Should I get Hyaluronidase or wait for filler to dissolve?

Question

I got 1ml of Juvederm volift injected into each cheek initially and thought it showed some improvement however I then went back in for another .5ml in each cheek but really don’t like the result as it makes my face look fat and seems to push on my eyes making them appear smaller. I’m not sure whether it is best to wait for the filler to dissolve or get Hyaluronidase, is there any potential problems that come with dissolving the filler?

Michael I. Echavez, MD · Answer

You did not mention how long ago you had your last injection.  I would wait at least 2 weeks after the last injection before judging the appearance of your face, as it does take a bit for things to settle down. If you are still unhappy with your result after this time, hyaluronidase could be used or you could just wait for the filler to dissolve naturally.  Whether to use hyaluronidase or not is really a decision up to you.  If your appearance really bothers you, then it would make sense to use the hyaluronidase.  If you don't mind just waiting for things to naturally go away, then that is the simpler solution.

Raffy Karamanoukian, MD, FACS · Answer

Filler complications are common and can cause emotional distress and in some cases, physical deformity. Swelling, lumpiness, and uneven facial volume are just a few of the complications associated with hyaluronic acid fillers. 
  
Our office is a global center of excellence for the management of facial complications. Once we receive a consultation for filler complications, it is imperative that an examination is performed with a detailed history to determine the type of facial filler and the severity of swelling and nodule formation. 
  
Hyaluronidase can work on facial fillers that are primarily comprised of hyaluronic acid. In some cases, we see patients who believe that they have had HA fillers; but may have had some other category of injections such as silicone or Artefill Artecoll. 
  
Management of HA fillers is complex; may require multiple sessions; and depending on the severity and volume of filler; may not be possible given facial biometrics or filler-specifics. 
  
We are often asked if hyaluronidase can affect normal tissue; and this is a question that may not have a simple answer. Hyaluronidase can affect hyaluronic acid, which is contained in your tissue. The degree of effect depends; lending us to perform conservative reversals.  
  
In a small subset of patients, surgery is required to remove fillers. 
  
Best, 
  
Dr. Karamanoukian
  
Realself100 Surgeon

Pradeep Mettu, MD · Answer

Hi there. I'm not sure what the time frame is but it looks like you still have swelling after the 0.5 mL was added and it looks like it was a fairly recent placement. Should that be the case, it might be best to let the swelling go down before deciding to dissolve the filler. Once the swelling goes down, you may be happy with the result. Should you decide to dissolve the filler, there are no serious side effects or complications from hyaluronidase. Hope that helps.

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