Hyaluronidase to Dissolve a Hydrophilic Polyacrylamide Gel Filler from Under Eye Area?

I had injected what I thought was an HA filler. Turned out to be a Hydrophilic polyacrylamide gel filler. 2wks after inj, my eyes were so swollen I almost couldn't see. I've had 3 surgeries to help my body push the filler out. (Drain bands being put in and steroid injs.) Now the Ocular Plastic Surgeons are wanting to try hyaluronidase injs and more steroid injs to see if it will help. I thought hyaluronidase was contraindicated when Hydrophilic polyacrylamide gel fillers were involved?

Doctor Answers 1

Hyaluronidase is not for Polyacrylamide gel

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Sorry to hear your story, but you are experiencing one of the major problems associated with these long acting or what can potentially be, permanent fillers.

Hyaluronidase is an enzyme that  your body produces naturally to facilitate the breakdown and turnover of the Hyaluronic Acid that is naturally produced by your own tissues. The most popular Hyaluronic Acid based fillers have slight variations but all consist of  cross linked Hyaluronic Acid. The cross-linking makes your own Hyaluronidase less able to quickly break the filler down and accounts for the products lasting for several months. Eventually all of the Hyaluronic Acid filler material is broken down and dissolved.

Many consumers are enthusiastic about filler materials that promise to last longer than Hyaluronic Acid based fillers in hopes of a permanent fix, less maintenance and in many cases less long term cost. The problem is that any filler can result in an infection, lumps, asymmetries, foreign body reactions and other more serious consequences.  Using Hyaluronic Acid based fillers reduces the risk of complications overall and they have the benefit of a potential antidote known as Hyaluronidase. This enzyme can be made by most compounding pharmacies and when injected carefully will greatly accelerate the break down of this class of products. Hyaluronidase is also occasionally used to facilitate the diffusion of other injected medications such as local anesthetic. 

Hyaluronidase has a very limited shelf life so must be fresh and some patients can be allergic to it's use. It does not break down collagen, fat, calcium hydroxlapetite, acrylic or acrylamide based fillers.

Good luck,

Dr. Mosher

Vancouver Plastic Surgeon
4.5 out of 5 stars 34 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.