The Aesthetic Practitioner’s Essential- Hyaluronidase

Hyaluronidase is an important product aesthetic practitioners will no doubt keep stock of. It is used to dissolved Hyaluronic acid or reverse the procedure of dermal fillers.

The most serious complications of vascular occlusions require the administration of  Hyaluronidase , as this enzyme is the only way to remove HA without damaging the skin’s layers.

Hyaluronidase is also used to correct aesthetic procedures if the patient is not happy with their results. Although HA breaks down naturally over time and is not a permanent anti-ageing or volume-increasing solution, there may be reasons for why a practitioner needs to dissolve it sooner.

Hyaluronidase dosage depends on several factors based on the individual filler’s characteristics, for example, if it is monophasic or biphasic, how much cross-linking there is and the concentration of hyaluronic acid.

The Aesthetics Complications Expert (ACE) Group recommendation is to inject as much hyaluronidase as required to achieve the required results, rather than following a specific dosage.

In support of this, many practitioners report that they have always had to inject a lot more hyaluronidase than is described in guidance. This is particularly true in removal of lip fillers and emergency procedures.

For lip procedures, instead of injecting 15-30 units as per guidance for the perioral skin, injectors are using higher doses from 150 units.

How do different fillers behave to Hyaluronidase?

Fillers with the highest content of HA are the most resistant to degradation as compared to fillers with lower concentrations. Monophasic gel was comparably sensitive to degradation than biphasic gel. High cross-linked fillers also have stronger resistance to the enzyme.

It is always important to know what filler has been injected to ensure Hyaluronidase gives the best results when it is most needed. 

Hyaluronidase is available from Filler World/eprescription.