Lip filler: does hyaluronidase also break down your natural HA in face?

Question

I've heard (watched a doctor's video who showed it using scan results) that fillers actually don't dissolve but rather migrate to rest of the face, which is why after repeated filler injections your face looks very very weird. In this case can you not just get HA dissolving injections to your face before getting new fillers? Or would hyaluronase given it's an enzyme also break down your natural HA in face? Unless filler HA somehow structurally different from natural HA molecules? Thanks

Andrea Marando, MD · Answer

Thank you for your question. Yes, the hyaluronidase is very effective in dissolving hyaluronic acid, however, it is unable to distinguish between the filler and your own, and therefore in my professional opinion it has to be used very selectively and only one strictly necessary.

All the best

Andrea Marando
Plastic and Cosmetic Surgeon
Manchester and London, UK

All the best

Andrea Marando
Plastic and Cosmetic Surgeon
Manchester and London, UK

Raffy Karamanoukian, MD, FACS · Answer

Hyaluronidase enzyme continues to be an excellent option for patients with fillers that need to be dissolved. Fillers can swell and migrate unpredictably, especially when a filler with a high-edema quotient is used in thin areas. Our office uses disciplined approaches to help patients with acute or chronic issues related to hyaluronic acid fillers. We begin by assessing for any tissue compromise and advocate early treatment to avoid complications with vascular occlusion. In chronic issues, it is important to gradually break up and dissolve filler so there is no further migration of loose filler substrate. Conservative staged dilution may also help avoid volume loss. If the filler is not dissolving, we may consider stronger concentrations or surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Lip filler: does hyaluronidase also break down your natural HA in face?

Answers (2)