Dissolving Restylane - How Long to Wait to Get Hyaluronidase Injections?

One month ago I had Restylane injections to improve my tear trough and cheek area, and now I'm wondering if I can get rid of them and how long would I have to wait before it's safe to use Hyaluronidase acid. Also, would I need the same number of  Hyaluronidase injections as I had for the Restylane?

Doctor Answers 12

Correcting Filler problems with Hyanluronidase.

One thing that is wonderful about the HA fillers (Juvederm and Restylane being the most popular) is that they can be reversed if desired.  There are two ways to remove HAs:  extraction or dissolution.  Extraction means that if there is a blue blob of filler left from a poorly administered HA a qualified practitioner can prick the area with a needle and squeeze out some of the gel. This can work even if the filler has been present for years.  The second method is dissolution which in my hands always works. Hyaluronidase is an enzyme that is injected into the area in question and dissolves the material.  The treatment can be done immediately or months or even years later.  There are only a couple of pinpricks and my patients have experienced no pain.

Paradise Valley Dermatologic Surgeon
4.5 out of 5 stars 35 reviews

Hyaluronidase anytime

Hyaluronidase can be used immediately. It does not need time to settle etc. Just be sure you are seeing someone experienced in fillers as it is equally important to know how to fix a problem as it is to know how to avoid it in the first place. By the way, you will see results within hours and the product will be gone within 24-48 hours. Another reason to choose hyaluronic acids as your fillers of choice.

Shawn Allen, MD
Boulder Dermatologist
5.0 out of 5 stars 1 review

Tear troughs are tricky

Tear troughs are tricky to inject.  In my opinion there are many who perform this procedure that inject far too much filler leaving a visible mass that looks like a jelly bean under the eye.  The only way to fix the problem is to dissolve the filler using hyaluronidase.  It works like a charm but you may get some swelling and redness after the hyaluronidase is injected. 

Patricia Farris, MD
Metairie Dermatologic Surgeon

How soon to use Hyaluronidase?

Hyaluronidase can be used immediately after the injection of any hyaluronic acid filler.  There is no need to wait for reversal of the initial injection procedure. The number of injections will vary depending on the amount of Hyaluronidase used for each injection site.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.3 out of 5 stars 6 reviews

You can use hyaluronidase immediately

You dont have to wait at all to inject hyaluronidase for Restylane removal. You could have it done immediately, if you really wanted to. It usually takes many less injections of hyaluronidase than you had of Restylane, but it depends on the injector's technique.

Jonathan Hoenig, MD
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 40 reviews

Hyaluronidase Instructions

Hyaluronidase injections work within a couple of days.  Depending on the site, however, I may wait a week or two before reinjecting.  Some swelling may occur with injections and I like that to settle down before re-evaluation.  It's not necessarily the hyaluronidase but chasing the misplaced filler that can cause the edma.  Good luck, Dr. Vargas

Hannah Vargas, MD
Kansas City Facial Plastic Surgeon
4.7 out of 5 stars 45 reviews

Hyaluronidase to dissolve filler

You can have hyaluronidase injected whenever you want following filler injection - it dissolves the filler immediately.  It typically is not the same number of injections as when the filler is done. You may have swelling and bruising afterwards.

Keshini Parbhu, MD
Orlando Oculoplastic Surgeon
3.9 out of 5 stars 10 reviews

Hyaluronidase to reverse Restylane

Thank you for your question. Sorry to hear that you're experience with injectables has not been ideal. I would recommend that you visit an experienced injector who is a plastic surgeon or dermatologist who has worked with Hyaluronidase in their practice. I have used Hyaluronidase in this region even years after an injection that has lingered around with some success. 

Young R. Cho, MD, PhD
Houston Plastic Surgeon
4.8 out of 5 stars 37 reviews

When to consider hyaluronidase to reverse / dissolve Restylane

Hyaluronidase can be injected in appropriate dose and volume to completely reverse Restylane once you have decided that the Restylane is either a mistake as you do not like the appearance or it has been introduced with poor technique and looks very odd. Hyaluronidase can be used as early as one day post but most oculoplastic surgeons will not reverse it until the patient has had time for any swelling associated with the Restylane injection to have settled, and to reflect on whether they really do like it after all. 

Since hyaluronidase is used under medical prescription and only off license with full agreement of the patient and physician that this is the best treatment option, it is best to leave it at least 10 days before rushing to reverse it. One month is sufficient time to make the decision.

Hyaluronidase itself is not risk free as it can cause temporary discomfort of injection, redness, swelling, and very rarely allergy. 

Anyone considering hyaluronidase, for instance in the tear troughs and cheeks,  should have a consultation assessment with the oculoplastic surgeon to discuss their Restylane concerns, and together they can decide if it is the best treatment. 

As to the number of injections, it depends because Restylane is often given by cannula so by one injection. Hyaluronidase can involve tow or three small injections.

From Miss Jane Olver, Consultant Oculoplastic Surgeon, Clinica London, UK

Jane Olver, MBBS, FRCS
London Oculoplastic Surgeon
4.3 out of 5 stars 6 reviews

Reversing Restylane, Jeuvederm, Voluma, Bolera and other HA fillers with Hyaluronidase

One month after injections of HA is a safe time to use hyaluronidase if you wish to removed the results. You do not have to inject the same number of syringes.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 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.