If filler has been injected too high beyond the orbital septum, is it possible to dissolve it with hyaluronidase injections?

Question

I've had filler injected in my tear trough and I have a slight scleral show on my right eye. I wonder if the filler may have been injected too high or too deeply, beyond the orbital septum. Is it going to dissolve with natural hyaluronidase, or is it going to stay in place for years? I would like to have it dissolved because it is very uncomfortable. I can feel it almost permanently. Thank you for your answers. ( sorry for my English, it's not my native language )

Raffy Karamanoukian, MD, FACS · Answer

Hylauronidase has many advantages and should be considered in patients who are unhappy with their results or in acute cases of overfilling or occlusion. Its often better to reverse filler and restart then to deal with long term edema. Filler migration and permanence is a very common problem because there are many different types of HA fillers on the market and each is specified for a specific part of the face. Use of highly cohesive fillers on thin skin may cause swelling and nodularity. If patients have filler migration or nodules, we recommend a combination approach of filler reversal with enzymes Hylenex and Hyaluronidase in different strengths to dissolve the filler. We may also need to add Kenalog to the mix in order to reduce fibrous tissue. If the filler does not dissolve, it either means the filler is not HA material or we need more enzyme. The HA reversal can be combined with other lasers and skin treatments at the same time, and it usually (usually) does not affect adjacent tissue.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jonathan Kulbersh, MD · Answer

I would schedule an in-person assessment with your injector or another board-certified plastic surgeon. If the filler you received was a hyaluronic acid product, hyaluronidase can dissolve the filler. Common hyaluronic acid fillers include the Juvederm and Restylane lines.

Paul E. Goco, MD · Answer

Thanks for your question. Yes the hyaluronidase will dissolve the filler if it was a hyaluronic acid type of filler. It will correct your problem IF it is due to the filler. Please go to your injector and see if they think it is causing a  problem.  Please see a qualified experienced injector as the eye area is very sensitive to any procedure.  Best!

Jean M. Casello, MD · Answer

You should be re-evaluated by your injector or an experienced provider.  If it is due to the filler  and the product  is a hyaluronic based filler than it is possible to have it dissolved.

Shaun Patel, MD · Answer

Hyaluronidase will dissolve hylauronic acid based fillers, example of which are Restylane, Juvederm or Belotero.

If filler has been injected too high beyond the orbital septum, is it possible to dissolve it with hyaluronidase injections?

Answers (5)