Hyaluronidase alternatives for upper eyelid filler? Please help?!

Question

I had upper eye filler about 18 months ago and I am SEVERELY depressed over my decision. The filler isnt botched but I truly miss my old eyes and fear I will never get them back again. I tried massaging the filler but it doesnt flatten. Hyaluronidase is NOT an option as there are hundreds of accounts with pictures CLEARLY showing tissue damage so I dont understand how any physician can recommend this. Filler can last 6 years in this area and I cant handle that. What other options do I have left?

John Tang, MD · Answer

Thank you for sharing your concerns.  I have used Hylaronidase quite often and will use it if I find it to be appropriate for that particular situation.  However, there are times I will use an RF device (similar to laser) to break down the filler.  This is especially good when there is concern that the Hylaronidase will damage the surrounding tissue since the heat actually will stimulate collagen while breaking down the filler.  There are many RF devices that I use depending on how strong I would like to go and whether there is concerns of downtime from the patient.  I have used RF for this situation with complete success.  Good luck.

Harold J. Kaplan, MD · Answer

Hello Regretful.  While we respect your opinion about Hyaluronidase, we do not agree.  Hyaluronidase is an enzyme specifically developed to dissolve synthetic hyaluronic acid based dermal fillers.  HA does not exist in concentrated enough quantities in the skin to be affected by this enzyme.  We do respect your desire not to use it but the only other viable option would be surgical removal and we would never suggest that over using Hyaluronidase.  Best of luck.

Eric M. Joseph, MD · Answer

If hyaluronidase is not an option for you to consider, dilute steroid injections may help to lessen the effect of HA and other fillers. Depending on your examination, excising the filled area (skin and HA), similar to upper blepharoplasty surgery may be considered. Hope this helps. Dr Joseph

Mehdi Sina, MD · Answer

Hi,While it is true that hyaluronidase can cause some inflammation, in experienced hands, it works extremely well. Fillers in the upper eyelids can persist for years and if you are truly unhappy, it may be a good option to have some dilute hyaluronidase injected in the area of concern. Best,

Mitesh Kapadia, MD, PhD · Answer

With all due respect I have used Hyaluronidase hundreds of times to dissolve filler and have never seen tissue damage. In trained hands this treatment is very safe. I am honestly not sure where all the bad hype comes  from on the internet. I suspect almost everyone who dissolves filler regularly will agree.

Hyaluronidase alternatives for upper eyelid filler? Please help?!

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Answer: Hyaluronidase

Answer: Hyaluronidase

Answer: Unhappy with eyelid fillers

Answer: Unhappy with eyelid fillers

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Hyaluronidase alternatives for upper eyelid filler? Please help?!

Answers (6)

Answer: Hyaluronidase

Answer: Hyaluronidase

Answer: Unhappy with eyelid fillers

Answer: Unhappy with eyelid fillers

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Recommended reading

Everything you need to know about Hyaluronidase

Our mission is to create a world where every investment in modern beauty is Worth It.