession.) However, as I learned more I became increasingly concerned with the ‘beauty industry’ in general. It seems so massively under-regulated, and this is bizarre for a country like Australia, which would have to be among the most regulated countries in the world. For example, Botox is a prescription medicine in Australia and, as such, one would assume that only a doctor can administer it. Not so! That being said, a doctor administered mine and where did that get me? The situation in the US appears similar. How does a novice to the injectables industry know about the FDA approval process? Or what ‘off-label’ use means? Or even what questions to ask the injector? How do we differentiate between a sales pitch and medical advice? And when did it become an ‘industry’ as opposed to the practice of medicine? This seems wrong at a fundamental level. The issue of competing interests for doctors is also cause for concern. Doctors who lease or buy (I assume mainly on credit) incredibly expensive laser machines etc basically must use them to pay for them. Does this affect their decision-making process in determining if someone is an eligible candidate for the procedure? Surely it must at least be a factor? How does this sit with the tenet that underpins the practice of medicine: “First, do no harm”? To my mind, it would seem somewhat difficult to reconcile. What also struck me was the “MORE” concept. There are so many reviews on RealSelf from people who say they had Fraxel and it ‘did not work’ so they had Affirm and it ‘did not work’ so they had Thermage and it ‘did not work’ so they had IPL and it ‘did not work’ etc etc etc. When does the ethical obligation of the provider kick in to say that it might not be a case of ‘did not work’ but it might actually be a case of damage caused by the procedure(s) themselves, particularly cumulative damage? It would appear that sometimes this obligation never kicks in, hence my general concern about adverse effects from combining procedures. Logic would dictate that the more procedures undertaken, the harder it is to work out the cause if there is a problem. The “MORE” concept is a large cause of the position I find myself in. If I had not put the brakes on myself, then I am confident that none of the doctors I saw would have done it for me and they should have. It was continually represented to me that there is a solution to every problem with injectables and I believed them because it is their job and they should know. I didn’t work out that they don’t know (and they are mainly guessing) until it was too late. The doctor who made the unforgivable mistake of administering Botox to me concurrently with tetracycline antibiotics was still suggesting dermal filler to camouflage my flat and dented cheeks at my last appointment with her. I stopped seeing any doctors a few months ago because I know how easy it is to say yes to something that sounds like a solution when you feel depressed and desperate. The ONLY thing that has helped my face is TIME. And lots of it. However, I can already see that time is not going to completely fix the damage to my face and fairly soon it will be appropriate for me to take a pro-active step in trying to fix the ghastly appearance under my eyes and the discolouration of my skin. I have waited 34 weeks. I am afraid but I can’t hide at home forever. Good luck at your consult with the surgeon, eyeschicago. I am very keen to hear how it goes and I will be thinking of you! I am 37, so we are of a similar age and I think we are undergoing very similar issues. Please ensure to tell the surgeon that you have active Botox around your eyes, even though your aesthetic result was good. From reading the ‘blepharoplasty gone wrong’ reviews on RealSelf and case studies in medical journals, I strongly suspect that some of the bad results are because the area is affected by Botox at the time of the surgery. I am going to let mine wear off absolutely and completely before considering blepharoplasty because weakened muscles cannot assist with clearing post-surgery swelling. I look forward to hearing from you. Cheers, K
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In my musings about the possible dangers of combining procedures, I was actually thinking of the effect of Fraxel on skin which has hyaluronic acid dermal filler under it, not the effect of Fraxel on the filler itself. Non-ablative lasers (ND:Yag, IPL, Medlite, Gemini etc) are attracted to colour - either melanin (brown pigment) or oxyhaemoglobin (red in blood) or both, so non-ablative lasers selectively treat issues like hyperpigmentation and broken capillaries. Ablative lasers (Fraxel, CO2, Erbium) are attracted to water in the skin and as a result remove the top layers of skin altogether. Hylaruonic acid dermal filler is designed to attract and hold water in selected areas under the skin. My question was if an ablative laser like Fraxel is used on an area of skin that has dermal filler under it, will the extra water in that area increase the danger of burns from the laser because the laser is 'overly attracted' to the area? It was just a thought. I am not sure what effect Fraxel would have on the filler itself. Maybe none? If anything, I would think an ablative laser would cause dermal filler to break down more quickly and therefore reduce volume. When someone complains on RealSelf of an overfill of Restylane or Juvederm, the advice of the doctors on this site is often to 'heat it up' and 'massage' to make the filler break down more quickly. Fraxel will certainly 'heat it up'!! What do you think, Mishka? Are you thinking of using Fraxel to try to reduce your filler? I am way too scared of ablative lasers to ever try them but I am considering a non-ablative laser in very selected areas of my face to try to fix the discolouration and broken capillaries left by the hyaluronidase. I look forward to hearing from you Mishka. Cheers, K
