Answer: DIfferent fillers require different doses of Hyaluronidase. Juvederm and more particalarly juvderm plus require higher doses of hyaluronidase to dissolve compared to other fillers. If the lumps are truly filler it is most likely a dosage issue.
In this case, hyaluronidase could have been an effective treatment if used at the right time, but unfortunately, it was left too late. Nodules can become resistant to hyaluronidase, and in this case, the patient was left with disturbing nodules for 7 years.
HOW LONG UNTIL I SEE THE EFFECTS OF FILLER DISSOLVING? Hyaluronidase has immediate effect and a half-life of two minutes with duration of action of 24 to 48 hours. Once we start the process of injecting the hyaluronidase, the dermal filler in that area starts to break down and soften immediately.
If the filler is in a location further away from direct blood flow than other locations, then this means that cells that secrete hyaluronidase will not be able to reach the hyaluronic acid gel, and will therefore be unable to dissolve it.
Can all dermal fillers be dissolved? No. Only dermal fillers made from hyaluronic acid can be dissolved with hyaluronidase.
You can have hyaluronidase as many times as needed. The most I usually do is 3x spread about a week apart. I never inject as much as your injector though.
Slowly inject approximately 0.05ml – 0.1ml per 0.1ml of filler to be dissolved in the centre of the lumps/swelling and then massage gently.
So while the body naturally breaks them down over time, there is a way to speed up the process: Injections of hyaluronidase. Hyaluronidase is what the body produces naturally to break down fillers, so by injecting more, it allows the lips to regain natural shape quicker, usually going down within 3-4 days.
Avoid any heat-inducing activities for 24 hours such as strenuous exercise, spas, saunas and hot showers.
Because dermal fillers are made of hyaluronic acid, a naturally occurring skin compound, they are naturally dissolved by your body over a period of 6 – 18 months. This process uses a compound called hyaluronidase.
Hyaluronidase works very quickly, with most of the effect taking place within 24 hours. You should be able to see defined improvement and less filler in the area injected, beginning within a few hours. After a few days if you still have areas that need correction, you can see Dr.
A published journal article states that higher doses [of hy'dase] can lead to damage of native extracellular matrix glycosaminoclycans, leaving a gaunt appearance with poor skin texture (Figure 4). Patients are increasingly presenting with hyaluronidase-related damage, which is often untreatable.
It is not likely for Hyaluronidase to migrate to other region of the face and cause volume loss. There might be a temporary natural HA loss but the body replenishes it within few days. Also, having several dissolving sessions with low dose is more ideal.
Answer: Hyaluronidase should be massaged after injection
Two, it helps the unwanted HA break down and resorb. You should know that hyaluronidase works very quickly, often times within a 1-3 day span, so if you don't see resolution, you should check back with your injectionist.
Conclusions: Our data suggest that the hyaluronidase loses its effect in dermis and subcutaneous tissue within 3-6 hours after the injection and successful engraftment of reinjected HA filler can be accomplished 6 hours after the injection.
Conclusion: In this study, sodium bicarbonate buffered 2% lidocaine was found to be a safe and effective local anaesthetic, with reduced time of onset, and improved quality of both anaesthesia and akinesia. Sodium bicarbonate (7.5%) may be used as an alternative to hyaluronidase in ocular anaesthesia.
Immediately after your treatments, you can apply an ice pack, as there may be mild swelling. You should use a cold compress if needed.
Hyaluronidase has also been shown to diffuse into the lumen of blood vessels even when injected external to it; for potential cases of necrosis due to intravascular deposition of hyaluronic acid, it is not essential to inject directly into the vessel—injection into the surrounding area is also likely to result in ...
The Hyaluronidase enzyme speeds up a break down of hyaluronic acid (Lip filler). It works very quickly though it can have side effects and these include: A probable minimal and temporary effect on your own natural hyaluronic acid, which then re-grows after the injection.
Dissolving agents begin to work immediately and are pretty much done after 48 hours. I do not recommend redoing fillers until at least day 3 and usually ask patients to wait a week just in case there's any mild swelling or anything.
Massage can encourage the filler to be broken up by the body more quickly. But in practice this still takes a long time (like weeks of daily vigorous massage) to improve the outcome. This may also spread the product over a larger area causing more problems.
Though Hyaluronidase can dissolve your body's own natural hyaluronic acid, hyaluronidase is not able to dissolve tissue. Hyaluronidase, either naturally occurring within the body or as an injection, is able to break down hyaluronic acid and only hyaluronic acid, which means that it cannot break down normal tissues.
A good rule of thumb for hyaluronidase dosing is 1 vial of hyaluronidase for 1 mL of filler. Hope this helps.
Due to the spreading effect of hyaluronidase, treatment should not be performed in an area where botulinum toxin has been performed within the last 48 hours or an area of skin infection unless there is a vascular occlusion and the risks outweigh the benefits.
Answer: How much hyaluronidase to dissolve HA fillers
It really depends on the amount of filler in the area and how much you are looking to dissolve. Most surgeons will use between 0.1cc to 0.3cc. The enzyme starts to work pretty fast.