hyaluronidase, your face will go back to its usual self, especially in cases of overfilling or misplaced filler. For ultimate results, the treatment must be done by a professional doctor, and follow-up reviews should be involved, such as cleaning and cold application, to avoid rubbing the treated area.
What is Hyaluronidase
Hyaluronidase is the naturally occurring enzyme responsible for breaking down hyaluronic acid very rapidly. Hyaluronic acid, of course, is a commonly used dermal filler itself for the purpose of filling wrinkles, adding volume, and contouring the face. Injections of hyaluronic acid are not perfect, and at times overfilling or unnatural results may occur. In those cases, hyaluronidase can dissolve the hyaluronic acid for adjusting or reversing the outcome of the filler.
Hyaluronidase is not confined to the cosmetic field. It can be medically indicated in urgent situations where hyaluronic acid is inadvertently placed into a vessel and causes vascular occlusion. Hyaluronidase would unblock the vessel very fast, therefore avoiding serious complications. This is because hyaluronidase degrades the molecular structure of hyaluronic acid, with its subsequent fast degradation and metabolism by the body. Thus, it is perceived that whenever problems occur following the injection of hyaluronic acid, then hyaluronidase will be the most effective means of correction.
About the cosmetic filler complications treatment, hyaluronidase is very specific: it degrades excessive hyaluronic acid but gives a minimal effect on other tissues. This is why specificity makes hyaluronidase one of the most reliable tools of aesthetic medicine.
How It Works
Hyaluronidase binds to the hyaluronic acid molecules and breaks their cross-linked structure. Hyaluronidase acts on the cross-linked areas of hyaluronic acid by breaking up the large chains in a molecular structure. This serves to reduce the volume of the filler. This is a gradual process, and most of the volume of the filler will be dissolved within 24 to 48 hours after injection.
Individual characteristics in the action of hyaluronidase depend on several factors:
The degree of cross-linking of the filler has a strong bearing on how hyaluronidase works. Fully cross-linked hyaluronic acid fillers are resistant and may not be degraded easily, hence requiring a higher dose of hyaluronidase in dissolution. Another factor would be the depth at which hyaluronic acid has been injected. The shallower this filling is, the faster hyaluronidase will act. Moreover, the dosage of hyaluronidase and speed of metabolism of one’s skin will determine its effectiveness.
In the process of treatment, doctors will carefully control the dose and injection site according to the distribution of filler and the patient’s desired outcome. Such personalized treatment allows hyaluronidase to meet large extent needs of the patient.
Its dissolving effect is usually evident a few hours after injection, but the final result generally takes one to two weeks to stabilize. In cases of large volumes of hyaluronic acid filler or a high degree of cross-linking, multiple injections of hyaluronidase may be required for an appropriate outcome.
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Will My Face Change
The question most patients have in mind is whether their face is going to return totally to the pre-treatment state after the treatment of hyaluronidase. Hyaluronidase acts by degrading only hyaluronic acid fillers and does not induce other long-time damaging effects on the other tissues of the skin. Thus, most faces in such instances can return to a state similar to before the injection of hyaluronic acid.
In any case, however, recovery results depend on a number of factors. If the filler was injected recently and in small amounts, the face would normally recover quickly and appear natural again; but if a large amount was injected or if the filler has been in the skin for a long period, removing it may result in slight sagging or looseness of the skin.
Specific clinical studies show that, after treatment with hyaluronidase, most patients are brought closer to their natural self. An estimated 85% of patients experience marked improvement within one to two weeks. For the few with thinner skin or too many fillers, more time will be needed for adjustments and recovery.
It is also interesting to note that this enzyme, while highly specific in its dissolving action, affects the natural levels of hyaluronic acid in the body when given in very high amounts. This effect is temporary, and through metabolism, natural hyaluronic acid levels will gradually recover.
Recovery Time
Hyaluronidase takes effect very fast, but the time for complete recovery differs from one person to another. In general, hyaluronidase starts its action of degrading the hyaluronic acid filler within 24 to 48 hours after the injection. The final recovery results will be present in most patients within a week or two, though in some instances, the recovery time can take up to a month, especially with large volumes of fillers or deep injections.
