I had hyaluronidase injected to remove juvederm but it hasn't worked?

Hi Chad. Here are a couple possibilities.1. It wasn't Juvederm. If not Juvederm (or another HA filler) then the Hyaluronidase will not work. Was it a reputable practice and did you see the box?2. It wasn't Hyaluronidase. There would be no way for you to know and it seems unlikely but it's certainly one possible reason it may not have worked.3. Injection technique was bad and did not get the Hyaluronidase to the right location. If not injected near the site of the lumps or at the proper depth, the Juvederm may not dissolve.4. Lumps are granulomas rather than product. If this problem is a side effect associated with an immune reaction (granuloma) instead of a product lump, then Hyaluronidase will not work.

Filler migration, swelling, and granulomas can cause significant discomfort and cosmetic ramifications. Our office specializes in the use of enzymes and filler reversal techniques without hyaluronidase to help improve the results of botched cosmetic fillers, whether caused by Juvederm, Restylane, or foreign fillers. Our plastic surgery institute provides expertise in filler removal. We begin by examining the facial fillers and assessing the likelihood of fluctuance or liquid volumization. If appropriate, we use Hylenex, or other filler reversal agents to reduce swelling and filler migration. Hylenex can be targeted into the areas of concern using multiple layered injection techniques. If the filler does not completely resolve, then additional concentrations may be employed. The technique has the potential to reduce the filler and may slightly impact normal hyaluronic acid. Treatments are repeated and results can improve immediately and with time.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Sometimes it is better to underdo it and have to retreat than to overdo it and create a depression in the skin.A second treatment should be more effective.

A specific dosing is required to get rid of any HA filler. While I tend to be conservative with any hyaluronidase injection, excessive conservatism could mean not enough was injected to remove the filler. I would prefer to inject hyaluronidase more than once rather than over-inject at the beginning. Or, you simply don't have Juvederm in there and there's no way for hyaluronidase to work. Hyaluronidase begins working immediately and is done within 48 hours, so if everything isn't gone at that point, you may need another round of treatment. Or you need to determine if it really is Juvederm to begin with. "This answer has been solicited without seeing this patient and cannot
be held as true medical advice, but only opinion. Seek in-person
treatment with a trained medical professional for appropriate care."