Does Hylaronidase Dissolve Some Natural Hyaluronic Acid?

Dear Katie - I would strongly recommend massage, now. There's no downside as it will not make your concerns worse and will likely help you. If that does not work, small amounts of hyaluronidase will help dissolve your filler. Better to be conservative and risk having to return to your cosmetic surgeon for another hyaluronidase injection than to overdo it. Best wishes.Stephen Weber MD, FACS

Filler migration, swelling, and granulomas can cause significant discomfort and cosmetic ramifications. Our office specializes in the use of enzymes and filler reversal techniques without hyaluronidase to help improve the results of botched cosmetic fillers, whether caused by Juvederm, Restylane, or foreign fillers. Our plastic surgery institute provides expertise in filler removal. We begin by examining the facial fillers and assessing the likelihood of fluctuance or liquid volumization. If appropriate, we use Hylenex, or other filler reversal agents to reduce swelling and filler migration. Hylenex can be targeted into the areas of concern using multiple layered injection techniques. If the filler does not completely resolve, then additional concentrations may be employed. The technique has the potential to reduce the filler and may slightly impact normal hyaluronic acid. Treatments are repeated and results can improve immediately and with time.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Hyaluronidase will break down the filler material, and should not have any major impact on your "native" tissues other than transitory swelling.

This enzyme will dissolve all hyaluronic acid that it comes in contact with, yours included. However, your body is in a state of constant remodeling. The HA that you make is constantly being chewed up and remade. If outside HA-dase contacts your own stores of HA, you will have a temporary loss, but yor body will correct the problem.

On a better note, Viafill is a new fat transfer system that makes the fat trasnfer process easier and smoother, especially around the eyes.

Hyaluronidase dissolves hyaluronic acid regardless of its origin.  For decades the drug has been used to assist in tissue separation during surgery because of that.  It was uncommonly used prior to Restylane and Juvederm coming to market and in fact was hard to find a decade ago.

Your body makes hyaluronic acid constantly and dissolves it just as fast.  Naturally occurring hyaluronic acid is in constant flow as it is produced and then hours later dissolved.  So within hours, or at worst days, your body will reestablish the natural balance present prior to your Juvederm.  Juvederm and Restylane differ from the natural product primarily in that they have been cross-linked.  The purpose of the cross-linking is to protect it from your natural dissolving mechanism.  Cross-linking does not protect it from the effects of Hyaluronidase so it can still be dissolved that way.

Hyaluronic acid was first approved in 1948 and is primarily used to aid the infiltration of other drugs, particularly local anesthetics. It is widely used in the ophthalmology field and there are no reports that I can find in the literature to indicate that it causes a clinically significant loss of native hyaluronic acid. Some formulations of hyaluronidase do require skin testing to ensure that you are not 'allergic'. Otherwise, it is a great drug to reverse negative effects seen with hyaluronic acid fillers.