Dr Chiké Emeagi at Hampstead Aesthetics is an expert in treating complications of dermal filler facial injections.
At our clinic Hyaluronic acid dermal fillers such as Juvederm, Restylane, Teosyal, Belotero and Stylage can be dissolved using an enzyme called Hyaluronidase. The enzyme is naturally occurring, but can be injected at a higher concentration to dissolve dermal filler at a precise location.
The solution works by breaking up the bonds that hold the Hyaluronic acid (HA) molecules together. The enzyme has an immediate effect and has a half-life of two minutes with duration of action of 24-48 hours.
REASONS A DERMAL FILLER MAY NEED DISSOLVING:
Dermal Filler migration resulting in swelling-
Ultimately the filler will move to the path of least resistance to find a comfortable place to sit. Some patient’s tissues have more “pockets” or laxity and therefore less support in keeping a filler in place. Additionally filler is quite soft and moveable for the first 48 hours post treatment, so there can be some compression of filler around areas of higher muscular contraction or if a patient swells greatly post treatment, this can also cause some compression or movement of product.
Asymmetry and product overfilling, lumps and unevenness of dermal filler product
Areas where we see lumps and bumps the most unfortunately is in the trough and lips. The tear trough because the skin is so thin and unforgiving here and anatomically it is quite unique and more complex. The lips because of the high muscular function, the area, and tissue differences seem from patient to patient. Other areas of the face such as the chin, cheek bone, or nose, we are almost trying to create small “lump or bumps” referred to as boluses, to help lift the tissue and create structure.
Here we try to ensure they are smooth and consistent , however we don’t want to over massage these areas, as we would lose the lifting or volumizing effect that was initially intended with the dermal filler injection.
WHAT IS THE PROCESS OF FILLER DISSOLVING?
1. Full Consultation and assessment of the proposed region to be dissolved. Full discussion will be had detailing the risks of the procedure and benefits to be achieved. The after treatment plan will be discussed.
2. Patch test must be done as there is a small chance of allergic reaction with the Hyaluronidase enzyme. A patch test is performed by injecting a small amount of the enzyme subdermally in the forearm. Our protocol is to wait 30 minutes at the clinic to see the result of the patch test.
3. Topical analgesia--Numbing cream can be applied on the areas that need dissolving 15-20 minutes before the injection.
4. Hyaluronidase enzyme is injected at the intended site
Note. Tear trough previously overfilled with dermal filler.
Hyauronidase Enzyme via cannula used to dissolve Filler.
Pictures immediately after the procedure. Immediate results seen.