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The popularity of hyaluronic acid injections has increased, as treatment with injections of cosmetic dermal fillers have sky rocketed over the past ten years. Well known hyaluronic acid fillers include Juvederm®, Restylane® , Perlane, Juvederm Voluma & Belotero. These dermal fillers have revolutionized the field of cosmetic dermatology. Due to the longevity of these hyaluronic acid fillers, and the simplicity of the treatment, facial rejuvenation has never been easier. Hyaluronic acid dermal fillers are a fabulous treatment for a variety of cosmetic concerns. They are able treat both fine and deep wrinkles and to replace lost facial volume, creating natural-looking, facial rejuvenation.

However, 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 injections. Too often, dermal fillers are injected by untrained or inexperienced injectors, leaving patients with poor cosmetic results. Improper injection technique 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” result or are just unhappy with the results of your dermal filler injections, having hyaluronidase injections with Dr. Michele Green in NYC can reverse the negative effects of these hyaluronic acid fillers. Hyaluronidase injections are the “antidote” to these cosmetic 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.

For Hyaluronidase procedures in NYC, Dr. Michele Green is an expert in dermal filler injections and reversing the improper cosmetic injections of hyaluronic dermal fillers. It is important to inject the correct amount and location of hylauronidase and have an expert dermatologist, like Dr. Green, who can determine the right amount needed. Dr. Green has over 25 years of experience in cosmetic dermatology and is considered one of the best cosmetic injectors in NYC. Her boutique New York practice treats patients from NYC, but internationally as well. If you need correction of misplaced dermal filler or improper injection technique, Dr. Green can help you reverse these unwanted results.

N.S Before and After Vitrase 3 sessions MGWatermark

What is Hyaluronidase?

Hyaluronidase is an enzyme solution 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 these products and works fairly quickly, usually within 24 hours. Sometimes it may be necessary to return for a second or third injection. Hyaluronidase does not work on non-hyaluronic 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 breakdown 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).

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 break 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 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 can 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 an injectable hyaluronidase. Vitrase, Amphadase, and Hydase are all other common brand names for hyaluronidase and 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 human recombinant 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
  • Neck lines

Popular hyaluronic acid filler brands include the Juvederm line of hyaluronic acid dermal filler products, the Restylane line of hyaluronic acid dermal filler products, and Belotero dermal filler. Dr. Green takes a holistic approach to providing her patients with facial rejuvenation treatment and tailors each of her patients hyaluronic acid dermal filler treatments to best meet the concerns of each individual patient, 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 cosmetic injections with inexperienced dermal filler injectors, and are dissatisfied with their results. It is, unfortunately, common to encounter inexperienced injectors in a setting such as a medical spa, where oftentimes the dermal filler injections are not performed by a board-certified medical professional. Dr. Green always recommends that you do thorough research and have a formal in-person consultation when it comes to both selecting your dermal filler injector and the type of hyaluronic acid fillers used for your facial rejuvenation treatment.

It is important to understand the qualifications of your cosmetic injector and the exact type of dermal filler which 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 is dedicated to the satisfaction of her patients and works to make sure that each of her patients is completely satisfied with their dermal filler injections and has the best cosmetic 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 injection of a protein-based enzyme solution under the skin, 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 its reversal.

The process for hyaluronidase injection treatment 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, medical photographs, and work together to develop a treatment plan that will best meet your needs. 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. For most patients, the appearance of the previous dermal filler will be completely reversed, though some may need a second or third hyaluronidase treatment.

In order to achieve the most accurate results for reversing the appearance of hyaluronic acid filler, it is best to wait two weeks after your initial treatment to see how the dermal filler settles within the tissue. There can be some swelling as a result of the hyaluronidase injections themselves. At this point, if you’re unhappy with your results, or if you witness rare side effects such as lumps under the surface of the skin, Dr. Green can provide additional hyaluronidase injections to restore your natural facial contouring.

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 regards 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 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 all 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 dissolve natural hyaluronic acid?

