Hyaluronidase - my Experience with Filler and Hylauronidase

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I thought I would write on here my experience with...

I thought I would write on here my experience with fillers and now hyaluronidase to try to provide some help/reassurance to people in that awful position of wanting to get rid of your filler, for whatever reason.

I know when I was researching it I just couldn't find enough information about this product when I was desperate for some reassurance that something terrible (or more terrible than the problem I was trying to fix) would not happen to my face if I decided to go ahead.

As a bit of background to my situation – Over the last 18 months I have had a rollercoaster ride with good and terrible experiences with restylane fillers. I am relatively young, only 27, and therefore early many may think to be having fillers. However, I guess I am just unlucky - I have a face which always had nasolabial lines to a degree, and when I started to lose the puppy fat of my early twenties, these lines became pronounced and made me look much older than my years.

I had my first fillers at 26 and I was thrilled with the result. It improved the problem I had and I felt that I looked great, getting back those looks in the street from men which are such a boost to one's confidence! Anyway, after 3 months the fullness started to go and I went back for a top up. I also said to my doctor that I might like to try some in my cheeks. I had a completely 'gung-ho' attitude at this stage – as my first experience had gone so well I just thought why not put a bit in my cheeks to re-fill those out a bit as well – what an error that was.

I only had one syringe put between my cheeks and a top up in my nasolabial lines and I knew it was wrong from the start - my face just looked terrible from my first glance in the mirror after the treatment had been done. You don't realise or think until you do it what a little change will make to the proportions of your face – and not for the better. From almost the first day I had awful water retention in my cheeks and along my nasolabial fold. My face just looked wrong, on bad days I looked like a hamster and my whole face shape and appearance was changed.

Unless you have had a similar experience I don't think it is easy to imagine the absolute sickening, pit of your stomach dropping feeling when you look in the mirror and see what you have done to yourself and wish you can turn back time. In fact I stopped looking in the mirror after a while because it just upset me. I remember wishing so much that I could go back to what I had before, how it wasn't bad and cursing myself for being so vain that I would have done this to my face. I was so depressed (and I am not a depressive person) – it was the first thing I thought about when I woke up in the morning and it permeated my thoughts all day. Every time I met someone or saw a friend I just thought how horrid I looked.

My confidence disappeared and I didn't want to go out at all. At the age of 26 that was a big price to pay. As I looked online I saw the option of hyaluronidase and researched for days the effects/consequences of having it dissolved. The results were just what I wanted but I couldn't bear the risk of doing more damage to my face – especially my cheeks as any damage to the tissue there would be obvious.

Eventually after 2 weeks I went back to my doctor who gave me steroids for the swelling. I have since realised that this was completely wrong. The swelling was simply as a result of the water-binding nature of the filler and steroids can do nothing to get rid of that, only time can have an effect as it dissolves.

Anyway, the doctor said to come back if I wanted the hyaluronidase after trying the steroids. By this time I was worried about the competence of the doctor and so scared about what the hyaluronidase could do to my face that I decided to just wait the dissolving out. A depressing decision but I got on with day to day life. I have to admit at this stage I thought the filler would be gone in 9 months – this is a complete myth. I put up with 18 months of intermittent swelling – always when I drank alcohol (I became almost t-total!) and also if I ate certain foods, or just sometimes for no apparent reason at all.

My confidence has been so eroded and I learned to just be terrified of what I would see in the morning in the mirror – I never knew! There were some good days but the majority were not. The filler (I have since been told this by a doctor and learned from personal experience) will still have a base layer in your skin 2 years later. This is really not made clear. SO – sorry for the long explanation above – to move on to my recent decision to have hyaluronidase… After 18 months my filler had almost gone and I was looking 'normal' again – but this of course meant that the nasolabial lines were coming back.

You may think what on earth was I doing considering fillers again, but I had had such a good experience with the filler the first time (just in my folds) that I was sure if I insisted only a tiny bit was used, it could only improve things and I could go back to how things were 18 months ago.. Wrong again!!

A week ago I went to a very highly recommended doctor in London. After explaining my terrible experience she was very sympathetic and said I should've just had the bad filler removed with hyaluronidase in the first place and not put up with a year of swelling. I said I was scared of the dissolving of your own hyaluronic acid in your skin/permanent damage and she said that is not what happens at all. Anyway this was 'by the by' at this stage because I thought that would never be needed by me again. So I had the filler put in to my folds (one syringe) and as soon as I got home I knew something wasn't right.

One side had been completely overfilled and when I smiled my face was all wonky. Also, some of the swelling was back again because the filler appeared to be slightly up in my cheek. I was literally beside myself. I couldn’t believe this had happened to me again. I felt (and have felt since) physically sick, so depressed and just could not bear to look at myself. It was almost worse this time because it opened a raw wound of the emotional rollercoaster and trauma that I had been through the previous year. And I cannot share my distress and sense of desperation and misery with anyone – not my boyfriend, my friends or my mother.

It is an awful lonely feeling of despair and misery – and completely self induced. I live with my boyfriend and he has been wondering what is wrong, why I am so distant. It is because this is all I can think about. What I have done to my face, again. Anyway, this time, I just could not bear to waste another year of my life waiting for this filler to go away. The thought of that was now worse to me than the risk of what the hyaluronidase could do to my skin.

