Can hyaluronidase injections to dissolve filler under the eye cause permanent tissue atrophy?

Filler complications are common and can cause emotional distress and in some cases, physical deformity. Swelling, lumpiness, and uneven facial volume are just a few of the complications associated with hyaluronic acid fillers.

Our office is a global center of excellence for the management of facial complications. Once we receive a consultation for filler complications, it is imperative that an examination is performed with a detailed history to determine the type of facial filler and the severity of swelling and nodule formation.

Hyaluronidase can work on facial fillers that are primarily comprised of hyaluronic acid. In some cases, we see patients who believe that they have had HA fillers; but may have had some other category of injections such as silicone or Artefill Artecoll.

Management of HA fillers is complex; may require multiple sessions; and depending on the severity and volume of filler; may not be possible given facial biometrics or filler-specifics.

We are often asked if hyaluronidase can affect normal tissue; and this is a question that may not have a simple answer. Hyaluronidase can affect hyaluronic acid, which is contained in your tissue. The degree of effect depends; lending us to perform conservative reversals.  

In a small subset of patients, surgery is required to remove fillers.

Best,

Dr. Karamanoukian

Realself100 Surgeon