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Am thinking of trying fraxel. I have tried the ipl-I do have some discoloration,especially lip area (above upper lip way too much filler placed there also)The ipl does seem to help some with this-had 3 tx. I have heard fraxel may break the filler down faster,but I think it could swell for a few weeks(or more) first-hate to deal with that. I will be 9 months with this April8-my face is still fat and lop-sided-I can still push on areas to tell what I used to look like without filler.I believe I REALLY dodged a bullet using so much hylaronerase-the only reason it didn't wreck my face was the GIANT amount of filler present-who knows though maybe there is a problem and am not seeing it with the other issues -my face seems to have been pushed forward-weird.Anyway thanks so much for insight! Much luck with Ipl-also one more thing-sat in a infrared sauna twice in the past two weeks-said to remove toxins etc. My face seems to look some better since.Worth a try-could just be the fluid loss-but usually when that happens it puffs up twice the size a day or 2 later-didn't happen. Thanks!
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I too have been dealing with this hell for nine months or more, so I feel your pain! I also understand the need to 'do something about it'. I too am sick of looking (and feeling) horrible every day. Do you have any worries about the filler holding fluid from the swelling from Fraxel? If you do decide to do Fraxel, can you please let us know how it goes for you? Thanks, K
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K (tried but failed), you make a great point about waiting until the botox wears off before having a bleph. But from your posts it sounds like that could be up to a year or more, so no bleph for me in the near term. I have to say that my eyes are NOTICEABLY drier now that I've had all these injections. I can't say whether it's the botox, the hyaluronidase, or the filler, but I know it is like an overnight change and sometimes my eyes just ache. I also get terrible headaches, AND to make matters worse, my medial fat pad on one eye (the inner corner fat of my left eye) has "popped out" (this happened overnight last weekend). I saw in one of the posts related to the botox disaster that one of the people who wrote to you also had this as a botox side effect. Lovely. Now I feel I HAVE to get a bleph to fix this, as what's the possibility it will move back behind the fascia or the muscle where it belongs? It looks really bad to me, although others say it's "hardly noticeable." Just like my frigging black eye is "hardly noticeable" when I have a TON of makeup on. I agree with what you said in your posts and CAN'T BELIEVE this stuff isn't regulated better. It is just a bunch of docs trying to pay for their stupid machines. I think there's a strong motive (money) NOT to do research into the side effects of some of this stuff. If people and the regulatory bodies knew the truth, they might put a stop to some of these practices, like botox under the eyes ... damn it, I never even had crows feet to begin with!
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Will let you know how it goes if I decide to try the fraxel. If I do it it will be the "gentle" one. My big fear is the swelling. I am sure it would be temporary,but hate the idea of looking worse for a while. Did I read you had some Botox problems too? I wonder if the sauna I described would help with that? It's a thought-non-invasive with some other health benefits. I have gotten facial massage afterwards and it does seem to show slight improvement.I guess I am looking at everything that doesn't involve needles. I wish that they would come up with something that would dissolve whatever else is in the filler that makes it hang around so long-maybe not the hylaronic part. Something that would not mess up the face? I wonder what else it is made up of? I try to take every supplement I can think of that helps with fluid retention and inflamation-I also jog and jump on trampoline-thinking it will help the lymph rid this stuff-nothing helps!! Will keep you posted.
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Also read you were considering lower blepharoplasty. I am thinking about this also. Filler placed under eyes has really stretched and caused skin to sag. Would you wait till all filler has dissolved? I am wondering if it could be another 9 months in my case. I have read this can be done endoscopically? Seems like an easier way. Maybe less trauma?
