Beside Hyaluronidase , Restylane Can Removal by Surgery ?

Beside Hyaluronidase to dissolving Restylane , Restylane can removal by surgery ? i had injected Restylane 4 months ago, but now, 2 side at my cheek have blue bruise , seem it will never fade away. But i don't want use Hyaluronidase.

Doctor Answers 9

Surgery is not the Best Option for Removal of Restylane

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Surgery will leave a scar and is not the way to remove Restylane 4 months after the injection. Even hyaluronidase may or may not give you any improvement but it is worth a try because it is relatively harmless. Ultimately, time will be the solution.


South Burlington Dermatologic Surgeon
4.4 out of 5 stars 13 reviews

Blue streaks and hyaluronidase

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Hyaluronidase is a great product to help dissolve the filler material.  It really is the best way to start and certainly the simplest solution if it works.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Removal of Restylane

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The use of Hyaluronidase is by far the best option and we routinely use it on lower lid Blepharoplasty patients prior to surgery if they have had filler in that area in the past.  The persistent appearance of bruising may be due to hemocitron staining that is caught in the filler. Once again the injection is best to eliminate this issue. 

If this is completely out of the question try warm moist compresses.  The heat will speed the metabolism of the product as well as help eliminate the bruising. 

Lee Robinson, MD - RETIRED
Portland Facial Plastic Surgeon

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No this is not a place for surgery.

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Is there some reason why you don't want hyaluronidase?  I personally will not inject someone with hyaluronic acid fillers who is allergic to enzyme or won't have enzyme for some reason.  The existence of the enzyme is what makes lower eyelid and tear trough treatment with fillers possible.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Hyaluronidase is a better alternative to surgery

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Greetings Hanji~

If you have some blue discoloration in the areas the Restylane was injected this long after the procedure the Restylane may have been injected too superficially.  Hyaluronidase is a safe way to dissolve the Restylane and get you back to the way you looked prior to injection. If the product is very superficial sometimes it can just be extracted by making a small incision with the end of a needle and massaging the product out.  Surgery is really not an option for something like this.

Good luck~

Dr. Grant Stevens 

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 152 reviews

Restylane - Beside Hyaluronidase, Can Restylane Be Removed by Surgery ?

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Not really.

Hyaluronidase is the first line of treatment for excess hyaluronic acid (the primary component of Restylane/Perlane and Juvederm).  That includes both (a) complications related to its use, such as pressure phenomena and (b) issues of aesthetic concern, such as overfilling in specific areas, lumps, irregularities and contours that are not what the patient wanted.  It is by far the best thing to do.

However, it normally works best early on.  At four months, you have to reasonably assume that at least some of what you're seeing, at least from the standpoint of volume, maybe due to persistent swelling and/or scar tissue.  Even that should subside over time, but I'm not sure how susceptible it will be to hyaluronidase injections.  For many patients, 4-6 months is the approximated duration of the treatments, even under the best of circumstances.

Finally, surgery to remove the area, even if technically feasible (it's not always so easy to find the areas that have Restylane or other substances in them) risks leaving you with scars that may be more noticeable than what you have now.

My advice:  start with a series of hyaluronidase injections (you have relatively little to lose), give it at least a year from the time of treatment (to let everything settle down) and only decide at that time if you want to pursue it.

I hope that this helps, and good luck,

Dr. E

What's the best way to remove Restylane

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Surgery is not a good alternative for the removal of unwanted Restylane. Besides the possibility of scarring with surgery their is no well defined mass that can be surgically excised. Hyaluronidase is a highly safe and effective means of removing unwanted Restylane.

Ted Brezel, MD
Long Island Dermatologic Surgeon

Hyaluronidase is the best option

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Hyaluronidase is the best option, i do not think any physician would surgically remove the restylane.  If you really do not want hyaluronidase, then give it time, restylane is not perminant and should last 6-9 months.

Mitchel P. Goldman, MD
San Diego Dermatologic Surgeon
4.9 out of 5 stars 26 reviews


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It's quite unusual to have bruising four months after injection of Restylane.  This should be evaluated by a physician who has extensive experience with Restylane at the earliest opportunity.

Paul Carniol, MD
Summit Facial Plastic Surgeon
5.0 out of 5 stars 8 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.