Best method to inject hyaluronidase in widespread area? (Photo)

Filler migration and permanence is a very common problem because there are many different types of HA fillers on the market and each is specified for a specific part of the face. Use of highly cohesive fillers on thin skin may cause swelling and nodularity. If patients have filler migration or nodules, we recommend a combination approach of filler reversal with enzymes Hylenex and Hyaluronidase in different strengths to dissolve the filler. We may also need to add Kenalog to the mix in order to reduce fibrous tissue. If the filler does not dissolve, it either means the filler is not HA material or we need more enzyme. The HA reversal can be combined with other lasers and skin treatments at the same time, and it usually (usually) does not affect adjacent tissue.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Good Afternoon! Sorry that you're experiencing trouble with your filler. In my opinion, if you want it all gone, you need to "flood" the area with hyaluronidase to get it to all dissolve. I dissolve with a needle rather than cannula as it tends to be more focused. Some will advocate for diluted hyaluronidase, though I don't choose to do this myself. If you're looking to reduce, but not completely eliminate, I would recommend small amounts over 1-2 weeks to get the result you may want. Hope this helps you!