Conflicting info on hyaluronidase? Why are doctors not aware that high doses can cause side effects?

A published journal article states that "higher doses [of hy'dase] can lead to damage of native extracellular matrix glycosaminoclycans, leaving a gaunt appearance with poor skin texture (Figure 4). Patients are increasingly presenting with hyaluronidase-related damage, which is often untreatable. Hyaluronidase therapy to the periocular area can have devastating results..." Why don't doctors know about this problem and why don't they believe patients who are suffering these side effects?