Do the natural collagen and fats under the eyes re-generate after being dissolved with hyaluronidase? (photo)

I had lumps under my eyes from Restylane injected in 2010. I'd left it alone to dissolve over time. In Jan 2013, I visit a plastic surgeon who said my eyes look terrible (they weren't that bad) and he can fix this with hyaluronidase. He injected A LOT my eyes now have wide horrible indentations underneath. Its not filler but either too much natural collagen dissolved or fat herniation and my skin is loose. I had Perlane injected 1wk ago to hide dents but they still look terrible and lumpy.

Doctor Answers 2

Hyaluronidase does not dissolve collagen or fat.

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Hyaluronidase is an enzyme that breaks down hyaluronic acid, including the type used for fillers.
I have not had a problem with too much removal. There is not usually that much natural hyaluronic acid present in the skin except when you have had fillers.
It is more likely that you just unmasked the natural irregularity that led to your seeking a filler in the first place. Injecting more filler had put you back to square one. The eyelid skin is very thin and any arregularity is very visible. You need to inject very small amounts of filler very carefully and uniformly to get a good result.
It seems that sometimes the filler in this area lasts a very long time.

Cleveland Plastic Surgeon
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Collagen loss after hyaluronidase

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Hyaluronidase needs to be injected very sparingly. The issue is that a lot of times the person trying to correct the initial injection isn't the person who performed it, so, we have to surmise the amount used and injected in each location. Thus, it's always best to be conservative. I will always prefer to have a patient return a time or two rather than overinject the hyaluronidase. The issue is that when overinjection occurs, yes, natural collagen can be lost. Hyaluronidase destroys hyaluronic acid, so if it's put into a location where there is synthetic HA (like Restylane or Juvederm or Perlane) it will dissolve that. If it's put into a place where there's no synthetic hyaluronic acid, then yes, it can dissolve some of your own. Collagen reformation takes a long time, so yes, it can resolve, but it will take a good deal of time.

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