In cosmetic medicine, hyaluronidase is used to dissolve dermal fillers that have been placed incorrectly, excessively, or unevenly. It is also used in emergency situations where dermal filler has been inadvertently injected into an artery causing occlusion of the blood supply. It is injected into the vicinity of the dermal filler that needs to be dissolved. The action of hyaluronidase is very quick and starts to work immediately on the dermal fillers. The fillers are permanently dissolved and metabolised. Note that hyaluronidase does not work on permanent or semi-permanent dermal fillers.
Having hyaluronidase on hand during dermal filler treatment is compulsory, and may help to reverse adverse outcomes as a result of intra-arterial injection of fillers. Intra-arterial injection of dermal fillers can cause serious complications including death of the skin (causing scarring), and blindness. Hyaluronidase can be quickly injected into the area of occlusion to re-establish blood supply to help avoid complications.
The below image is an example of poorly injected dermal filler and excessive filler which over time has migrated out of the lip itself causing a “shelf-like/duck” appearance. The left image is before hyalase, middle image is straight after hyalase and the right is 2 weeks later. By dissolving filler it means that we can start again with dermal filler for a more aesthetically pleasing results.