However, I did not just take my doctor's word for it – I spent a great deal of time researching what hyaluronidase could do. I looked on these message boards and noticed the conflicting experiences. There is on one hand all the doctors saying that they perform it on hundreds of patients and have no problems, that it is an effective solution. However they all say 'they are not aware' or 'have no experience of' damage to the native tissue – not a definitive 'it does not cause damage' which is what you want to hear. On the other hand you have the experience of people who are writing and who have had it done. These are almost all bad.

Now I don't know if this is because you only go online and find these boards if you have had something go wrong and you are looking for support – this is what I was hoping – because the more I read the personal views of people of hollows in the skin, persistent swelling, changes to the skin colour and generally looking worse than before, the more awful the situation became. Because the situation facing anyone who has had fillers go wrong is this – do I put up with my face looking terrible and wait (up to 2 years) for it to dissolve naturally, or do I risk this hyaluronidase, which is not studied for the long term affects to skin, not FDA approved for filler dissolving and has not been used for much time so could result in problems to my skin in the future that people don't know about yet.

This is an awful predicament, especially because of the misery and depression that is suffered by someone who has had a disaster with fillers. You just want to get rid of them but you don't want to do more damage. Stuck between a rock and a hard place. This is not helped of course by the horror stories to be found online of what can go wrong with hyaluronidase. Anyway, I did do research and through looking at scientific studies (just on hyaluronidase in general) it seemed that the following could be concluded:

1. It DOES dissolve your natural hyaluronic acid in your skin as well as the filler

2.however, the hyaluronic acid bonds broken by the hyaluronidase are theoretically 90% recovered within 48 hours of the hyaluronidase being injected The damage to the other structures in your skin and the time it takes to fully recover I don't know. I also don't know if there is permanent damage. It seems to me that there will be some damage but that the body is very good at repairing. The body knows how much hyaluronic acid is native in your skin and will work to restore that amount. Will the skin be the same as if you had never had the filler? Probably not and certainly not immediately but over the course of months, it will hopefully recover to pretty close. So as to my experience.

THE GOOD NEWS - it has been 5 days now and touch wood it has been exactly as the doctor predicted. My outer skin has not indented, my face is not swollen. I have no strange marks. I am so thankful I can't tell you! However I don't want to jinx it at this early stage so fingers crossed that I have truly experienced all the effects by now! I had a solution of 0.2 strength injected into my overfilled areas. There was some initial swelling (I expected more but it really wasn't bad at all) and I could feel a tingling and the filler disappearing almost immediately.

THE BAD NEWS – it really does get rid of the filler. All of it. If you have, like me, had filler before, even a couple of years ago, there is some still there and that will be gone too. So you are back to what you think is 'normal' (but wasn’t really) and even more. You are therefore faced with the original problem that you went to have fillers for, whatever that may be. And you are also however-many years older so it is worse that you remember it was originally. This is what I think you have to prepare for. I look awful now. I have my nasolabial folds back in their raw natural state (which is not good!) However, to me this is better than the overfilled swollen look I had with the filler. You have to weigh this up in your head. You have to be aware that you are going to look bad – but this, if you have had a terrible filler, is better than that unnatural filler look.

MORE BAD NEWS - If I feel along my fold where the hyaluronidase was injected, there does seem to be an indent in the base layer of my skin.

This panics me and has left me with a residual worried feeling that I have done permanent damage. I just feel like something permanent in my skin has dissovled, right at the base. It is so soft there when I press down compared to the rest of my skin, like the bottom firm layer has disappeared and I can push down to the bone (this is compared to areas never touched by hylauronidase). I hope this is my perception being wrong, or maybe some of the filler is still there in the surrounding area and the difference between these and the hyaluronidase is where I can feel the 'dent'. I am not convinced and I think something has happened to my natural skin. However, it is only 5 days after the hyaluronidase so I should give it time to recover. Given the stories online here I am not hopeful it will change, but we will see. Because the outward appearance of my skin has not changed at all I can't get too upset. So, the conclusion of my story is that hyaluronidase does do what it says and CAN be Ok, but I am reserving judgment on whether it does 'dissolve' part of your native skin. It will not produce a good result simply because it is taking you right back to the state that drove you to fillers in the first place. But it will take away your filler problem. I should say 2 things that the doctor said are the biggest issue – 1. Injecting hyaluroidase around the eyes – this is apparently a much more difficult area and can cause all sorts of issues with swelling if not done properly 2. if you are someone with a 'face full' of fillers and have had them for years and use hyaluronidase you will get dents where the filler is dissolved and you will not be happy with the look of your natural skin underneath. I hope telling my tale provides some help to someone out there trying to weigh up the options. You will be surprised to hear that I will be going back for more fillers after all this.

The fact is I look terrible 'au naturel' and it is a case of trial and error. I now know where my filler should be injected to get a good result AND to insist only half a syringe. However I will be waiting a few months to give my skin time to recover.

Good luck to everyone going through these problems. It is an awful time. I just wish there was more openness and follow up with doctors and proper examination so that people can know for sure whether hyaluronidase is or is not safe.
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