Complications | cosmetic doctors | hyalurondase - remove fillers

Hyaluronidase is used to remove temporary fillers. It is an antidote that only works with a certain group of fillers; hyaluronic acid fillers. Examples include Juvederm and Restylane. Occasionally, it happens that too much of the hyaluronic acid filler has been used. Then customers come to us and ask what we can do about it. If you feel dissatisfied with the certain result, we will initially refer you to the treating doctor. He/she can dissolve the filler if necessary.

Hyaluronidase effect?

Hyaluronidase is an enzyme that specifically removes hyaluronic acid. A disadvantage of hyaluronidase may be that it may also dissolve some of your own hyaluronic acid. That's why we are cautious about using hyaluronidase.

Hyaluronidase Restylane — Juvederm side effects?

Hyaluronidase is less accurate when treatment with fillers and good guidelines for the dosage of hyaluronidase are missing. Furthermore, we often need more than one treatment to properly dissolve the hyaluronic acid filler. A second disadvantage of dissolving hyaluronic acid with hyaluronidase is that it may also dissolve some of your body's own hyaluronic acid. By breaking down the connective tissue intermediate, your own connective tissue can also become more flexible. As a result, there may be a temporary loss of volume in the skin.

Hyasone dosage

Due to the possible side effects, we are somewhat reluctant to use hyaluronidase and use it in as small amounts as possible. Depends on the complication, localization, and the amount of volume used. By dosing precisely, we can choose to soften the filler a little or remove it completely.

• Hyaluronidase dosage under the eyes: —slight recovery after treatment with 1 ml hyaluronic acid under the eyes; then we use 5-15 units, divided into 2-3 injections of hyasone per side, to soften the filler — full recovery after treatment with 1 ml hyaluronic acid under the eyes; then we use 30-40 units, divided into 2-3 injections of hyasone per side to dissolve the filler in its entirety
• Hyaluronidase dosage for lips -In the lips, we use a similar dosage as under the eyes. However, we dose a bit higher in the lips because we see fewer side effects of hyasone in the lips. — When dissolving 2 ml, 3 ml or 4 ml hyaluronic acid in the lips (they don't do it in our clinic, because then your lips are really big), we do not use a multiple of the amount of hyasone. This is because Hyasone is an enzyme and does not need to be “dosed”. Then we use the same amount, evaluate the result after two weeks and further solve it if necessary.
• Dosage of hyasone rest of the face — Watch out for 'overdosing' with hyasone. It seems very easy to dissolve hyaluronic acid, but especially when installing deeper filler, it is often desirable to dissolve hyaluronic acid with hyasone Echo-guided.

When can hyaluronidase not be used?

There are also fillers that do not consist of hyaluronic acid. Such as permanent fillers (bio alcamid - pms silicone oil) and temporary fillers such as Sculptra and Radiesse (bio stimulator fillers). Radiesse cannot be dissolved with hyaluronidase! With these fillers, the treatment with hyaluronidase is pointless. With the other fillers, a corticosteroid injection may be considered to reduce the reaction in case of a possible complication.

Hyaluronidase in various types of hyaluronic acid.

Not all hyaluronic acid fillers are soluble! Hyaluronidase does not work equally well with all types of hyaluronic acid. We work with hyaluronic acid Juvederm and Restylane ourselves because we know that they dissolve well with hyaluronidase. So make sure you are treated with a good, safe hyaluronic acid filler... and yes, they are often a bit more expensive. Dissolve fillers. What does that actually cost? For the treatment of complications with Fillers, a special consultation hour has been set up at the ErasmusMC in the dermatology department. During the consultation at the complications office at the ErasmusMC, an ultrasound will be made of the area where the complication occurred and, if possible, it will be treated immediately. Treatment of filler complications is covered by medically necessary care and is covered by your insurance. However, you will need a referral from your doctor before you can go to this office hour. Scars can occur due to the treatment of complications from permanent fillers. When treating complications of hyaluronic acid fillers, no scars occur. We soft/dissolve the hyaluronic acid filler by inserting Hyaluronidase/ Hyason into the filler itself. Then it dissolves. The hyaluronic acid falls apart, as it were, and what remains is sugar and water. This is then simply absorbed by the body and no one can see that you have been treated. We cannot promise that all fillers will be dissolved after one hyasone treatment. Depending on the type of hyaluronic acid used, you will see results from this treatment within 1 to 24 hours. It often takes at least 1-2 days for maximum results and sometimes we need up to eight treatments to properly dissolve the hyaluronic acid. A dent in the skin can also occur by removing swelling. This treatment, with the help of laser or lipofilling, is usually not covered by your insurance. Erasmus MC complications consultation Department of Dermatology, P.O. Box 2040, 3000 CA Rotterdam Solving fillers at the Doctor Frodo clinic At the doctor Frodo clinic, we can also dissolve fillers. For customers who have been treated with us, this is a service treatment. However, if you have been treated by another doctor, we are never sure where exactly the filler is. Then we charge 500 euros per treatment. Are you aware that we sometimes need up to 8 treatments to solve it properly. We solve the filler by locating the filler by ultrasound (ECHO). With an ECHO, the filler is searched for, after which the hyaluronidase is placed in the middle of the filler. This way, we can solve problems in a very targeted manner and prevent unnecessary side effects. Fillers and Corona