Hylenex is an injectable treatment used to reverse the results of injectable hyaluronic acid fillers. HA fillers are popular for their instant and natural-looking results. However, if the results are not to your liking or you want to return to your baseline, you may not want to wait for them to go away on their own. You may also have migration of your filler over time and prior to any additional filler procedures this will need to be dissolved to keep your appearance as natural as possible.
Hylenex is made with hyaluronidase, which is an ingredient that dissolves hyaluronic acid formulas. Hyaluronidase has immediate effect and a half-life of two minutes with duration of action of 24 to 48 hours. Once we start the process of injecting the hyaluronidase, the dermal filler in that area starts to break down and soften immediately. Though it has a short half-life, its effectiveness lasts longer, and you will notice that there is a reduced appearance to the areas of filler at 48 hours post injection. Some patients feel discouraged initially as the effects are confused by some of the swelling that occurs with hyaluronidase injection, again this should all start to settle and show effect by 48 hours.
Common areas that we find filler migration or visibility when we should not see filler product is the under eye and outside of the upper lip line.
Examples below:
Q: How many units will I need?
A: The number of units needed depends on the area being dissolved and what type of filler is being dissolved. In some cases, there needs to be multiple sessions of dissolving due to the amount and thickness of the original filler placed.
Q: Is it painful?
A: Hylenex does burn when it comes into contact with HA filler. If the dissolving is in the lips, we can do a dental block to numb the area completely or more conservative topical numbing.
Q: When can I get more filler after dissolving?
A: You will need to wait at least 2 weeks before refilling the same area.
Q: What is the cost?
A: $500.
Q: How long is the treatment?
A: A small patch test for Hylenex allergy will be administered to your forearm and will be evaluated 20 minutes after placement. If no reaction occurs, the dissolving will take place and is a very short procedure. You must stay in the clinic at least 30 minutes for monitoring post-treatment.
Q: Is this treatment safe?
A: All cosmetic procedures carry a certain risk, but dissolving filler is safe, and we take extra steps to ensure this. Some patients that have a history of bee or wasp allergies can have a cross allergic reaction with Hylenex. We do a small patch test with Hylenex on your forearm prior to injecting to determine the risk. We also carry epinephrine and other medications in clinic to use in an emergency if a patient does have an allergic reaction.
Q: Will I have loose skin in the area where the filler was?
A: Hylenex dissolves the hyaluronic acid filler, and this can at first leave you feeling a bit deflated. It can also reduce the natural hyaluronic acid in that area, but this is temporary. Once the swelling reduces from the dissolving injections and you begin to heal, your natural hyaluronic acid will return and attract water, restoring your natural volume. It is important to note that if a large amount of HA filler was originally placed, you may have laxity of the skin and treatments such as Microneedling with PRF or PDGF+ can be helpful to restore collagen and elasticity. Some patients are not candidates for filler replacement two weeks post Hylenex treatment due to the skin laxity.
Suggested Add-ons & Well Paired Treatments
PRF and/or Microneedling to restore collagen and elasticity.
PDGF+ to restore collagen and elasticity.