Inject Hylaronidase in Same Spot As Dermal Filler?

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,

Doctor Answers 7

Hyaluronidase works great at dissolving bad HA jobs

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.

Laguna Niguel Dermatologic Surgeon
4.9 out of 5 stars 216 reviews

Hyaluronidase is safe and effective

First, it is important to see a board certified dermatologist or other aesthetic physician like a plastic surgeon or oculoplastic surgeon familiar with the use of Hyaluronidase. It is important that the product be FDA approved and not compounded in order to decrease the risk of allergic reaction. It should be injected into the unwanted lump and in most cases, the reduction in size is in minutes to just a few hours. The process can be repeated in a few days until the lump is gone. Or, if the hyaluronic acid was superficially injected, the skin can be nicked and the material milked out. I would get this done in order to look better faster. Left alone, the excess material will last for months.

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 18 reviews

As I mentioned in another question that you posted - go...

As I mentioned in another question that you posted - go for it. Hyaluronidase is a safe drug that can be injected in the area of concern. The medication will diffuse to some degree under the skin and dissolve the hyaluronic acid present. Start with a low dose and realize it may take several injections to get the result that you desire. Unfortunately massage won't likely make the Juvederm go away totally. Deep massage can move the hyaluronic acid but the volume will still likely be present.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
3.9 out of 5 stars 14 reviews

Patience before hyaluronidase usage

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.

William Ting, MD
Bay Area Dermatologic Surgeon
4.8 out of 5 stars 12 reviews

Juvederm removal

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. 

Chris Thiagarajah, MD
Denver Oculoplastic Surgeon
4.9 out of 5 stars 9 reviews

Hyaluronidase is very effective for removing Juvederm, Restylane, or Perlane

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.

Keith Denkler, MD
Marin Plastic Surgeon
5.0 out of 5 stars 18 reviews

Hyaluronidase for dissolving Juvederm

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.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.