After several rounds of hyaluronidase: Is this volume loss or do I need to dissolve more?

Question

I get filler for irregularities (I have volume deficiency on the left side due to trauma and scar tissue). Last December I got filler but the dr put it all over the lover face ( he diluted 1.5 syringe of restylane defyne) and I had to dissolve it . I cannot get my jaw and chin countour back. It looks like my jaw looks more voluminous but others say I have volume loss. Based on before and after how would I get a similar look to before ? The pics are a year apart.

Nelson Lee Novick, MD · Answer

It is difficult to say from the photos whether the unwanted changes are the result of the filler treatment or the series of hyaluronidase injections used to undo the treatment. Diluted hyaluronic acid can function like a "skin booster" to promote dfiffuse new collagen and elastic fiber synthesis, which might be playing a role in the irregularities, and the hyaluronidase can in my experience affect not only the unwanted injected product, but surrounding normal, native hyaluronic acid, which could also be responsible for the current problem. Despite the controversy that surrounds the issue of hyaluronidase and whether it can actually effect native hylauronic acid, hyaluronidase was used medically in the past to help promote dispersion of medications through certain tissues--something it would have unlikely been used for if it didn't affect native tissues. And in the July, 2019 issue of JAMA Dermatology, one investigator used it to dissolve unwanted fibrous tissue in a patient with scleroderma affecting range of motion around her mouth having nothing whatever to do with any prior injections of hyaluronic acid--highlighting hyaluronidase's potential for affecting non-injected tissue. You would be well advised to seek consultation with a board certified aesthetic physician to assess your current problem and to formulate an appropriate treatment plan. Best of luck.

Leonard Grossman, MD · Answer

It's kind of difficult to tell exactly what's going on in your face with the set of pictures you have submitted. I would recommend an in-person consultation with a plastic surgeon to determine what exactly is going on and what it is that you would like to achieve. The reason that I am saying this is because 1.5cc's of any filler is an extremely small amount and should not change your face significantly. I hope this helps and good luck from York City

Liliana Marcu Awan, MD, FAAFP - Account Suspended · Answer

It is very difficult to know exactly what you really need. The best solution is to have the physician who injected you take another look at your face and determine what exactly you need for better results of filling the gaps and making your face /chin symmetrical From Ft Lauderdale

After several rounds of hyaluronidase: Is this volume loss or do I need to dissolve more?

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After several rounds of hyaluronidase: Is this volume loss or do I need to dissolve more?

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.