Hyaluronidase injections are excellent at dissolving hyaluronic acid, and this does mean 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 dissolved 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 determine will determine the appropriate amount of hyaluronidase for each injection depending on the amount of dermal filler which 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 own natural tissue?

Hyaluronidase does not dissolve your own tissue. 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. 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 the course of 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, which is used in development of collagen fibers, 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.

Fat cells can be dissolved by a different non-invasive injectable, Kybella. Kybella is an FDA-approved injectable that dissolves and contours submental fat, which can reduce pockets of fat, particularly for those frustrated by the appearance of a double chin or excess 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.

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 the course of several weeks, these fat cells will be permanently eliminated from the body. CoolSculpting is safe to use on a variety of areas on 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 fully dissolve your hyaluronic acid filler and reverse their effects can vary depending on the type and amount of hyaluronic acid dermal filler that was initially injected during your facial rejuvenation treatment. If there were several syringes of HA filler that were injected during a dermal filler treatment session, then it is entirely possible that a patient may require multiple vials of hyaluronidase to completely dissolve the filler product. 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 Juverderm 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 injections 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 the course of a few days, though 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 to 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 to 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.

Does Hyaluronidase have any side effects?

Side effects to hyaluronidase are both rare and uncommon. The most likely side effect of hyaluronidase is mild allergic reaction near the injection site for patients with a hypersensitivity to the treatment, with a reported incidence of between 0.05% to 0.69%. Recent studies have shown that hyaluronidase is antigenic, which means that repeated hyaluronidase injections of relatively large may lead to the production of neutralizing anti-bodies. 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 severe side effects.

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 the course of a few hours to a few days. If, after several weeks, your skin continues to appear depleted or sagging, Dr. Green can help to stimulate collagen production within the body to offset these undesirable effects. In this case, Dr. Green can work with you to develop a customized restorative treatment plan. Collagen stimulating treatments include laser resurfacing, Thermage, microneedling, and chemical peels, among others.

Does Hyaluronidase spread? How far?

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 increases dispersion of those drugs or agents. For example, according to a review done by Cavallini, et. al. (https://doi.org/10.1177/1090820X13511970), 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 for cosmetic injection.

Hylenex

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 injected directly into the dermal plane of your skin, in the area where the HA filler is typically located.

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. Proper 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 which 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 ranges from $500 and up. When you work with Dr. Green, she will be sure to carefully assess your concerns due to hyaluronic acid filler, 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

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 for removing 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 and restore patients 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 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 completely dissolve the dermal fillers. Once all fillers are dissolved, a cosmetic treatment plan for future dermal fillers will be discussed at that time 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 it 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 are unable to 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 giving her patients the 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 take 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 and 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 hylenex, guaranteeing that any swelling does not affect the cosmetic results of newly placed dermal filler. For patients who have 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 as to whether any additional Hylenex is needed or if a patient is ready to have new cosmetic injections.

How soon after hyaluronidase can I get filler?

There are a number of reasons that patients may elect to have treatment with 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 the delayed formation of nodules, or unwanted or unsatisfactory cosmetic results due to having their initial treatment 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.

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 dermal filler treatment, 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 a board-certified cosmetic dermatologist in New York City with over twenty five years of experience providing the best in dermal filler injections for some of the most discerning men and women from around the globe. She is recognized and appreciated around the world for her holistic approach to facial rejuvenation treatment and “less is more” philosophy when it comes to cosmetic dermal filler injections, and her dedication to her patients and to 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.

Dr. Michele Green works closely with each of her patients to create a personalized treatment plan that incorporates the procedures that will best target the specific concerns of each individual and give them their ideal cosmetic results. Our offices are based in NYC, and Dr. Green utilizes the most cutting edge technology and innovative techniques to treat her patients, including Botox, dermal fillers, chemical peels, and cosmetic lasers. To find out more about hyaluronidase treatments and to reverse unwanted dermal filler treatments, please contact the office of Dr. Green online today or by calling  212 535 3088 . Our offices are based in NYC, and we treat patients with Botox, dermal fillers, chemical peels, and cosmetic lasers, from all over the world.

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