With the increasing use of hyaluronic acid (HA) dermal fillers in the non-surgical aesthetic industry,1 we inevitably will come across more and more patients that require filler removal.
This is either due to incorrect placement, poor results, lumps and bumps or simply through changes in aesthetic trends. Removal due to trends and more complications in general are certainly what I am seeing in my practice.
In this article, I will discuss the use of hyaluronidase, what happens physically and anatomically when HA is dissolved, considerations around when to re-treat and best practice guidance. It’s important to note that emergency reversal is not covered and is outside the scope of this article.
Hyaluronidases are a family of enzymes widely used as off-label drugs by aesthetic practitioners to prevent complications such as necrosis, treat nodules and remove unwanted or overcorrected HA. They are also naturally occurring enzymes found in the human body. 2
Hyaluronidases have been used widely in medicine for a number of years as a diffusing agent.2 Some examples of its use have been in treatment of vitreous haemorrhage, prevention of tissue damage in…
