Making adjustments to fillers is nearly as much as an art form as injecting fillers to begin with. Because of his surgical skill and his artistic cosmetic abilities, Dr. Rueckl is often sought after to fix fillers gone awry from other injectors. There are issues, particularly in Nevada, with under-experienced injectors doing fillers, which can lead to various problems including over- or under-filling, putting fillers into the wrong facial contours, using the wrong types of fillers, blocking blood flow, and generally creating odd looks. It is our opinion at Lakes Dermatology that you should always seek a board-certified core injector for your fillers, and not shop for the cheapest price, but instead, the most experience. Like all filler injections at this office, adjustments to fillers will only be done by Dr. Rueckl.
If you have had fillers that need adjustment, Dr. Rueckl is skilled at doing many types of corrections. Hyaluronidase only works on fillers that are composed of hyaluronic acid. In cases where you don't have hyaluronic acid filler, but instead have RADIESSE®, Sculptra, or even silicone, Dr. Rueckl has surgically removed and corrected many issues with these. A consultation would be needed if you need this type of procedure because each case is unique. However, if you have had hyaluronic acid fillers, like Restylane®, JUVÉDERM®, Belotero, or others, hyaluronidase is an injectable enzyme that breaks down these types of fillers with a more simple procedure.
What is hyaluronidase and what does it do?
Hyaluronidase is an enzyme (compounded by special pharmacies) that causes hydrolysis (breakdown) of hyaluronic acid. It is often referred to as a reversal agent for hyaluronic acid-based fillers. When the enzyme is injected it dissolves the synthetic hyaluronic acid filler, leaving your own intact.
In some cases, for full correction of fillers, Dr. Rueckl may recommend fixing your filler by adding another syringe(s) of filler into one area, and removing some filler from another. This is recommended when filler is placed into the wrong area to begin with. You cannot have additional filler added and get hyaluronidase on the same day—the enzyme doesn't know which filler is new and which is old, and it will start dissolving both. Therefore, if you need more filler added, as well as some taken out, multiple visits will be required. This is often the case with filler correction.
Where is hyaluronidase used?
Hyaluronidase is used to dissolve hyaluronic acid fillers that have been placed incorrectly, excessively, or unevenly. It is injected into the same locations that the filler already is. It does not remove all of the filler entirely, and Dr. Rueckl will decide how much hyaluronidase to inject based on how much filler needs to be removed.
What is a hyaluronidase treatment like?
Hyaluronidase is injected, along with lidocaine (and sometimes epinephrine), into the area where the filler needs to be dissolved. The injection is very easy for most people to tolerate, but it can sting a bit, so the lidocaine is used for numbing purposes to alleviate this sensation.
There have been a few reports that some people may have an allergy to hyaluronidase, which happens to those who are allergic to bee stings. We have never had anyone have an issue with hyaluronidase injections in this office. The most common side effect is bruising, which can happen with any type of injection. Bruising should resolve within a week or two.
The most difficult aspect of using hyaluronidase is judging the amount required to dissolve a certain amount of filler, so over- or under-dissolving can occur, which means you may need to return to the office for follow-up procedures. Remember that it's nearly as much of an art to remove filler as it is to inject it in the first place.
What kind of results can I expert from a hyaluronidase treatment?
Hyaluronidase works very quickly, with most of the effect taking place within 24 hours. You should be able to see defined improvement and less filler in the area injected, beginning within a few hours.
After a few days if you still have areas that need correction, you can see Dr. Rueckl for another round of hyaluronidase, or for additional syringes of filler to be added. Remember that you cannot have hyaluronidase done and additional filler added into the same area, on the same day.
How much does a hyaluronidase treatment cost?
Each round of hyaluronidase costs between $100-$200 for the enzyme injection, depending on how much is needed. It may require more than one session to achieve adequate filler dissolving. Adding any additional fillers would cost the regular prices of those syringes, on another day.