Will Hylenex Dissolve Filler Encased in Biofilm?

Hylenex (hyaluronidase) is effective at dissolving hyaluronic acid-based fillers like Voluma, but when the filler is encased in a biofilm—a protective layer formed by bacteria—it can be more resistant to enzymatic breakdown. Biofilms can act as a physical barrier, making it harder for Hylenex to fully access and dissolve the filler.

In some cases, multiple sessions are needed, especially if the filler is deeply embedded or partially degraded. If you've already had about six rounds of Hylenex without significant improvement, it’s possible that a biofilm is impairing the response. In such scenarios, a combination approach using antibiotics to disrupt the biofilm, followed by additional Hylenex injections, may be more effective.

Persistent nodules or lack of resolution after multiple treatments warrant further evaluation, and in rare cases, surgical removal or biopsy may be considered.