Inject Hylaronidase in Same Spot As Dermal Filler?

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 a) does it matter if it’s injected in all the same spots as Juvederms as that is hard to guess or do the enzymes just find it and dissolve it?
	
		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

Lorrie Klein, MD · Answer

Hyaluronidase works great at dissolving bad HA jobs (Juvederm, Restylane, Perlane, etc.) when the product is put in too superficially, in a bumpy fashion or too much is injected. It should be injected directly into the area that you want to dissolve.

William Ting, MD · Answer

Hyaluronic acid fillers such as Juvederm, Restylane, and Perlane partially work via their humectant property, e.g. drawing water to injected area. Remember that at least 10-15% of what you see during first week of hyaluronic acid filler injection is swelling. Most of the time, hyaluronic acid fillers do settle down nicely. If you get hyaluronidase too early, you may take away much more filler than what you or your aesthetic physician intend to do.

Chris Thiagarajah, MD · Answer

I would give it one more week just to see how the Juvederm settles down. The wydase or hyuloronidase is not an exact science so a. it doesnt seek it out b. it has to be injected into the same area and massaged around to completely remove it. First however the Juvederm may settle down more and become more subtle so I would give it a full two weeks atleast.

Keith Denkler, MD · Answer

Small, incremental injections of hyaluronidase will remove and reverse excess or lumpy Juvederm, Restylane, or Perlane. Massage is the best first step for lumps. If there is a bluish discoloration, a nick with a sterile needle follwed by expressing the gel is another option. Injections of Vitrasse (hyaluronidase) will reverse and dissolve uvederm, Restylane, or Perlane as another option. The goal is to remove excess, not all of the filler.

Steven Wallach, MD · Answer

Hyaluronidase is a good way to treat over injection of Restylane or Juvederm.  It should be injected in the vicinity of the over correction and massaged a bit.

Inject Hylaronidase in Same Spot As Dermal Filler?

Answers (5)