Filler after Hylenex? How long do I have to wait?

Question

Hello! I've been slowly working with Dr. A on removing bad under eye filler injected by Dr. B in March. I had what seems may be my last hylenex injection today (.25 per eye). How long do I have to wait to return to Dr. A to redo the under eye filler? I forgot to ask.

Matthew Richardson, MD · Answer

I would generally recommend that patients wait at least two weeks after dissolving any filler for before even considering placing any more filler into the same area. Keep in mind that in some cases, the filler injection technique might not be the problem, and it may be that the anatomy does not facilitate the types of changes the patient is looking for. Regardless, be sure to use an expert physician injector.All the best,

Nima Shemirani, MD · Answer

Hi @Mochaccinaa! I recommend waiting at least two weeks after Hylenex to receive more dermal filler. Best of luck to you!

Melissa Chiang, MD, FAAD · Answer

Hylenex works quickly (most of the effect takes place within minutes, but it may have a continued effect for 1-2 days).  I would wait to do the next injection until 1) the area has stopped changing and 2) there is no swelling/bruising.  Typically this time frame occurs quite quickly, but waiting a week would generally satisfy both criteria.

Andrew P. Trussler, MD · Answer

A hyaluronic acid filler can be dissolved with hyaluronidase. The amount of cross linking in the filler and location will determine the ease of dissolution. Filler in the under eye region can be placed in different levels so it is important to estimate where and what was placed. When the filler is dissolved it can lead to temporary bruising and swelling which can blunt the accuracy of replacement filler. I would recommend at least 2 to 4 weeks post dissolution at the earliest because you do not want to go through this again.

Tanya T. Khan, MD · Answer

Hello, usually Hylenex works fairly quickly (within a few days to a week you should notice its full effect). You can gently massage to further along the activity of Hylenex. I would say reliably after 10-14 days would be a good time to get filler re-injected, carefully and from someone who is experienced with eyelid anatomy.

Jonathan Kulbersh, MD · Answer

I would follow up with your injector about the timeline, but it is recommended to wait a few days after hylenex before getting another filler treatment. Hope this helps.

Jason Emer, MD · Answer

I recommend waiting at least a few days before getting filler, however, I recommend following up with your injector about their protocol for filler after hylenex. Keep in mind, a combination approach will give the most improvement. Fillers, lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer

Sagar Patel, MD · Answer

I got you. The half life of Hylanex is eye tissue is between 60 and 112 hours. That’s the time it takes for the concentration to be halved. Generally speaking the body doesn’t degrade it completely by then but that is when it is safe to get filler. I would err on the side of caution since this isn’t an emergency procedure so we typically wait 5 days to be safe. After that a lot depends on what filler you had before, where it was injected, why are we erasing it, and what we would be objecting next. This is where you pay for the board certification. Hope that helps.

Sagar

Sagar

Amadi Aesthetics Plastic Surgery · Answer

I would recommend waiting at least 48-72 hours after hyaluronidase treatment before getting filler injected to the same area.  When treating the under eye area, we like using Restylane-L because of its relatively low swelling, cohesivity, and longevity.  When it comes to your eyes, I would highly recommend that you get evaluated by a board-certified oculofacial plastic surgeon.  Hope this helps!

Monika Soni, MD · Answer

Thank you for your question! Wait 2-3 days before getting injected again. Longer if you have inflammation. We recommend a low viscosity filler such as Belotero, Juvederm Ultra, or Restylane. To be sure, see two or more board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have these treatments. Best of luck!

Filler after Hylenex? How long do I have to wait?

Answers (10)

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