Hyaluronidase before or after Fotona laser treatment?

Question

Hello, I would like to get my nasolabial filler dissolved and wanted to know weather I should do it before or after the Fotona 4D treatment? Can it ruin the fotona outcome if done after? I know that there’s new collagen buildup afterwards. Thanks a lot!

Raffy Karamanoukian, MD, FACS · Answer

Filler migration, swelling, and granulomas can cause significant discomfort and cosmetic ramifications. Our office specializes in the use of enzymes and filler reversal techniques without hyaluronidase to help improve the results of botched cosmetic fillers, whether caused by Juvederm, Restylane, or foreign fillers. Our plastic surgery institute provides expertise in filler removal. We begin by examining the facial fillers and assessing the likelihood of fluctuance or liquid volumization. If appropriate, we use Hylenex, or other filler reversal agents to reduce swelling and filler migration. Hylenex can be targeted into the areas of concern using multiple layered injection techniques. If the filler does not completely resolve, then additional concentrations may be employed. The technique has the potential to reduce the filler and may slightly impact normal hyaluronic acid. Treatments are repeated and results can improve immediately and with time.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

John Quinn, MBChB · Answer

Helllo!
I love combining facial volume restoration and energy based devices.
You have not said why you would like your nasolabial filler dissolved but I am presuming that the area has been over filled? This leads to a blunting of the nasolabial angle and a simian appearance. If this is the case, then I would suggest dissolving the filler first. 
Lasers and energy based devices are excellent at improving skin quality and can tighten around the existing facial structure. They do not, however, add volume. I would worry that if you have the laser treatment first, that you may be disappointed if you then have the filler dissolved.
Best of luck with whatever you decide to do!

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