How many doses of hyaluronidase to dissolve this volume? (photo)

Longterm filler problems include migration, edema, and nodularity. 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

Hello there,I'm sorry to hear about your concerns.  Unfortunately, there it takes several rounds of treatments with hyaluronidase several days apart in order to complete.  The doctor should be using the same length of needle in order to inject in the same areas.  A good rule of thumb is approximately the same amount of hyaluronidase should be used as the amount of HA filler injected.  Hope this helps.All the best,Carlos Mata, MD, MBA, FACSBoard-Certified Plastic Surgeon

It's difficult to give you an estimate, but it will take a series to dissolve. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer