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Hyaluronidase is an injectable enzyme used to reverse the effects of hyaluronic acid fillers. Dermal fillers are more popular than ever due to the ease of having treatment, the lack of downtime and side effects, and the consistently stunning rejuvenation results achieved. As much as dermal fillers have been a boon to cosmetic dermatology, there are times when patients may feel dissatisfied with the final results of their hyaluronic acid fillers. Too often, dermal fillers are injected by untrained or inexperienced injectors, leaving patients with poor cosmetic results. Improper injection techniques can leave patients unhappy with their cosmetic filler injections and can even cause them to need to have their treatment reversed. If you are dealing with an “overdone” look or are otherwise unhappy with the results of your hyaluronic acid fillers, having hyaluronidase injections with Dr. Michele Green in NYC can reverse the effects.

Hyaluronidase injections are the “antidote” to poor results of hyaluronic acid filler injections. By injecting hyaluronidase into unwanted areas of hyaluronic acid fillers, these cosmetic injections can be dissolved and reversed. Through hyaluronidase injections, your skin can be restored to its original pre-injection condition. If you need to have cosmetic injections of Restylane or Juvederm dissolved, hyaluronidase injections may be the best solution for you. Hyaluronidase needs to be injected into the appropriate locations in precise amounts to ensure optimal cosmetic results and prevent unwanted side effects. An experienced injector, such as Dr. Green in NYC, should always perform hyaluronidase injections.

Dr. Michele Green is an internationally renowned board-certified dermatologist with over two and a half decades of experience providing some of the world’s most discerning individuals with the best non-invasive cosmetic treatment options, including dermal fillers and hyaluronidase injections. As an expert injector, Dr. Green takes a holistic approach and embraces a less-is-more philosophy regarding facial rejuvenation, customizing each patient’s treatment plan best to suit their particular skin concerns and overall aesthetic goals. She is consistently identified as one of New York City’s best dermatologists by Castle Connolly, New York Magazine, and Super Doctors for her dedication to her patients and expertise. If you need correction of misplaced hyaluronic acid fillers or improper injection technique, Dr. Green can help.

N.S Before and After Vitrase 3 sessions MGWatermark

What is Hyaluronidase?

Hyaluronidase is an injectable enzyme that is marketed with several FDA-approved brand-name formulations, including Hydase, Hylenex, Amphadase, and Vitrase. Hyaluronidase is injected into the same area of the tissue as the hyaluronic acid product (Juvederm, Restylane, Belotero) was injected previously. Hyaluronidase injections are used to break down or reverse hyaluronic acid fillers and work fairly quickly, usually within 24 hours. Sometimes, it may be necessary to return for a second or third round of treatment with hyaluronidase, depending on the type and amount of hyaluronic acid filler that was initially used. Hyaluronidase does not work on non-hyaluronic acid fillers, such as Radiesse or Sculptra, and you will need to discuss options with Dr. Green beforehand, as results vary per patient.

Hyaluronidase is an enzyme that occurs naturally in the body, and it is produced by white blood cells in order to move more quickly through connective tissues in the body. Hyaluronidase enzymes have been discovered in insects,  mammalian tissues, and even snake venom. There are a variety of different hyaluronidase classifications, with the most common being Hyal1 and Hyal2. Hyaluronidase activity within Hyal2 has less enzyme activity but is, in fact, able to break down hyaluronic acid with a higher molecular weight. Within hyaluronidase injections, this enzyme is typically collected from purified bovine tissue (ovine testicular hyaluronidase) or derived from human albumin sources (recombinant human hyaluronidase). At her private dermatology office in Manhattan’s Upper East Side neighborhood, Dr. Green uses Hylenex, a synthetic, recombinant DNA product made from human products. Recombinant human hyaluronidase has a purity 100 times higher than some of the bovine preparations, and allergic reactions to Hylenex are very rare.

What does hyaluronidase do?

Hyaluronidase has a variety of FDA-approved medical functions, including improving the diffusion of anesthetics in pain therapy, aiding in the absorption of treatment agents in chemotherapeutics and ophthalmic surgery, as a spreading agent in subcutaneous injections, and off-label to great effect in dissolving hyaluronic acid fillers. Different types of hyaluronidase work through different mechanisms of action, meaning the biochemical reactions that occur when hyaluronidase reacts with other substances in the body. Hyaluronidase derived from mammals and leeches breaks down glycosidic linkages via the process of hydrolysis, which is when a chemical reaction occurs with the help of water to break a compound down, unlike hyaluronidase derived from microbes. By breaking down the glycosidic linkages of hyaluronic acid, hyaluronidase leads to the decreased viscosity, or thickness, of hyaluronic acid intramolecular bonds, contributing to the dissolution of the hyaluronic acid in the treatment area, making it a highly effective treatment to reverse the effects of poorly executed hyaluronic acid fillers. Studies have shown that if hyaluronic acid fillers were erroneously injected intravenously, hyaluronidase could be injected into the tissue surrounding the vein in order to dissolve the hyaluronic acid to great effect.

What is Hylenex?

Hylenex is one of the FDA-approved brand names for injectable hyaluronidase. Vitrase, Amphadase, and Hydase are all other common brand names for hyaluronidase. They can essentially be used interchangeably in order to remove HA filler that is unwanted or that has migrated, though some of the properties do differ between formulations. Hylenex is unique from other available FDA-approved hyaluronidase injectables in that it is the only product that does not include any materials derived from animal products. The effects of hyaluronidase should be consistent, irrespective of which hyaluronidase injectable is used to remove your hyaluronic acid fillers. Since Hylenex is a recombinant human hyaluronidase, there is no risk of experiencing an allergic reaction to the injections. Hyaluronidase products that are derived from animal products may rarely cause an allergic reaction. Dr. Michele Green has over two and a half decades of experience with cosmetic injectables, including hyaluronic acid dermal fillers and hyaluronidase, and prefers to use Hylenex.

What is Hyaluronic acid?

Hyaluronic acid also referred to as hyaluronan, is a naturally occurring substance in the body that is designed to stimulate collagen production in the skin. Hyaluronic acid is a glycosaminoglycan, which is considered a major component of the extracellular matrix, as it links together collagen fibers, connective tissue, and protein filaments in the body. Hyaluronic acid is formed by a polymer of two primary disaccharides, D-glucuronic acid and D-N-acetylglucosamine. Hyaluronic acid filler injections are commonly used to boost the volume of the skin via subcutaneous injections, and the majority of hyaluronic acid fillers use hyaluronate cross-linking technology. These linkages connect hyaluronic acid molecules with a plasticizing agent for optimal facial contouring.

Essentially, hyaluronic acid fillers rely on the natural collagen production that occurs in the body and are used to create targeted new collagen growth within a given treatment area. Dr. Green uses hyaluronic acid fillers to treat a variety of cosmetic concerns without the need for plastic surgery, including:

  • The reduction of fine lines and wrinkles in the eye area
  • The reduction of fine lines and wrinkles around the mouth, including marionette lines, smile lines, and perioral lines
  • Lip augmentation
  • Cheek enhancement
  • Chin augmentation
  • Jowl correction
  • Correction of age-related volume loss in the midface
  • Correction of age-related volume loss under the eyes to reduce the appearance of dark circles or under-eye bags
  • Volume loss in the hands
  • Buttock augmentation
  • Hip Dip correction
  • Necklines

Popular hyaluronic acid filler brands include Juvederm, Restylane, and Belotero. Dr. Green takes a holistic approach to facial rejuvenation treatment and tailors each of her patient’s dermal filler injections to meet the concerns of each patient best, embracing an artful, “less-is-more” philosophy when it comes to her dermal filler injections. Often, Dr. Green consults with patients who have had their hyaluronic acid filler injections with inexperienced or unqualified injectors and are dissatisfied with their results. It is, unfortunately, common to encounter inexperienced injectors in a setting such as a medical spa, where a board-certified dermatologist does not perform the dermal filler injections. Dr. Green always recommends that you do thorough research and have a formal in-person consultation when it comes to selecting both your dermal filler injector and the type of hyaluronic acid fillers to use for your facial rejuvenation treatment.

It is important to understand the qualifications of your cosmetic injector and the exact type of dermal filler that you are choosing in order to guarantee that your cosmetic results are satisfactory, performed in a safe and sterile manner, and to avoid any complications or unwanted side effects. Dr. Green embraces a less-is-more philosophy regarding dermal fillers, and she is dedicated to the satisfaction of her patients. She works to make sure that each of her patients is completely satisfied with their dermal filler results so that they look and feel like the very best version of themselves. For men and women who come to her frustrated by a previous hyaluronic acid filler experience, she is able to offer hyaluronidase treatment, which can dissolve the effect of overdone or unwanted hyaluronic acid filler results.

How does hyaluronidase work?

The treatment procedure involves the subcutaneous injection of a protein-based enzyme solution, which aims to break down the collection of hyaluronic acid, often the result of a previous cosmetic injection such as Restylane or Juvederm and other dermal filler treatments. Basically, it does the opposite of the filler itself due to the hyaluronidase enzyme. The injection of hyaluronidase will decrease the dermal filler injection and lead to the reversal of its cosmetic effects. Patients should always wait at least two weeks after their dermal filler injections to consider hyaluronidase, as the fillers can take up to two weeks to settle.

The process of getting hyaluronidase injections is simple and convenient. First, you’ll meet with Dr. Green to discuss your issues with your current hyaluronic acid filler results, as well as your medical history and medical photographs, and work together to develop a treatment plan that will best meet your needs. Dr. Green will inquire as to the amount and type of hyaluronic acid fillers used in your initial treatment. Then, for your hyaluronidase injection procedure, Dr. Green will administer hyaluronidase to the initial hyaluronic acid filler treatment area in order to reverse the effects. After your treatment, you can resume normal activity, as this procedure requires no downtime. Some potential side effects include swelling, bruising, and tenderness at or near injection sites, which tend to resolve independently within one week of the hyaluronidase injections. The effects of hyaluronidase are usually apparent after just 48 hours. For most patients, the appearance of the previous dermal filler will be completely reversed, though some may need a second or third hyaluronidase treatment. Dr. Green will ask you to return to her office two weeks after your initial hyaluronidase injections to evaluate the results and determine whether any touch-up is required.

JS 47yo f before and after Hyaluronidase 2weeks after undereyes Front MGWatermark

40-49 year old – Hyaluronidase 2 weeks before and after

What is hyaluronidase used for?

The use of hyaluronidase injections is approved by the Food and Drug Administration (FDA) for a variety of treatments and is commonly used for the following:

  • For fluid infusion through subcutaneous tissues (known as hypodermoclysis), particularly within pediatric care.
  • as an adjuvant to accelerate the diffusion of drugs and local anesthetics subcutaneously in regard to both dispersion and delivery
  • as an adjunct in promoting absorption of contrast agents (dye) in urography (x-ray of blood or lymph vessels in the urinary tract)
  • as a method of edema reduction (off-label use)
  • as a treatment of vitreous hemorrhage
  • clinical use within chemotherapy patients for the treatment of extravasation (fluid leakage) in order to prevent tissue necrosis (skin cell injury).
  • for retrobulbar anesthesia within ophthalmic surgery
  • to dissolve the effects of hyaluronic acid fillers, particularly incited by an allergic reaction, delayed-onset nodules, HA-incited blindness, Tyndall effect (blueish hue to the skin), vascular occlusion, or an unacceptable cosmetic outcome.

According to an in vitro study by Rao et al., hyaluronidase is successful in reversing the effects of most popular hyaluronic acid fillers, though the amount of hyaluronidase needed to dissolve the fillers varied by formulation. The study looked at two hyaluronidase formulations and four hyaluronic acid fillers that are commonly used in the United States and found hyaluronidase effective at reversing the effects of the fillers in each case. For additional clinical information on hyaluronidase, there are many articles of note on Pubmed, in particular in the Journal of Cosmetic Dermatology and Dermatol Surg.

Does hyaluronidase have any side effects?

Side effects of hyaluronidase are rare. The most likely side effects include a mild amount of swelling, bruising, and tenderness at or near injection sites, which tend to resolve independently within one week of hyaluronidase injections, should they occur. Another potential side effect of hyaluronidase is a mild allergic reaction near the injection site for patients with a hypersensitivity to the treatment, with a reported incidence of between 0.05% and 0.69%. A skin test may be performed before your hyaluronidase injections to evaluate for hypersensitivity. Recent studies have shown that hyaluronidase is antigenic, which means that repeated hyaluronidase injections of relatively large may lead to the production of neutralizing antibodies. This means that hyaluronidase will not necessarily continue to be as effective in dissolving hyaluronic acid filler with large amounts of use. Additionally, it’s good to note that hyaluronidase should not be injected via intravenous injections, as this can put patients at risk for allergic reactions and more adverse events.

Occasionally, patients may observe a “depleted” look due to a temporary dip in the natural hyaluronic acid stores within the body. However, in this case, your natural hyaluronic acid will return to normal over a few hours to a few days. If, after several weeks, your skin continues to appear depleted or sagging, Dr. Green can suggest a non-invasive cosmetic procedure to help stimulate collagen production within the body to offset these undesirable effects. In this case, Dr. Green can work with you to develop a customized treatment plan. Collagen-stimulating treatments include laser resurfacing, Thermage, Microneedling, and chemical peels, among others.

Does hyaluronidase dissolve natural hyaluronic acid?

Hyaluronidase injections are excellent at dissolving hyaluronic acid, and this means that hyaluronidase is able to dissolve natural hyaluronic acid as well. However, hyaluronidase will target the hyaluronic acid linkage within the designated treatment area, which means that it will dissolve the hyaluronic acid filler before dissolving any natural hyaluronic acid. Additionally, hyaluronic acid is a substance that is both produced and dissolved by the body constantly as a part of the body’s natural ebb and flow. Even if the hyaluronidase injection dissolves natural hyaluronic acid, your body will be able to restore your natural hyaluronic acid to its pre-filler level in very little time.

Dr. Green will determine the appropriate amount of hyaluronidase for each injection depending on the amount of dermal filler that was previously injected. Dr. Green’s experience as a cosmetic injector ensures that the amount of hyaluronidase is safe and appropriate and reduces the risk of any unwanted side effects.

Does hyaluronidase dissolve your natural tissue?

Hyaluronidase does not dissolve your tissue. Though hyaluronidase can dissolve your body’s natural hyaluronic acid, it 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. Though occasionally, patients might observe a “depleted” appearance on their skin after hyaluronidase treatment, this is due entirely to the temporary absorption of hyaluronic acid. After a hyaluronidase injection, the skin will typically restore its hyaluronic acid levels within a few days or, in rare cases, over a few weeks.

As hyaluronidase can dissolve natural stores of hyaluronic acid, it is incredibly important that a board-certified medical professional be relied upon to determine the amount of hyaluronidase necessary to reverse the effects of a hyaluronic acid filler. Dr. Green personally develops all hyaluronidase treatment plans and determines the correct amount for each patient. Her “less is more” approach is applied to both dermal filler and hyaluronidase treatment in order to optimize the effects of cosmetic injectable treatments and avoid any dissatisfaction. The safety and satisfaction of all her patients is Dr. Green’s top priority.

Two treatments of Hyaluronidase under the eyes to dissolve improper Juvederm injections under her eyes (tear troughs)

Can hyaluronidase dissolve fat?

Hyaluronidase does not dissolve fat. Hyaluronidase is an effective way to dissolve hyaluronic acid, and hyaluronidase injections are specifically used to dissolve hyaluronic acid filler injections. Fat cells are dissolved and metabolized within the body by different means, as fat cells are created through different processes in the body. However, fat cells can be metabolized through a variety of non-invasive cosmetic treatments offered by Dr. Green.

A different non-invasive injectable, Kybella, can dissolve fat cells. Kybella is an FDA-approved injectable that dissolves excess fat and is particularly effective for those frustrated by the appearance of a double chin or a stubborn pocket of unwanted fat around the jawline. Kybella uses a synthetic form of deoxycholic acid, a natural substance that helps to metabolize dietary fat in the body. It is able to eliminate fat cells near the injection site, thus preventing these fat cells from further fat accumulation. In this way, Kybella®  can actually permanently eliminate fat cells at or near the injection site. Kybella requires little to no downtime and often requires as little as one treatment for optimal results. Most patients require three treatment sessions of Kybella to achieve their ideal cosmetic results, with each treatment session spaced one month apart. The most common side effect of Kybella is swelling, which resolves on its own within several days of treatment.

Another method of fat reduction that is highly popular is that of CoolSculpting®. CoolSculpting is an innovative body contouring device that uses “fat freezing” techniques (Cryolipolysis) to eliminate excess fat on the body. Though CoolSculpting is not a weight loss technology, it can be an ideal tool for those who have lingering pockets of fat in the abdomen, along the arms, or under the chin, even though they maintain a healthy lifestyle. CoolSculpting is able to “freeze” fat cells at a higher temperature than other cells in the body, and then these frozen cells are able to be metabolized naturally in the body. Over several weeks, these fat cells will be permanently eliminated from the body. CoolSculpting is safe to use on a variety of areas of the body, including the legs, arms, stomach, lower back, upper back, bra area, and under the chin. The procedure requires no anesthesia, recovery, or downtime, and the results are entirely permanent, provided patients don’t experience excessive weight fluctuation post-treatment.

How much hyaluronidase to dissolve fillers?

The precise amount of hyaluronidase that will be required to dissolve your hyaluronic acid filler and reverse its effects fully can vary depending on the type and amount of hyaluronic acid dermal filler that was initially injected during your facial rejuvenation treatment. If several syringes of HA filler were injected during a dermal filler treatment session, then a patient may require multiple vials of hyaluronidase to dissolve the filler product completely. Usually, using one to two vials of Hylenex is suitable for dissolving the one syringe of hyaluronic acid dermal filler product, though each patient is different. Generally speaking, a one-to-one ratio of hyaluronic acid dermal filler to hyaluronidase is required to dissolve the product. In the case of hyaluronic acid fillers that utilize cross-linking technology, such as Restylane Defyne or Juvederm Voluma, multiple treatment sessions with hyaluronidase may be needed. Additionally, whether the filler is particulate or non-particulate and the concentration of hyaluronic acid within the formulation of the filler can affect the recommended amount of hyaluronidase.

While clinical trials have shown that hyaluronidase injections are safe and effective for reversing the effects of HA dermal fillers, current literature widely diverges in terms of recommended hyaluronidase doses. For this reason, it is recommended to rely on expert opinion and to use moderation in the application of hyaluronidase. Conservative injections of this enzymatic treatment are recommended at this time. Dr. Michele Green in NYC tailors hyaluronidase injection treatments based on her expertise and extensive knowledge of hyaluronic acid fillers. For each patient that she treats with this injectable, she offers and encourages a follow-up appointment, scheduled approximately two weeks after an initial hyaluronidase treatment with her, to determine whether a second (or third) hyaluronidase injection procedure is needed to get the best results.

When you meet with Dr. Michele Green in her private dermatology office located in the Upper East Side neighborhood of Manhattan, you will have the opportunity to discuss in-depth with her regarding your medical history and the previous cosmetic treatments that you have had, including the type and amount of hyaluronic acid dermal filler products used for your facial rejuvenation treatment. During your consultation, you will work with Dr. Green to address your primary cosmetic concerns and determine how much hyaluronidase may be needed to completely dissolve your previously injected hyaluronic acid dermal fillers so that you can restore your appearance and, if necessary, later have expert cosmetic injections performed by board-certified dermatologist Dr. Green, who has the experience and mastery to provide patients with the optimal cosmetic results.

How long does hyaluronidase take to work?

The effects of hyaluronidase will begin to appear within two to three days after the hyaluronidase treatment has taken place. However, the amount of time it will take for the full effect of hyaluronic acid filler reversal varies depending on the individual patient. The majority of patients see complete results from hyaluronidase injections over a few days. However, some may need two or more weeks in order to appreciate the full results of the hyaluronidase treatment. It is best to wait two weeks to determine your cosmetic results and to determine if additional hyaluronidase is needed. Hyaluronidase injections can cause swelling at the site of injection as well.

After the hyaluronidase takes full effect, some patients may feel that they’d like to boost their collagen production through alternative means aside from dermal fillers. In this case, Dr. Green can help develop a revitalizing skincare treatment plan, which can range from laser resurfacing, radiofrequency lasers such as Thermage and Vivace, chemical peels, and microneedling. Dr. Green is an expert in cosmetic dermatology and anti-aging techniques and can help you both look and feel like your best self.

Is hyaluronidase safe?

Yes, like Juvederm and Restylane, it is safe to inject hyaluronidase, and side effects are rare. That said, you could potentially look at testing it gradually via multiple treatment sessions, which can be arranged with cosmetic dermatologist Dr. Green in New York. Unlike procedures that use alternative substances such as Radiesse, Sculptra, or silicone oil fillers, hyaluronic acid fillers can be dissolved immediately after the procedure is done or months later. It is always important to have your hyaluronidase injections with an experienced board-certified dermatologist like Dr. Green to ensure that you get the best results while limiting potential side effects. Hyaluronidase must be injected into the appropriate areas in precise amounts to prevent dissolving natural hyaluronic acid, which can result in crepey skin. Dr. Green is an expert injector with over 25 years of experience and will work with you to achieve your ideal aesthetic results.

Does hyaluronidase spread? How far does hyaluronidase spread?

One role of hyaluronidase in the medical field is to help with the diffusion, or spreading, of drugs or agents injected into the tissue. Diffusion can be defined as how well or how far a substance can spread. Hyaluronidase is a highly effective substance to accompany treatments in the medical field as it can help to increase the permeability of cells and blood vessels into which drugs or chemical agents need to be absorbed and increase the dispersion of those drugs or agents. For example, according to a review done by Cavallini et al. (, hyaluronidase is often used during chemotherapy to assist with the permeation of the treatment drug into a malignant tumor. Hyaluronidase can also be used in the field of radiology to aid with the diffusion and absorption of the agent used to provide healthcare workers with a better view of the treatment area. In ophthalmic surgery and pain therapy, hyaluronidase is also used to help the anesthesia spread throughout the treatment area.

Can hyaluronidase be used if I have an allergic reaction to my hyaluronic acid filler?

Yes, depending on the type of allergic reaction to hyaluronic acid filler, hyaluronidase can dissolve the ha filler and help minimize any potential side effects.

How is hyaluronidase made?

Hyaluronidase is derived through the collection of natural hyaluronidase either via bovine sources or human albumin sources. In order to prepare a hyaluronidase injection, the hyaluronidase is not diluted with saline or water. Besides cosmetic use, hyaluronidase is used as an adjunct in subcutaneous urography for improved resorption of radiopaque agents. However, hyaluronidase is a highly complicated substance to create in injectable form and should never be attempted to be made at home. Hyaluronidase should only ever be administered by a board-certified medical professional, and only FDA-approved brands should be used. These brands include Hydase, Hylenex, Amphadase, and Vitrase. Under no circumstances should hyaluronidase be used from an unverified source. Dr. Green typically uses Hylenex formulation for her hyaluronidase treatments, as she’s found its formulation to be reliable and consistent for a wide variety of patient needs.

Where can I buy hyaluronidase?

Hyaluronidase can only be injected by a licensed medical professional. A patient cannot purchase hyaluronidase from the internet or elsewhere for cosmetic injection.

How to mix hyaluronidase?

Hyaluronidase comes as a vial of one ml liquid solution. It does not need to be mixed, diluted, or reconstituted before injection into the treated area.

How to inject hyaluronidase?

Hyaluronidase is a subcutaneous injection placed directly into the dermal plane of your skin in the area where the HA filler was initially injected.

What is the most common area of the face injected with hyaluronidase?

One of the most common areas of poor injection or improper injection technique is the lower eyelid area, in the tear trough. Factors like patient selection, inexperienced injections, improper training of healthcare workers, and poor technique often result in overcorrection of the tear trough area using HA fillers. This delicate under-eye area is perhaps one of the most difficult injections. It is not surprising that this is one of the main areas that need to be dissolved with hyaluronidase injections.

What does hyaluronidase cost?

The cost of hyaluronidase varies based on how much treatment is required and the areas affected. We can provide a quote based on consultation, but the average treatment is around $1,000. When you work with Dr. Green, she will be sure to assess your concerns due to hyaluronic acid filler carefully and provide you with a treatment plan that best fits your budget and individual needs.

JS 47yo f before and after Hyaluronidase 2weeks after undereyes undereyes AngleR MGWatermark

Hyaluronidase: 2 weeks under eyes – before and after

How to dissolve filler with hyaluronidase

Having unwanted or unsatisfactory hyaluronic acid filler dissolved with hyaluronidase is a quick and straightforward cosmetic procedure that is offered and regularly performed in the office of Dr. Michele Green in NYC. To have your HA fillers dissolved with hyaluronidase, you must first consult with Dr. Michele Green for a consultation at her private dermatology office in the Upper East Side neighborhood of Manhattan. She will review your medical history, history of cosmetic treatments, including dermal fillers, and your specific skin care concerns and aesthetic goals. Treatment with hyaluronidase injections may be performed on the same day as your consultation or scheduled for a later date. Patients do not need to use a topical numbing cream prior to having hyaluronidase treatment to remove previously injected HA filler.

Patients note that the Hylenex injections may sting somewhat, though the injections themselves are quickly performed, and the discomfort is both minimal and brief. Once injected, the hyaluronidase begins working immediately to break down the hyaluronic acid fillers, restore the patient’s appearance, and dissolve the previously injected HA dermal fillers. Although hyaluronidase begins working as soon as it is injected, it may take up to 14 days to see the full results of treatment after the initial injection. For this reason, Dr. Green typically recommends that her patients return to her office about two weeks after hyaluronidase injections. During this follow-up visit, it will be determined whether any additional hyaluronidase is required to dissolve the dermal fillers completely. Once all fillers are dissolved, a cosmetic treatment plan for future dermal fillers will be discussed with Dr. Green.

How to dissolve filler without hyaluronidase

Hyaluronidase is the only effective and safe treatment method when it comes to dissolving hyaluronic acid dermal fillers and reversing their effects due to its enzymatic properties of degrading hyaluronic acid. Cosmetic lasers, such as Thermage and Fraxel laser, will not help dissolve hyaluronic acid fillers. Additionally, dermal fillers that are not composed of hyaluronic acid cannot be dissolved with hyaluronidase injections. Patients who have been injected with dermal fillers that are composed of material other than hyaluronic acid, such as Radiesse (calcium hydroxylapatite) and Sculptra (poly-L-lactic acid), must wait for the effects of these dermal fillers to wear off over time. For this reason, it is imperative to be treated with cosmetic injectables by a board-certified cosmetic dermatologist who has both the expertise and the experience to perform your facial rejuvenation. Dr. Michele Green has over two and a half decades of experience in providing men and women from around the globe with the best cosmetic injectable treatments. She is internationally renowned for her holistic approach and ‘less is more’ philosophy when it comes to pan-facial rejuvenation treatment. Dr. Green always gives her patients long-lasting, natural-looking results that leave them looking and feeling like their absolute best.

How long does it take to dissolve filler with hyaluronidase?

Hyaluronidase works quickly and effectively to dissolve unwanted hyaluronic acid filler in the treatment area. Most patients will begin to see the effects of the treatment within 2-3 days of receiving the procedure, but results vary, and some may not see the full effects until approximately two weeks post-treatment. In addition, the various hyaluronic fillers have different degrees of density and may require an increased amount or repeated number of treatments to dissolve them. There will be some swelling at the injection site, which can last for up to two weeks. For that reason, Dr. Green recommends having patients wait two weeks before returning to the office for a follow-up appointment, where Dr. Green can assess the effectiveness of the first hyaluronidase treatment and potentially recommend a second or third treatment session.

How long does hyaluronidase stay in your system?

Hyaluronidase starts working immediately upon injection to break down hyaluronic acid dermal fillers and reverse their effects. The action of hyaluronidase may continue for up to 48 hours after injection. Patients may experience some residual swelling after their treatment with hyaluronidase injections, and this is a normal side effect after being treated with hylenex. This swelling effect may last for up to two weeks. For this reason, Dr. Green usually recommends that patients wait at least two weeks before having additional or new hyaluronic acid dermal filler placed after being treated with ethylene, guaranteeing that any swelling does not affect the cosmetic results of newly placed dermal filler. For patients who have had their previously injected HA filler corrected with hyaluronidase by Dr. Green, she advises a follow-up appointment two weeks after treatment to ensure the best results. At this follow-up, it may be determined whether any additional Hylenex is needed or if a patient is ready to have new cosmetic injections.

How soon after hyaluronidase can I get dermal fillers?

Patients should not have dermal fillers until at least two weeks after their last hyaluronidase injections. Waiting two weeks allows any side effects of the hyaluronidase injections, such as swelling, bruising, or tenderness at or near injection sites, to resolve. There are a number of reasons that patients may have hyaluronidase injections to correct the appearance of their hyaluronic acid dermal filler injections, including migration of the dermal filler product, a lumpy appearance due to allergic reaction or the delayed formation of nodules, or unwanted or unsatisfactory cosmetic results due to having their initial dermal filler injections with an inexperienced or unqualified injector. After having hyaluronidase injections with Dr. Michele Green in New York City to reverse the effects of your HA filler treatment, you should wait two weeks before returning to her office to have new hyaluronic acid dermal filler injections for replenishing lost volume or enhancing facial contour.

If you have hyaluronic acid filler injections too soon after hyaluronidase injections, there is a potential risk of the hyaluronidase dissolving the new dermal fillers. Dr. Green recommends that her patients fully reverse the effects of their previously injected hyaluronic acid fillers before having facial rejuvenation with cosmetic injectables so that they get the optimal cosmetic results from their treatment. When you consult with Dr. Green, she will work with you to establish a treatment plan and timeline that works best for you.

Does hyaluronidase dissolve Botox?

