Does Hylaronidase Dissolve Some Natural Hyaluronic Acid?

Question

I had fat transfer under the eyes a few years ago that left all sorts of bumps but have finally been successful with bringing it down to an acceptable level with Kenalog. There were some little bumps that I can live with but thought I would just smooth it all out with Juvederm so I gave it a try.
I had Juvederm injected under eyes a week ago and it is definitely too much and placed lower than it should have been. It looks like I had something injected and I really need it to all just go away – it was fine before. The doctor has not used hylaronidase before and our question is would hylaronidase dissolve some of the natural hyaluronic acid thus leaving me less plump than before (or other possible side effects) and if so would this correct itself?
Could regular massaging make it go away in a few weeks; is there any danger with hylaronidase or should we just do it?
Appreciate your expertise.
Thank you,
Katie

Stephen Weber MD, FACS · Answer

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

Raffy Karamanoukian, MD, FACS · Answer

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

Steven Wallach, MD · Answer

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

Robert M. Freund, MD · Answer

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.

Louis W. Apostolakis, MD · Answer

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.

Does Hylaronidase Dissolve Some Natural Hyaluronic Acid?

Answers (6)

Answer: If massage doesn't work, conservative hyaluronidase will help you

Answer: If massage doesn't work, conservative hyaluronidase will help you

Answer: Can slightly dissolve some natural HA

Answer: Can slightly dissolve some natural HA

Answer: Hyaluronidase

Answer: Hyaluronidase

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Answer: Hyaluronidase in not specific

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Answer: Hyaluronidase Dissolves All Hyaluronic Acid, but not to worry

Answer: Hyaluronidase Dissolves All Hyaluronic Acid, but not to worry

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Does Hylaronidase Dissolve Some Natural Hyaluronic Acid?

Answers (6)

Answer: If massage doesn't work, conservative hyaluronidase will help you

Answer: If massage doesn't work, conservative hyaluronidase will help you

Answer: Can slightly dissolve some natural HA

Answer: Can slightly dissolve some natural HA

Answer: Hyaluronidase

Answer: Hyaluronidase

Recommended reading

Everything you need to know about Hyaluronidase

Answer: Hyaluronidase in not specific

Answer: Hyaluronidase in not specific

Answer: Hyaluronidase Dissolves All Hyaluronic Acid, but not to worry

Answer: Hyaluronidase Dissolves All Hyaluronic Acid, but not to worry

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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.