Is the forehead safe for hyaluronidase injections?

Question

Wanting to remove filler(restylane) that i had put in forehead for an indent about 1 year ago. I was trying to wait it out but I don't even see a slight reduction in the fullness and its been just about 1 year. Is this safe? What are the side effects as in should I be expecting tons of swelling? Will I need to take off work the next day? Do you think it will dent my skin worse than it was before?

Nelson Lee Novick, MD · Answer

In the U.S. there are currently only two hyaluronidase products available, Hylenex and Vitrase. Vitrase of ovine origin should not be used in persons with egg allergies. Hylenex does not have this restriction. I have been using hyaluronidase for many years in varying concentrations, amounts, and areas of the skin for various purposes, including on the forehead. In fact, just the night before last I treated a patient for excessive tissue swelling (looked like a bump) who had received a hyaluronic acid filler elsewhere a number of months earlier in the center of the side of his forehead. Shrinkage following appropriate hyaluronidase injection occurs typically with 1-20 minutes and up to 24 hours following treatment. Make sure that you consult with a board certified aesthetic physician with experience in the use of hyaluronidase. Good luck.

Faiyaaz Kalimullah, MD, FAAD · Answer

Thank you for your question.  I'm sorry to hear that you aren't happy with your prior experience with Restylane injections to your forehead.  Hyaluronidase is generally safe to use to breakdown unwanted fillers, and should be safe to use on your forehead.  I have treated patients with ridges of filler in the glabella (the area between the brows) safely with hyaluronidase with excellent results.  Results are almost instantly visible in some cases, and continue to improve for about 24 hours after treatment.  Side effects can include swelling and bruising, but these are usually very mild and should not impact your ability to attend work the next day.
I would recommend that you consult with a cosmetic dermatologist or plastic surgeon to discuss the best treatment options for you.  Best of luck!

Samuel Baharestani, MD, FACS · Answer

It should be safe to use hyaluronidase in the forehead.  As you may know, restylane injections in the forehead is an off-label use of the product.  Try to stick with board-certified injectors who have extensive experience with the area they are treating.  Good luck!

Is the forehead safe for hyaluronidase injections?

Answers (3)

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