A published journal article states that higher doses [of hy'dase] can lead to damage of native extracellular matrix glycosaminoclycans, leaving a gaunt appearance with poor skin texture (Figure 4). Patients are increasingly presenting with hyaluronidase-related damage, which is often untreatable.
Local injections of hyaluronidase can cause side effects such as local pruritus and allergic reactions. The incidence of allergic reactions is reported to be 0.05% to 0.69%, and urticaria and angioedema have also been reported to occur at a low frequency (less than 0.1%) [2,16].
Just like there are risks or adverse events associated with injecting dermal filler, hyaluronidase itself is not risk free as it can cause temporary discomfort of injection, redness, swelling, bruising and very rarely allergy.
Our skin and tissues are not broken down by injected hyaluronidase, however. Because our natural hyaluronic acid is turned over constantly by naturally occurring hyaluronidase, the effect of injected hyaluronidase on our body's natural hyaluronic acid is temporary.
Collagenase in combination with hyaluronidase was quite efficient at destroying the connective tissue matrix, although elastic tissue appeared to be completely spared. Collagenase alone at higher doses degraded collagen, but hyaluronidase had little effect on connective tissue architecture.
After a hyaluronidase injection, the skin will typically restore its hyaluronic acid levels within a few days or, in rare cases, over the course of a few weeks.
Hyaluronidase has also been shown to diffuse into the lumen of blood vessels even when injected external to it; for potential cases of necrosis due to intravascular deposition of hyaluronic acid, it is not essential to inject directly into the vessel—injection into the surrounding area is also likely to result in ...
Hyaluronidase was also used to dissolve the suspected filler in a second patient, and the third patient has elected to continue with observation. Conclusions: Filler migration is one of the potential complications associated with the injection of soft tissue fillers.
With the increase of cosmetic injectable hyaluronic acid (HA), there have been more cases with serious complications, including skin necrosis, blindness, and cerebral embolism. Patients who have recovered from HA filler-induced total vision loss are extremely rare.
Hyaluronidase most certainly will not cause nerve damage. Now it is possible that the needle used to inject the hyaluronidase can hit or pierce a nerve which can cause a bruised nerve and temporary problems.
Hyaluronidase doesn't spread so you won't have a problem with having it injected into your top lip while avoiding the marionette lines, which you do like.
Vascular Complications
The injection of the enzyme can cause blood vessels around the lips to become squashed, which leads to the tissue being deprived of blood. If this goes unidentified, it can cause the tissue to die (causing Necrosis) and can ultimately leave you with a nasty scar around the lips.
Injection of hyaluronidase into the fibrotic scar lesion was effective in improving the pliability, height, and pigmentation of the fibrotic lesions by breaking down the ground substance of the connective tissue [1]. The VSS is used primarily as an index of scar after external wound.
Hyaluronidase has immediate effect and a half-life of two minutes with duration of action of 24 to 48 hours.
Most patients experience minimal recovery time following an injection of hyaluronidase. Mild swelling, redness, and discomfort at the injection site usually resolve within 10 days. In some cases, there are some minimal limitations on strenuous activity following the procedure.
Common side effects
temporary redness or purplish tone, and swelling of the lips. mild bruising and bleeding around the injection sites. temporary bumps or lumps that may arise around the injection sites.
Avoid any heat-inducing activities for 24 hours such as strenuous exercise, spas, saunas and hot showers.
Although a quick intra-occular injection hyaluronidase has been successful in dissolving the filler and preventing permanent blindness, there is no agreed method for reversing central retinal artery occlusion from fillers.
Hyaluronidase works primarily on hyaluronic acid but to a lesser degree on other mucopolysaccharides in connective tissue such as glycosaminoglycans in the skin's extracellular matrix. It does not affect fibroblast activity or collagen in the skin itself (collagenase is an enzyme that degrades collagen).
You can have hyaluronidase as many times as needed. The most I usually do is 3x spread about a week apart.
Answer: DIfferent fillers require different doses of Hyaluronidase. Juvederm and more particalarly juvderm plus require higher doses of hyaluronidase to dissolve compared to other fillers. If the lumps are truly filler it is most likely a dosage issue.
A vascular occlusion is a potentially severe adverse outcome that can occur when hyaluronic acid filler is accidentally injected into a blood vessel.
Once necrosis starts, it cannot be reversed. But, the earlier the diagnosis, the sooner you can take steps to prevent the necrosis from spreading. Skin necrosis can be caused by hematomas or seromas: collections of blood or fluid that form under the skin.
Answer: Signs of necrosis
Luckily if treated in time, this is reversible and should not cause any permanent damage.
While it is largely unreported on in the press and in medical literature, many people suffer from injuries and other problems after having Hyaluronidase injections to dissolve lip filler gone wrong.