A number of factors influence recovery time: the type of hyaluronic acid injected, the depth at which it was injected, and the speed of the skin metabolism of the patient. The usual immediate post-injection reactions to hyaluronidase are mild redness, bruising around the site of injection, and a little discomfort, all of which generally settle within days.
This is because most patients will have a rather quick reduction of filler volume after a few hours of injection, but as hyaluronidase continues to work, the filler volume will further decrease over the next couple of days and reach an optimum in about one to two weeks.
Recovery after hyaluronidase injection proceeds in the following steps: the immediate reaction phase, which is accompanied by mild swelling and redness of the skin, then follows the dissolving phase, where the hyaluronic acid filler gradually breaks down, and lastly, there is the recovery phase, where the face gradually goes back to its natural state; elasticity and volume are restored in the skin during this period.
Side Effects
Hyaluronidase is relatively safe, but small side effects can be observed nonetheless. Among these, minor side effects include redness at the site, bruising, and slight pain at the site of the injection. All these are temporary and thus resolve by themselves in a few days.
Hyaluronidase has rare allergic reactions, and hence, one should be cautious in patients that might have allergic reactions to such proteins derived from bovine or bee wax. Before any treatment, it is important that an allergy test be conducted to ensure a patient is not allergic to hyaluronidase.
Another possible side effect that one might be checking for is localized skin depression. In higher quantities, hyaluronidase can break down not only the administered hyaluronic acid but also take down a part of the naturally occurring hyaluronic acid levels in the body, thus causing depression to this area where the treatment has occurred. Such depression usually is temporary and, with the skin self-healing and natural levels of hyaluronic acid getting restored, it will subside gradually or disappear.
It is important to note that the occurrence of hyaluronidase side effects is quite rare. For most patients, critical complications from treatment are almost nil. A dermatologic surgery study in 2019 identified less than 5% incidence rates of side effects from hyaluronidase injection, and most are mild and transient.
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Aftercare Tips
Post-procedure care can reduce adverse events and maximize the effect of hyaluronidase injections. The first one is keeping the area clean and dry. Keep away from touching the injected area for 24 hours after the procedure to avoid infection or irritation.
Second, after the injection, one should avoid heavy exercises for a while and not be exposed to high temperatures or go for sunbathing, as such factors influence and worsen the condition of swelling and bruising. Light activities and comfort will help the body recuperate faster.
Cold compresses are a great way to reduce any kind of swelling and bruising, mainly in the initial days. Take an ice pack, wrap it in a towel, and press gently on the comfort of the treated area in intervals of 10-15 minutes.
Also, the site should not be massaged or pressed. Hyaluronidase takes time to dissolve the filler, and pressure interferes with the action of hyaluronidase, leading to **uneven
dissolution**.
Lastly, good hydration is a way to support the body’s metabolism of hyaluronidase. Since hyaluronic acid is part of how skin retains water, hydration helps your skin recover from a hyaluronidase treatment.
When to See Results
Hyaluronidase typically starts working and becomes noticeable in a period of 24 to 48 hours from injection. However, the time taken to recover definitely depends on the condition of the skin of the particular individual and the type of filler used. While one to two weeks can be enough for most patients to see the final result, deeper injections or greater volumes of hyaluronic acid fillers could take longer for complete recovery.
In general, the process of dissolving hyaluronidase is gradual: the volume of the filler will gradually reduce, and it takes some time for the skin to be restored to its natural state. If ineffective a few weeks later, one could make further adjustments according to the doctor’s advice.
Of note is that the effect of hyaluronidase is cumulative; therefore, even when one does not get the results that they want immediately, there is no need to worry. Most patients will have attained the desired improvement within one to two weeks following the treatment. If there is any concern during this time, then it is advisable to consult the doctor for evaluation and further adjustments.
By applying hyaluronidase, patients can rapidly treat the aesthetic problem caused by hyaluronic acid fillers. In fact, after having followed the aftercare given by the doctor, most of them will be able to have a natural recovery
