Hyaluronidase was used to dissolve the very poorly injected dermal filler
This is a product which may be injected into the skin to dissolve h********* a*** (there are many dermal fillers made of h******** a***)
Problems after dermal filler which can be treated with Hyaluronidase / Hyalase:
Lumps/ bumps of dermal filler: Hyalase / hyaluronidase can be injected to dissolve the lump of dermal filler product
Unevenness of dermal filler: Hylase /hyaluronidase can be injected to even out and smooth the appearance of dermal filler
Infections: With an infection related to dermal filler injection, hyalase /hylauronidase should be used (if the filler was h********* a*** type) See my dermal filler infection protocol #
Blue appearance under the skin due to dermal filler (Tyndall Effect): This will resolve with treatment with hyaluronidase / hyalase
Asymmetry of dermal filler: This can be treated with hyalase / hyaluronidase being injected into the larger side to bring the size down to match the other side
Overtreatment with dermal filler: This can be treated with hyalase / hylauronidase.
Filler placed in the wrong area: This can be treated
Vascular events relating to dermal filler injection: If an artery / arteriole is blocked during a dermal filler treatment, causing blood supply to the skin to be compromised. Hyalase / hylauronidase should be injected immediately to attempt to prevent skin necrosis in the area
Procedure for injection of hyalase.
The patient will be assessed through history and examination and the treatment will be discussed. The risks side effects will be discussed.
Photos will be taken.
If it is possible to use a needle to remove dermal filler, then this option is preferable to hyalase / hyaluronidase treatment and this will be performed. Also with asymmetries, if the addition of product will give a better cosmetic result, then this will be discussed.
A test patch of an injection of hyalase / hyaluronidase into the skin of the forearm arm may be used if the practitioner is concerned about allergy.
The skin will be cleaned with chlorhexidine twice.
The first dose for treatment will be a smaller dose to avoid allergies (which are more prevalent at higher doses)
Pressure will be applied to the area after injection with a gauze.
The patient will notice a reduction of the dermal filler within 1-2 days.
The patient should be reviewed at 1-2 weeks (all swelling must have resolved from the previous hyalase injection)
Second injection of hyalase is a similar procedure except a higher dose may be used
#for dermal filler infection protocol
#for dermal filler necrosis protocol
Risks of Hyalase / Hyaluronidase
Side effects are uncommon
Allergy. Can be very severe, including risk of anaphylaxis, which is very rare. Also risk of allergy in the local area of injection including redness and swelling.
Removing too much dermal filler H********* a***: The result of the dermal filler may be completely reversed, when only a reduction in the amount of dermal filler was planned
Removing the patients own h********** a***: This is a theoretic risk, but not one that is important in practice. When natural h******** a*** is degraded it is reformed almost just as quickly. In fact, natural h************ a*** is turned over on a daily basis so your body naturally degrades its own h********* a*** and replaces it.
Infection: Always a possibility when introducing a needle into the skin
Common areas where hyaluronidase are used
The most common area for use of hyalase after dermal fillers is in the tear troughs
also the lips and cheeks and temples
Cost of Hyalase / Hylauronidase
PHOTOS OF TYPICAL PROBLEMS WITH DERMAL FILLER REQUIRING HYALASE / HYALURONIDASE
Please note the blue lump of dermal filler product under the right eye
ump of dermal filler under eye 6 weeks after injection, needs treatment with hyalase
Lump of dermal filler under eye after injection, may require treatment with hyalase
Lump of dermal filler under right eye, 2 years after treatment of tear troughs, requires removal with hyalase
Lumps and blue appearance (Tyndall effect) due to poor injection technique to under eyes. For Hyalase hyaluronidase treatment
Patient presented with large lump in lip over 12 months after treatment with dermal filler. Hyaluronidase / hyalase may be required to dissolve lump