Are there alternatives to hyaluronidase that can be used to remove lip filler?

Question

Got 1ml of lip filler. Dr said it's Restylame classic. I never recieved the paper that proves the authenticity of the product (I later found out that I should have?). The filler has distorted my smile so much, I cry everyday. Want to get read of it but I'm afraid of hyaluronidase. Are there any alternatives? What if for example someone is allergic to it. Can it be removed in any other way? Also so many people get such bad effects , why does the medical community do nothing?

Kenneth D. Steinsapir, MD · Answer

Hyaluronidase, the enzyme that breaks down hyaluronic acid fillers like Restylane. I am not sure I would follow the advice of a doctor whose license is on probation. It is not the case that fillers just disappear. This volume problem you have could last for years. Do not be afraid of the enzyme. There are several lay people who post scary stories about enzyme. Mostly these people have had bad filler service and then poorly under-dosed enzyme treatment. This can cause mobilization of partially broken down filler into the skin resulting is chronic swelling. This is easily resolved with a proper dose of hyalurnidase to the affected area. Regarding is the product in your lip actually filler, sometimes the only way to know for sure is to attempt to remove the service with the enzyme. What disappears was hyaluronic acid filler. What persists was something else. Stop living in fear. Get the care you need. There is no alternative to the enzyme and treatment is safe. If you need a recommendation for a surgeon in Athens, directly contact my office.

Camille Cash, MD · Answer

The most reliable way to remove HA fillers is hyaluronidase.  If you do nothing the product will gradually metabolize on its own.  You can contact your injector for more information on the product that was used.  It is important for the best results to see an experienced injector.  Be sure to ask questions and review before/after photos of her/his work.

Mats Hagstrom, MD (license on probation) · Answer

To make an accurate assessment regarding the outcome of a plastic surgery procedure we generally need to see quality before and after pictures. Without including pictures, we can’t begin to assess your outcome. It doesn’t sound like anything is wrong other than your provider didn’t have the skill or your expectations were not lined up with what that provider was capable of.
Most HA Fillers are more or less gone by six months. Half of it should be gone in three months.
Perhaps the results are not to your liking, but I see nothing inherently wrong, other than perhaps you went to a provider who isn’t so good at these treatment.
In the hands of quality providers HA based fillers can deliver safe, high quality, consistent results. It has been very rare for me to need to use hyaluronidase. I have never seen any significant reaction or side effects to the use of hyaluronidase.
I think the medical community is doing a good job trying to meet the public’s insatiable appetite for improved facial aesthetics. 
I do think the public should be aware of how much discrepancy there is in regards to skill and experience when it comes to delivering consistent quality outcomes. 
This is very much a caviar emptor market and no one has to have aesthetic filler treatments.
Best,
Mats Hagstrom, MD

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