Teosyal and Juvederm - Why won't the enzyme dissolve my filler?

Question

i've been getting lip filler for about 16 years now. I recently decided I wanted to dissolve to start from scratch as the techniques have come so far since then. I went in for my first round of dissolving & it didn't really touch the filler. I've only ever had Teyosal and Juvederm so very standard HA fillers. Filler does tend to last much longer on me than the average person. My Dr. seems perplexed as to why it didn't work at all. Any ideas?

Raffy Karamanoukian, MD, FACS · Answer

Fillers can swell and migrate unpredictably, especially when a filler with a high-edema quotient is used in thin areas. Our office uses disciplined approaches to help patients with acute or chronic issues related to hyaluronic acid fillers. We begin by assessing for any tissue compromise and advocate early treatment to avoid complications with vascular occlusion. In chronic issues, it is important to gradually break up and dissolve filler so there is no further migration of loose filler substrate. Conservative staged dilution may also help avoid volume loss.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

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