Alternatives to hyaluronidase for filler dissolving (allergic). A physician recommended RF? If so - how many sessions?

Question

Almost a year ago I had filler injected in my tear trough. It looked uneven so I went in to my Dr to check & she chose to dissolve one side. Later that evening my face started to swell but my physician said it should be fine. Kept on swelling & she kept reassuring. She prescribed high-dose antibiotics but nothing happened. When it finally settled down I realized my face was uneven. Fast fwd a year later & I now hate smiling. The more I smile the more it shows.I just want my face back.

Raffy Karamanoukian, MD, FACS · Answer

Hylauronidase has many advantages and should be considered in patients who are unhappy with their results or in acute cases of overfilling or occlusion. Its often better to reverse filler and restart then to deal with long term edema. Filler migration and permanence is a very common problem because there are many different types of HA fillers on the market and each is specified for a specific part of the face. Use of highly cohesive fillers on thin skin may cause swelling and nodularity. If patients have filler migration or nodules, we recommend a combination approach of filler reversal with enzymes Hylenex and Hyaluronidase in different strengths to dissolve the filler. We may also need to add Kenalog to the mix in order to reduce fibrous tissue. If the filler does not dissolve, it either means the filler is not HA material or we need more enzyme. The HA reversal can be combined with other lasers and skin treatments at the same time, and it usually (usually) does not affect adjacent tissue.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jason Emer, MD · Answer

Thank you for your question, Fillers like Belotero, Volbella, and Restylane Silk are good for improving under the eyes, but keep in mind that a combination approach will give the most improvement. My patients try to get non-surgical treatments to avoid surgery, so we use fillers, lasers, microneedling/PRP and stem cells. I suggest consulting with an expert to develop a treatment plan best suited for you. Best, Dr. Emer

Chris Funderburk, MD · Answer

Have you considered facial fat transfers? This would be your own tissue, thereby avoiding potential allergens.
In this process, a small amount of fat is removed from another part of the body such as abdomen or thigh, strained or purified, and injected in small aliquots similar to how fillers are injected.
It can be done with just a touch of local anesthesia. 
I strongly recommend scheduling a consultation with a Board-eligible or Board-certified plastic surgeon to develop your treatment plan.

Alternatives to hyaluronidase for filler dissolving (allergic). A physician recommended RF? If so - how many sessions?

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Alternatives to hyaluronidase for filler dissolving (allergic). A physician recommended RF? If so - how many sessions?

Answers (3)

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Everything you need to know about Hyaluronidase

Our mission is to create a world where every investment in modern beauty is Worth It.