Can Injection of Hyaluronidase Help to Resolve 2 Months Old Hematoma After Lower Lid Blepharoplasty?

Hyaluronidase affects connective tissue but has no effect on blood clots or hematomas, nor bruising. It is not used for that purpose.

      Although the enzyme hyaluronidase has specificity for the HA fillers, it has less specific actions on ground substance and tissue in general.  The danger of injecting this to gain a nonspecific action is that it can have a detrimental effect as well if injected in a high enough dose.  Kenneth Hughes, MD Los Angeles, CA

Hyaluronidase does very effectively break down HA filler.  That is fact.  It was like having an eraser for this product and it is extremely useful in perfecting treatments.  Bruises are made of a number of components and are not affected by the hyaluronidase enzyme.  

I've never used hyaluronidase to treat a hematoma of any age. I'm not saying it doesn't work, just haven't heard of it used that way.

Hyaluronidase will melt Juvederm but has no effect on a hematoma.  If you have a hematoma or a residual bruise after in injection or surgery you may want to try either Arnica or alternating warm and cool compresses.  

Nothing proven on this one, and the actual bruising is caused by the iron or hemosiderin in the blood causing the bruise. The hyaluronidase will dissolve the filler, but its use for a hematoma is new to us.

 This is typically used to dissolve HA fillers.  Two months after a lower eyelid hematoma, scar tissue is most likely what you see and feel.  Hyaluronidase will have no effect on the scar tissue but dilute kenalog injections might be considered.