No, hyaluronidase does not dissolve Botox. Botox is a neurotoxin, not a hyaluronic acid dermal filler. Only hyaluronic acid fillers can be dissolved with hyaluronidase. As a neurotoxin, Botox is the gold standard for reducing dynamic fine lines and wrinkles. Dynamic fine lines are those that develop due to repeated facial expressions, typically affecting the glabella, forehead, and the corners of the eyes (crow’s feet). Botox injections inhibit nerve signals to certain facial muscles related to expression, essentially “freezing” them. This prevents them from overuse, ultimately leading to a smoother skin texture and a reduction in visible fine lines. The effects of Botox typically last up to four months, with most patients engaging in regular treatment sessions to maintain the best results.

hyaluronidase 1576173046

How long does lip filler take to dissolve with hyaluronidase?

The effects of hyaluronidase injections are typically observable within 48 hours. There may be some side effects of bruising and swelling, which tend to resolve independently within one week of the procedure, should they occur. Some patients may require more than one treatment session of hyaluronidase injections to dissolve their filler completely. The amount of time and hyaluronidase required to dissolve lip filler fully depends on the type and amount of lip filler injected initially. Dr. Green will reassess the treated area two weeks after your initial hyaluronidase injections to evaluate the results and determine whether any additional hyaluronidase is needed.

Does hyaluronidase damage the skin?

Hyaluronidase will not affect the skin’s natural collagen or otherwise damage the tissue. Hyaluronidase is specifically used for dissolving hyaluronic acid fillers. Hyaluronidase may dissolve some of the skin’s natural hyaluronic acid, potentially causing a slightly crepier skin texture in the treated area. Side effects of hyaluronidase injections can include tenderness, bruising, and swelling at or near injection sites. To ensure you obtain the best cosmetic results while limiting the potential side effects, it is always recommended to have hyaluronidase injections with an experienced board-certified dermatologist, such as Dr. Green in New York City. Dr. Green is an expert injector with over two and a half decades of experience providing some of the world’s most discerning individuals with the best non-invasive treatment options available. If you’ve had dermal fillers that need correction, Dr. Green is here to help.

Does hyaluronidase hurt?

Some patients report a slight stinging sensation during hyaluronidase injections. Common side effects can include mild swelling, bruising, and tenderness at or near injection sites, which tend to resolve independently within 48 hours of the treatment. Patients with sensitive skin may choose to apply a topical numbing cream one hour before their injections. Dr. Green will prescribe the lidocaine cream to the pharmacy of your choice. Once you arrive at Dr. Green’s private dermatology office in Manhattan’s Upper East Side neighborhood, the lidocaine cream will be removed, and the skin will be sterilized. Ice packs will be applied to the treated area immediately after the hyaluronidase injections to limit swelling.

Will hyaluronidase dissolve all fillers?

Hyaluronidase will effectively dissolve hyaluronic acid fillers. Dermal fillers that are composed of other substances, such as poly-l-lactic acid or calcium hydroxylapatite, can not be dissolved with hyaluronidase. For this reason, it is imperative that an experienced board-certified dermatologist, such as Dr. Michele Green in NYC, always perform dermal filler injections. Dr. Green has over two and a half decades of experience providing some of the world’s most discerning individuals with the best non-invasive cosmetic treatment options, including dermal filler injections. Dr. Green takes a holistic approach and embraces a less-is-more philosophy regarding facial rejuvenation, customizing each patient’s treatment plan to cater best to their particular skin concerns and aesthetic goals.

How do I have unwanted dermal fillers dissolved with hyaluronidase today?

If you have had cosmetic injections with an inexperienced or unqualified injector and are now left feeling disappointed with the cosmetic results of your hyaluronic acid filler injections, hyaluronidase injections with Dr. Green in NYC may be just the solution you have been searching for. Hyaluronidase injections are considered to be the gold standard treatment when it comes to dissolving unwanted or misplaced hyaluronic acid fillers that have produced poor cosmetic results.

Dr. Michele Green is an internationally renowned board-certified cosmetic dermatologist with over two and a half decades of experience providing some of the most discerning individuals with the best non-invasive cosmetic treatments available, including dermal fillers and hyaluronidase injections. Taking a holistic approach and embracing a less-is-more philosophy regarding facial rejuvenation, Dr. Green customizes each patient’s treatment protocol to provide a natural-looking, long-lasting, more youthful appearance.

Her dedication to her patients and her practice is well-reflected by the fact that she is consistently voted as one of NYC’s best physicians by Castle Connolly, Super Doctors, and New York Magazine. When you consult with Dr. Green at her private dermatology office in Manhattan’s Upper East Side neighborhood, she will work with you to create a personalized treatment plan that best suits your particular skin concerns and overall aesthetic goals. To schedule a consultation with Dr. Green, contact the office online today or call 212 535 3088.

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