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Tear trough edema still there after Hyaluronidase. What should I do now? (Photo)

Savoir40Feb 19, 2024
I received a shot of 12 U of Hyaluronidase to treat a 2 years old tear trough edema caused by a highly cross linked hyaluronic filler injected by mistake inside orbicularis and lip elevator muscles (ultrasound revealed that it was fragmented in tiny particles infiltrating muscular fibers). Even after 12 U of Hyaluronidase the permanent edema reduced very little, but the “lump” is still there. What could be done now?

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Dr. Anil R. Shah, MD
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Dr. Anil R. Shah, MD
Board Certified Facial Plastic Surgeon
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Answered on Feb 20, 2024
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Dr. Nelson Lee Novick, MD
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Dr. Nelson Lee Novick, MD
Dermatologic Surgeon, Board Certified in Dermatology
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Answered on Feb 20, 2024
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Raffy Karamanoukian, MD, FACS

I perform this technique a lot in my Kare clinic in Los Angeles. Highly crosslinked HA may require more than one session in the tear troughs. Best, Dr. Karamanoukian Realself100 Surgeon

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Nelson Lee Novick, MD

I am sorry that you are having this issue. There is a possibility that this problem is one of filler-related lymphatic obstruction (lymphedema). If so, it can be a persistent and particularly difficult one to treat. HA fillers have the distinct advantage of being able to be dissolved with the...

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Randal Haworth, MD, FACS

Hyaluronidase is a common filler dissolver, but other enzymes like collagenase are also used. Discuss with your provider if an alternative enzyme may be suitable for your case. Best of luck !

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Michael A. Persky, MD

Hello Marilyn Rose, You may have eye filler dissolved anytime before or after surgery. It will allow you to recover from any bruising or swelling concurrently with your surgical recovery. Once any swelling and/or bruising has resolved around your eyes, you may have filler injections. I would...

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Michael A. Persky, MD

Thank you for submitting your question! Dr. Persky gave his response in the attached video. Be well!

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Raffy Karamanoukian, MD, FACS

Your lips may be swollen after the root canal from retraction. I would suggest waiting a few days for the Hylenex treatments. Best, Dr. Karamanoukian Realself100 Surgeon

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