Botox and Hylenex in the same day? Will Hylenex effect the Botox? (Photos)

There is not any science to support having or not having hylanex and Botox in the same day.  However, theoretically, the Hylanex could cause diffusion of the Botox if the injections area is not separated by a reasonable distance.  I would suggest not combining.  There isn't really a downside, except lost time, to separating the treatments, and there could be a problem.  I would suggest playing it safe and separating the treatments.   

You should space the treatments apart by a few days at least just to minimize the chance that hylenex will not cause further dissolution of product and potentially compound your Botox results. I think Hylenex first, then Botox. Not the same day. 

Hylenex will dissolve the filler but has no effect on the mechanism of action of the Botox. In theory it may cause Botox to dilute or migrate if it is injected in the same area.

Yes, I believe it would be alright for you to have both treatments on the same day as long as you are seeing an experienced injector. However, if the filler was done recently, you may want to give the swelling some time to resolve. 

Both Hylenex and Botox work with different mechanisms. Therefore, they can be injected at the same time without changing their effects especially since they are being injected into two different areas. Your pictures look as though the filler was injected into the tear trough may be into the lower lid area causing the fullness. This is a very difficult area to treat and it makes sense to inject the Hylenex to dissolve it.

I suggest you have the Hylenex injected to decrease the presence of the filler and then wait at least a week and have the Botox done for the crow;s feet. you are correct that it is hard to tell what to do in this environment and i refer you to my latest book SkinSkam and tio melvinelsonmd.net

I understand your concerns perfectly well. I think you should wait another week or so for the swelling to come down in the lower eyelid area. After that point in time you can definitely administer hyaluronidase and have the bags dissolved. This may require more than one treatment. You can definitely have the crow's feet treated at the same time with botox without any fear. Go to a reputable plastic surgeon or dermatologist as I don't recommend going to spas in general.Good luck from New York City