How Soon After Restylane Removal Can I Have a Punch Incision?

I had restylane injected and the skin from an injury to my nose is still indented and noticeable especially in shaded lights. I have a MEDPOR strut in my nose which has been fine for over 6 years. I want to remove the restylane now that I had injected 2 weeks ago as it hasn't helped the rolling type of cut to my nose. It did improve the appearance but I want to have the same texture across the tip of my nose. Can I have the restylane removed and how soon can I have a punch incision done? 2-3mm

Doctor Answers 6

Restylane and Jeuvederm removal

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Hyaluronidase is an enzyme that breaksdown Restylane and Jeuvederm (hayaluronic acid is the main ingredient). Go to an experienced Plastic Surgeon or Dermatologist for a consultation. A punch biopsy could probably be done at any time.

Hyaluronidase and restylane

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Hyaluronidase is the only product that I knwo of that can actually dissolve the restylane. It is a very simple procedure just like the injection process of restylane.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Restylane easily dissolved with hyaluronidase

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Any hyaluronic acid (such as Restylane) can be dissolved by an injection of hyaluronidase. This usually removes the material within 24 hours, returning to the look and contour that was present before injection.

Punch incisions may be done at anytime during or after restylane, but I'm unclear as to what you are seeking this for. Is it for correction of scarring? Nasal contour? Depending on the reason, you may be better off with subcision rather than punch incision.

Chad L. Prather, MD
Baton Rouge Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

Punch excision after restylane removal

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Restylane can be dissolved away within 48 hours using a product called hyaluronidase. Doing a punch excision after restylane removal should be safe once all of the restylane is gone perhaps a week or two later if this is truly what you desire. I hope this information helps.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

I would question the removal of the filler after only 2 weeks

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I am seriously questioning your judgement. The filler can be removed.  However, should it be removed?  I would recommend less haste in removing this material.  What is the rush? You undoubtedly spent good money having this material placed.  It takes time for these treatments to settle. I would recommend giving this treatment more time.  And yes, you should be able to have a punch biopsy 2-3 weeks after a treatment.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Punch incision after restylane

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If you are referring to a punch graft, which is a removal of a small circular scar, replaced with a circular punch graft, usually taken from behind the ear or in front of the ear, you would wait at least several weeks after hyaluronidase would be injected to dissolve the Restylane. This allows you to be sure that enough Restylane is dissolved, should you wish it to be treated again with more hyaluronidase. Furthermore, wait at least a month, if not more, after hyaluronidase before the punch graft so that there is new blood flow to the area that had been injected. Punch grafts are not guaranteed to live the shock of transplantation and the trauma from the injection might upset the oxygenation of the area for a little while (although this never has been proven). Some doctors do punch excisions, not incisions, and cut out the scar and sew the edges together, but at times the skin spreads wide and the scar becomes depressed again. Punch grafts may look good, but many of them get slightly raised and may develop a circular crease/scar around the graft. Resurfacing the graft may provide benefit but this is not done for some time after the procedure.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.