Does Hyaluronidase also dissolve some of your facial fat along with the filler?

Question

I am contemplating a facelift. I already have filler in my cheeks, along jawline and chin. The surgeon talked of fat grafting. I asked if we would need to dissolve my filler so he can see what he's working with. He said yes, if I don't mind doing that. I later read Hyaluronidase can also dissolve some fat. Since I know grafting doesn't last forever I am concerned about even losing more fat in my face. I lost some with Ultherapy.

Jason Emer, MD · Answer

hyaluronidase doesn't affect your normal fat or skin. I suggest you see an expert and consider sculptra long term if you are unhappy with fillers. Best, Dr. Emer.

Raffy Karamanoukian, MD, FACS · Answer

Filler migration and permanence is a very common problem because there are many different types of HA fillers on the market and each is specified for a specific part of the face. Use of highly cohesive fillers on thin skin may cause swelling and nodularity. If patients have filler migration or nodules, we recommend a combination approach of filler reversal with enzymes Hylenex and Hyaluronidase in different strengths to dissolve the filler. We may also need to add Kenalog to the mix in order to reduce fibrous tissue. If the filler does not dissolve, it either means the filler is not HA material or we need more enzyme. The HA reversal can be combined with other lasers and skin treatments at the same time, and it usually (usually) does not affect adjacent tissue.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Benjamin Barankin, MD, FRCPC · Answer

Hyaluronidase is used by cosmetic physicians to dissolve some or all of a hyaluronic acid based filler (eg. Juvederm, Restylane etc). It has no effect on fat whatsoever.

Aaron Stanes, MD · Answer

Hi faith2711,
Hyaluronidase is an enzyme that breaks down hyaluronic acid. It should have no effect on your natural fat tissue. It can break down your natural hyaluronic acid, however this is usually regenerated by the body over a few weeks.
As always, your treating surgeon/physician will be able to further clarify your concerns.
Best of luck.
Dr Aaron Stanes.

Leonard Grossman, MD · Answer

In my opinion fat grafting for facial rejuvenation is the simply best way of restoring youth in the face. After performing this procedure for more than 27 years I can argue that it is absolutely the best procedure. I would make sure that you go to a plastic surgeon with lots of experience in fat grafting to the face. You don't need to dissolve the hyaluronic I said fillers unless there is a lot of them in your face. Hyaluronidase does not dissolve fat, but it does dissolve hyaluronic acid fillers as well as some of your naturally occurring connective tissues. For those reason hyaluronidase has to be used with great care. I hope this answers your question and good luck from New York City plastic surgery

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