Should I have to pay for a Hyaluronidase treatment after a botched Juvederm treatment under the eyes? (Photo)

You should express your concerns directly with the treating physician. The details of your initial dialogue will dictate the response. Best, Dr. Karamanoukian Los Angeles

 Thank you for your question. I do routinely charge for Hyaluronidase treatments in my practice, unless it is for the rare patient in my own practice that is being treated. 

Thanks for writing.  It totally depends on the office policy.  In a very rare circumstance if I needed to use hyaluronidase on my own patient, I would do it without a fee.  If the patient is new to me and had the injection elsewhere, there is a fee.  Every physician and every office makes their own policies. 

In my opinion, Juvederm is not the best choice for filler in the tear trough.  It is too hydrophilic, leaving a watery appearance in a rather thin area.  Payment policies will vary with different practices, so this is an issue you will need to work out with your Doctor.

Having a patient charged for hyaluronidase is routine practice for most cosmetic surgeons, especially when the patient is coming in from elsewhere. I would address the issue with the initial injecting provider first.

I am sorry to hear that you have had a bad experience with fillers.  In my practice, if a patient has been had fillers at another office and is coming to us to have it dissolved, we do charge for hyaluronidase treatments.  In the rare case that one of my patients wishes to have their filler dissolved, I do not typically charge them.  I recommend that you return to the physician who did your treatment, express your concerns, and see what solutions they have to offer you.  Good luck. 

So many of the patients I have to inject with hyaluronidase were injected with Juvederm around the eye. I have a very nice blog about this, see the link. It's properties make it the wrong filler for this area. It is obvious that the doc isn't that "experienced" because he should know better. If it were me, I wouldn't charge for the reversal if I were the original injector, but I can't speak for him/her. If the person comes to me from elsewhere for hyaluronidase, I do charge. Restylane or Sculptra are better choices in the hands of an experienced injector. This is the most botched area in filler injections as seen by the number of questions about it on Realself.

When doing filler injections, complications can always arise and depends on many factors including the location  being filled, the type of filler used, the experience of the injector and the compliance of the patients post-op. Its hard to say what went wrong as complications can arise in even the best injectors. If you feel that you would like to dissolve it, I think you shouldn't have to pay for it. In our office, we charge slightly higher as this includes any post-care that is needed. The filler itself is non-refundable. 

Juvederm is most often a poor choice for under the eyes because it is too hydrophilic (pulls too much water there) and it looks bad when it's injected into thin skin, which most eye areas have. The problem with patients not liking fillers is that your physician paid for the product used and cannot get it out and reuse it on someone else. So most often, fillers are non-refundable. Charges for corrections will be based on each office's policies. Obviously as physicians we want our patients to be happy, so I would think that in most cases, a correction would not have a charge. But that's my opinion and not necessarily how every office will do it. "This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."