Correction of filler injections

Posted:10:16 a.m. Friday, Aug. 22, 2014

By Anita Mandal, M.D.

Question: My surgeon injected hyaluronic acid filler for my under-eye hollows to improve the eyelid bags. I’m not sure if I had Restylane™ or Juvederm™ but I’m overfilled. I’ve heard of a product that dissolves fillers, but can’t I just wait until it goes away on its own?

Answer: Hyaluronidase (HA’ase) is what your referring to and it speeds up the breakdown of hyaluronic acid (HA) in our body. It is commercially available as Vitrase™ or Hyelenex™ and is an accepted off-label to inject into tissues to dissolve certain fillers consisting of hyaluronic acid.
HA’ase won’t necessarily dissolve filler that is not an HA filler. Also, a monophasic filler like Restylane responds to HA’ase better than Juvederm which is biphasic.
The lower eyelid/upper cheeks are common areas of accidental overfilling. Good results are highly technique-sensitive and depends on injector skill. Additionally, swelling tends to pool in this area and any filler, especially if injected improperly, may not go away on its own in the expected time frame.
Additionally, fibrosis or scar tissue can form around fillers over time, further preventing filler resorption within the normal time frame. The lower eyelid area tends to retain HA fillers longer than other facial areas. For these reasons, early intervention with HA’ase to dissolve filler may be beneficial.
Proper injection the first time around by a Facial Plastic Surgeon who is skilled injector and knowledged on facial volumization and anatomy as well as can reduce complications that would require additional treatment.

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