Should I have hyaluronidase to dissolve excess filler or wait it out? (Photos)

Question

About a month ago I had Restylane placed in my tear troughs to treat eyebags. Since then I've noticed that I seem to have slight bumps of excess filler towards the inside corners of each of my eyes. I don't like how this looks, but I don't want to make a small problem worse by injecting Hyaluronidase and risking damage to my skin. If you were the doctor treating me what you would recommend: Wait for my body to dissolve the filler on its own or inject hyaluronidase to smooth these bumps out?

Jonathan Kulbersh, MD · Answer

Yes, you can have the filler dissolved with hyaluronidase. It won't negatively impact your natural tissue. It may take a series of treatments. Hope this helps.

Raffy Karamanoukian, MD, FACS · Answer

Longterm filler problems include migration, edema, and nodularity. 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

Harold J. Kaplan, MD · Answer

Hi Bree.  We would not recommend dissolving the bumps, unless you want to remove all of the filler.  The difficulty with using Hyaluronidase to dissolve only a portion of the Restylane is that it may remove too little, too much or create asymmetry from side to side.  For this reason, we would recommend leaving it unless you were ok with everything being removed.

Jason Emer, MD · Answer

Yes, if you're unhappy with your final results, you can have it reversed with hyaluronidase and try a different technique next time. See an expert. Best, Dr. Emer

Carmen A. Traywick, MD, FAAD · Answer

At our Med Spa we would want to see you in person for a follow up.  It is important to compare before and after photos to help determine exactly what is going on here.  The hyaluronidase can work well to dissolve, but too much could take all of the restylane out.  So, it really depends on the outcome that you are looking for.  I would certainly schedule a followup with your injector so that they can watch your progress and help you make the right decision.

Should I have hyaluronidase to dissolve excess filler or wait it out? (Photos)

Answers (5)

Answer: Unhappy with Tear Trough Injections (Volbella, Restylane, Belotero)--reverse with hyaluronidase

Answer: Unhappy with Tear Trough Injections (Volbella, Restylane, Belotero)--reverse with hyaluronidase

Answer: Come in for follow up

Answer: Come in for follow up

Recommended reading

Everything you need to know about Hyaluronidase

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

Should I have hyaluronidase to dissolve excess filler or wait it out? (Photos)

Answers (5)

Answer: Unhappy with Tear Trough Injections (Volbella, Restylane, Belotero)--reverse with hyaluronidase

Answer: Unhappy with Tear Trough Injections (Volbella, Restylane, Belotero)--reverse with hyaluronidase

Answer: Come in for follow up

Answer: Come in for follow up

Browse related questions

Recommended reading

Everything you need to know about Hyaluronidase

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