The majority of dermal fillers injected worldwide are comprised of HA.
One of the major appeals of the HA fillers is that they are reversible and are temporary. Hyaluronidase, an enzyme found across many species, is the “antidote” used to dissolve the HA fillers. The following conditions are appropriate to use hyaluronidase:
Dr. Weiner demonstrates and discusses how Hylenex can be used to dissolve Belotero. Hylenex is a human recombinant form of Hyaluronidase and is used to dissolve Hyaluronic Acid fillers. HA fillers need to be dissolved when there are lumps, infection, poor cosmetic result, and urgently for vascular occlusion. Dr. Weiner shows that for Belotero, an approximate equal volume of Hylenex is needed.
While there are a many variations of hyaluronidase available in the US (Hylenex, Hydase, Vitrase, Amphadase), the preferred brand at The Aesthetic Clinique is Hylenex. The reason to choose Hylenex is because it is a human recombinant form and is the least likely to have an allergic/anaphylaxis reaction.
Treating filler with Hylenex is not an exact science. There are huge variations in the amount of Hylenex required to dissolve a filler. The important factors to consider are:
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A typical Hylenex treatment is less than 5 minutes and very comfortable. The Hylenex is often mixed with lidocaine to improve comfort and leaves the area numb for about 30 minutes. The HA is dissolved within a few hours (sometimes minutes) but there will be some swelling from the injection that can take a day or 2 to resolve. If replacement of filler is desired, this can be performed in 3 days. Likewise, if further treatment is required (in a non-emergency situation), repeat injections are done at 3 days or later.