Collagen and elastin loss after hyaluronic acid dissolved, what can I do?

Question

After receiving a hyaluronidase (undiluted hylenex) injection at my eyelid cheek junction for a lump of tear trough filler (which obviously also dissolved my native hyaluronic acid), would it be correct to assume that collagen and elastin were also lost since HA enhances the body’s ability to produce and synthesize collagen? My entire cheek fell flat from top to bottom after the injection, which was 6 months ago, and I had never had cheek fillers. What can I do?

Philip S. Schoenfeld, MD, FACS · Answer

I am asked to see a number of patients who have been injectected elsewhere who present with Small nodules or lumps following injections of hyaluronic acid especially in the area around the eyes.  The incidence of this occurring  is increased in patients who have seen practitioners with decrease experience.  I generally use a diluted hyaluronidase to address these issues and have not seen any native tissue dissolved along with the filler.  There have also been studies performed to address this very question and no damage to native tissue has been demonstrated.

Jason Emer, MD · Answer

hyaluonidase DOESNT damage your native hyaluronic acid. I was apart of major clinical trials where we injected our arms with various dosing of hyaluronidase and looked at the skin and NO DAMAGE WAS DOCUMENTED in 1000x concentrations.  that said, any changes you have are not related to the injection and likely related to aging, sundamage, and not having good lasers or skin care or at home rolling.  See an expert. Best, Dr. Emer.

Robert M. Tornambe, MD · Answer

BeccaI am sorry you are having these issues after hyaluronic acid treatment and subsequent removal with hyaluronidase. I believe there is some confusion with regard to hyaluronic acid filler. While HA is an excellent choice to plump up areas of the face, it does not enhance the body’s ability to produce and synthesize collagen. Once the product goes away with time, re-treatment is necessary maintain the result. Hyaluronidase treatment to correct areas like the eyelid/cheek junction must be performed conservatively with judicious amounts injected, because  over correction with depressions can occur. However these depressions can be corrected with more filler. Consult with a board-certified plastic surgeon or dermatologist in our area to explore the best options for you. Good luck.

Jacquelline Leva, DO · Answer

So if you had the hyaluronidase 6 months ago then you have to think you will continue the aging process of more atrophy loss of superficial fat pads and what not. Also think if you are losing weight as well as that can make you have more loss of volume in your cheeks. There are options. You can talk to your doctor about fat grafting, doing more fillers. Also hyaluronidase does not remove elastin...only hyaluronic acid.

Leonard Grossman, MD · Answer

There's absolutely no better way to restore the volume that you have lost  than through the use of fat grafting. When fat grafting is done by an expert plastic surgeon, the results are natural and permanent. I hope this answers your question and good luck from New York City plastic surgery

Camille Cash, MD · Answer

I'm sorry to hear of the issues you experienced from your filler treatment.  Hyaluronidase will dissolve the HA product that was injected.  It will will not affect your collagen and elastin.  I encourage you to meet with an experienced board certified plastic surgeon near you to discuss your concerns and learn about corrective options.

Collagen and elastin loss after hyaluronic acid dissolved, what can I do?

Answers (6)

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