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EyesC - that was my question too! When the doctors say 'botox always wears off' and 'there will be no permanent change' I look at the hideous result on my face and just think that is not possible for it to go back. How on earth will these protruding fat pads sink back in? How on earth will these bizarre horizontal wrinkles go away? And sadly I am right, neither has gone away after 9 months! Natural ageing - give me a break! I wanted the dark circles under my eyes treated with filler because I have hated them all my life. I wanted to wear LESS makeup but now have to wear a ton of it too and it still doesn't camouflage the now BLACK circles. All this whole 'treatment' did was to make the dark circles darker and add wrinkled bags under my eyes to boot. Just excellent. The black, puffy, wrinkled bags under my eyes are now super obvious instead of midly annoying. If my injector had told me that Botox around the eyes had even a less than 1% risk of making the area under my eyes look worse than before (read TWENTY years older than the rest of my face) then I would have said NO. I never even had crows feet either. I was 'upsold' on Botox to make the filler last longer (the fries with my burger!) and I never needed it in the first place. I paid more than a grand for both products instead of $700 for the Juvederm. Nice add on sale. And I think the injector just does the same Botox for everyone - bunny lines, crows feet, forehead without a thought for each person's individual face. Talentless hack. I am so sorry to hear about your increasingly diabolical result with all of this chicagoeye and, believe me, I know exactly how you feel. There is something about the helplessness of watching it happen and wondering what is going to happen next that is just excruciating, but there is nothing you can do and you just have to let it run its course. My face got progressively worse for more than a month from the Botox because of the tetracycline antibiotics. I could do nothing to stop it. By the time the Botox had stopped 'working' my face was so frozen I could hardly move it at all. My forehead was cement. I can hardly frown now! The festoon under my left eye protruded so much it was actually smooth. The wrinkles only appeared as it started to wear off - like a deflated balloon. I too fear that a blepharoplasty is some time away. There is no point in me doing anything until the botox has worn off. I am impatient for this horrid episode to be over as much as I am sure you are too, but we both just have to ride it out together! What did the surgeon say? K
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Hmmm... I wondered if the filler could be removed DURING a blepharoplasty as I don't really want to wait until it is gone and there is no way I am ever having hyaluronidase again! I am definitely waiting until the botox is gone because a blepharoplasty with botox-weakened muscles around the eyes just screams DISASTER to me. Thanks for the tip - I will look in to whether it is possible to remove the filler during the surgery. Do you have milia (the white cysts) under your eyes. I do. Can these be removed during surgery as well. I hate them!
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Yes I do have milia!! Hate them and never had this before filler! This Simoni(sp) Guy in L.A. does endoscopic bleph. Doesn't believe in anesthesia. I am going to check into him.
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Tried but Failed ... Went to see the surgeon. He can do my upper eyes (they are relatively unaffected by this nightmare, save for the upper fat pad on my left eye near my nose, which suddenly popped out -- I read that is b/c of botox, but he can reposition it or cut it as this is quite common in OLDER people, though not 40-year-olds). But the lower, he won't do (yet). He said wait it out. I am still black and blue under the right eye especially. He could not identify why I have a rather large bag IMMEDIATELY under my left eye. I thought this was filler, but b/c of the dry eyes and the posts I've read on your other blog I think that while I don't quite have the full "chipmunk" effect you describe I do have relaxation of that orbital muscle on the right side. As a result, I have (1) a black circle under the eye, like a half moon), (2) a festoon (which I NEVER had before or anything remotely like it) and (3) aforementioned fat pad immediately under the eye. All I have in the other eye is the upper fat pad problem (annoying) and a small amount of blue but very manageable and not in need of a ton of makeup. His exact words: "It's like you have two different lower eyelids." He was absolutely puzzled by the fact that the hyaluronidase caused the blue-and-black response but was intrigued. His results are fantastic. Daniel Tresley in the Chicago area. His booking person showed me a photo of her own mother (random person not in his before and afters) and she looked equally incredible as the rest of them; I was very impressed. But he was so puzzled by my experience, which I now recognize as being a botox plus filler issue (botox placed too low and too close to that left eye; other side OK). Right now my obsession is with the lower lids, not the uppers, because my right lower looks so awful. I am waiting six months or more and probably will have all four lids done. In the mean time I will also go and see Brooke Seckel for a second opinion. By the way the only good thing about this is getting to know you by email. I am also an attorney in litigation. First initial also is K!
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I mixed up right and left in the message above. Suffice it to say that the only problem in one eye is a small upper bulge (fat pad) and the other eye has ALL the other problems caused by botox/hyaluronidase/filler.
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