Will Hyaluronidase Correct an Uneven Lip Augmentation Result?

The use of hyaluronidase for dissolving excess hyaluronic fillers (such as Restylane or Juvederm) is a not uncommon. Other approaches to improve excess filler or lumpiness includes insertion of a hypodermic needle to extract (aspriate) the product.

• Before a physician uses either of these approaches it is essential to evaluate the lump to make sure that it is specifically excess product and not a granuloma or other type of mass that may potentiall occur after filler injections.

• Before you visit another physician, obtain your past injection records and insist that this include product brand names and the lot numbers from any product injected into you to verify the legitimacy and origin of any injectable. (It is an essential and appropriate practice that the lot number or a sticker bearing the lot number of any dermal filler be recorded in your patient record at the time of injection). The brand and lot number will also be valuable in researching whether there have been adverse events associated with the particular product lot that you received.

Unfortunately, hyaluronidase will fix your problem but you will have to start from scratch. By its nature, hyaluronidase will dissolve into the surrounding tissues and dissolve any hyaluronic acid in its path.

Hyaluronidase injections are a valuable option when hyaluronic acid fillers need to be dissolved.  You are correct in being concerned with whether or not the hyaluronidase can "spot treat" just the one area that appears over-filled.  There is no way to tightly control where the enzyme will work and no way to contain the effects.  However, we have found that using very small amounts of hyaluronidase, combined with patience, makes this a good treatment option for many without reversing the total effects of the original treatment.

Hyaluronidase works like a charm to reverse HA fillers.  It usually does its work in 24 hours.  By its nature, hyaluronidase infiltrates and spreads from the injection site.  I would expect all the filler in the area to be reversed.  I think you will have to start over unless you are willing to just wait it out.  

The ability to reverse the filler is one of the many advantages of HA fillers.  Even the most experienced and careful injector can get a result that the patient just does not like.  Hyaluronidase to the rescue!

I do all my HA injections myself and also require my patients to stick with one injector (hopefully me).  It's very difficult to treat patients who have more than one provider injecting them.  Sometimes I have someone come in who was treated at a medispa and got a "great deal" on filler or Botox and had a poor outcome and I don't know what or exactly where or how much was injected.  Patients should find someone who does a good job and stick with them and ignore those "one time specials".

Dermal fillers are an excellent option for lip augmentation. However, it is possible to develop an uneven result after an injection. Your best bet is to work with a board-certified plastic surgeon was a great deal of experience working with lip tissue and dermal fillers. They will be able to assess you and let you know if you would best be served by the addition of more filler into other areas to balance your result or a portion of the dermal filler may be drained, or if an injection of a small amount of hyaluronidase will correct this. Hyaluronidase is a powerful enzyme that can help break down a hyaluronic acid-based filler.