TL;DR:
- Hyaluronic acid treatments are effective but should be done by qualified specialists to handle complications properly.
- Hyaluronidase is an enzyme that dissolves hyaluronic acid, treating complications like granulomas, vascular issues, and bacterial infections.
- It breaks down molecules, aiding absorption and spreading substances in the body, but can trigger allergic reactions, especially in those allergic to bee venom or bovine protein.
- Procedure steps: review medical history, disinfection, optional allergy test, and enzyme injection using a thin needle. Effects appear in ~72 hours.
- Uses: Treat skin necrosis, asymmetry, lumps, biofilms, filler displacement, and allergic reactions.
- Contraindications: Allergies (insect venom, bovine protein), infections, and skin damage.
- Visible improvement occurs in 1-7 days, and full results are evaluated after 72 hours. Safe if performed by experienced doctors.
Hyaluronic acid treatments are very popular and provide satisfactory results. However, there are cases in which hyaluronic acid was injected by an unqualified person and caused some damage. Performing implants using hyaluronic acid should be done by specialists who are familiar with the treatment of adverse reactions after injecting the acid. In the situation of complications after the applied hyaluronic acid, the use of aesthetic hyaluronidase, which dissolves excessive amounts of the injected filler, proves to be very helpful. Among its most important uses are the treatment of granulomas, vascular complications and biofilm-type bacterial infections.
Hyaluronidase what is it?
Hyaluronidase comes from a group of enzymes and has the ability to depolymerize – break down molecules such as hyaluronic acid. This happens by breaking chemical bonds, which directly results in the breakdown of hyaluronate molecules and accelerates its biodegradation. It also has the effect of facilitating the spread and increasing the absorption of foreign substances in the human body. Hyaluronidase is produced by some cells in the human body, including bacterial ones. It is also found in insect venom (wasps, hornets, bees) and bovine protein. Hyaluronidase is one of the main allergens of bee venom. It finds great application in aesthetic medicine.
Course of the hyaluronidase procedure
Before the procedure, it is necessary to take a detailed medical history to ensure the proper course of the procedure. You come to the procedure without makeup (or wash it off immediately before), and the doctor begins to disinfect the area where the enzyme is to be administered. If there are absolute indications for the administration of hyaluronidase (such as health-threatening skin necrosis), then the enzyme is administered without performing a sensitization test. In other cases, when there is time, the doctor performs a sensitization test. A small amount of hyaluronidase is applied to the forearm area. The area is then observed to see if there is any adverse allergic reaction. If there is nothing wrong, after 15 – 30 minutes, the hyaluronic acid can be dissolved. Hyaluronidase is applied using a very thin needle. The application is made in the area where the filler was previously injected – such as the lips, nasal area and cheeks. A small amount of the substance is injected directly into the lump formed after the injection of hyaluronic acid. Sometimes there may be slight swelling or bruising after the application of the enzyme, which disappears very quickly. Some patients react to the application of hyaluronidase with a local inflammatory skin reaction, pruritus, urticaria or microangiitis. The first effects become apparent after 72 hours – this is how long hyaluronidase takes to work.
Indications
The main indications for hyaluronidase in aesthetic medicine mainly concern complications after the administration of hyaluronic acid or the dissolution of an improperly selected filler. It is also recommended for:
- Threatening necrosis of the skin and subcutaneous tissue caused by the administration of hyaluronic acid,
- Visual disturbances,
- Violent allergic reaction,
- The occurrence of granulomas,
- Asymmetry,
- Biofilm formation,
- Occurrence of intolerance of the body to previously administered hyaluronic acid,
- Unwanted displacement of the filler,
- Administration of excessive amounts of hyaluronic acid filler,
- Persistent swelling due to water retention at the filler application site,
- Appearance of lumps and bumps caused by too shallow previous administration of hyaluronic acid.
Contraindications
Application of hyaluronidase enzyme is not always possible. Contraindications to the procedure include:
- Allergy to insect venom (bees, wasps, hornets) or to bovine and ovine protein,
- Damage or ulceration of the skin surface in the treated areas,
- Fungal, viral and bacterial infections.
Effects
For the first 6 hours after treatment, do not touch the treated areas. ** However, within 72 hours after the procedure, it is not recommended to massage, rub or rub the treated areas**. Hyaluronidase works virtually immediately. The full effect of the treatment becomes apparent after 72 hours. The hyaluronidase enzyme dissolves both hyaluronic acid in the form of a filler and its own – natural hyaluronic acid present in the skin. This process takes up to 3 weeks, followed by gradual restoration of the defect. Visible improvement in skin condition usually occurs 24 hours to 7 days after the enzyme application. The body should excrete and metabolize hyaluronidase within a week of treatment. One treatment performed should be sufficient to achieve a satisfactory result. In some cases, it can be repeated. 72 hours after the procedure, the aesthetic physician evaluates the results obtained. After this time, he may decide to reapply the enzyme. This procedure is carried out even after several months after the injection of hyaluronic acid filler. In this case, however, one should expect a much lower effectiveness of the procedure.
Safety of the procedure
The enzyme injection procedure itself poses no risk to the patient, provided that it is performed by a specialist in aesthetic medicine. Like any interference with the body, the administration of the enzyme is also subject to some risk of adverse events. The most dangerous consequence of using the enzyme is an allergic reaction. It can take a life-threatening form. This is why it is so important that this procedure is carried out by an experienced doctor. After the administration of hyaluronic acid, a blockage of a blood vessel can occur. If this happens, hyaluronidase should be administered immediately under full anti-embolism protection.
Conclusion
Hyaluronidase is a powerful tool in aesthetic medicine for treating filler complications. It effectively dissolves excess hyaluronic acid, fixes issues like granulomas or asymmetry, and prevents serious risks like necrosis. However, its success depends on skilled administration by a qualified doctor to ensure safety and proper outcomes. While results are often quick, the procedure requires careful medical evaluation. Trust only experts for this treatment—your health and satisfaction rely on it.
