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

Question

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?

Hannah Vargas, MD · Answer

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

Young R. Cho, MD, PhD · Answer

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.

Larry S. Nichter, MD, MS, FACS · Answer

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.

Harold J. Kaplan, MD · Answer

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.

Michael A. Persky, MD · Answer

Hi nz in DC,
Oops, sounds like a little too much filler under your eyes.  It is safe to use Hyaluronidase to dissolve the excess Restylane at this time.  In fact, it can be used any time, but we usually wait a few days until the injection area has stabilized.  Good luck and be well.
Dr. P

Keshini Parbhu, MD · Answer

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.

Jane Olver, MBBS, FRCS · Answer

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

Renita (Lourdhurajan) Rajan, MD, DNB · Answer

One month is a good enough interval to know whether you want to keep the filler or get rid of it. It is okay to go ahead with hyaluronidase any time now.

	Actually, one can use hyaluronidase any time after filler injection to dissolve it - but atleast 2 weeks interval after the procedure should be a good time to make a judgment about the outcome and its desirability!

Susan Van Dyke, MD · Answer

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.

Patricia Farris, MD · Answer

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.

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