Dermal fillers attract over 3 million Americans yearly. These treatments offer a safe option, yet complications can emerge. Hylenex injection provides a reliable solution to reverse unwanted filler results. The active enzyme hyaluronidase in Hylenex has established a 15-year safety record in esthetic medicine to dissolve hyaluronic acid-based fillers.
Our patients feel more confident knowing their filler dissolution options. Hyaluronidase injections can tackle numerous complications. The treatment addresses minor esthetic concerns like overcorrection and asymmetry and manages serious problems such as vascular occlusion. This piece will walk you through Hylenex protocols, proper administration techniques, and methods to resolve filler-related complications.
What is Hylenex and How Does it Work
Hylenex is a purified preparation of recombinant human hyaluronidase that contains 447 amino acids with an approximate molecular weight of 61,000 Daltons [1]. We developed it as an FDA-approved injectable treatment, and each milliliter contains 150 USP units of recombinant human hyaluronidase [1].
The way Hylenex works involves a precise enzymatic process. It acts as an endoglycosidase and breaks down hyaluronic acid by splitting specific molecular bonds – the glucosaminidic bond between C1 of an N-acetylglucosamine moiety and C4 of a glucuronic acid moiety [1]. This action makes the cellular cement less viscous temporarily and helps spread injected materials.
Hylenex is different from other hyaluronidase products because:
- It’s the only FDA-approved hyaluronidase without animal-derived materials [2]
- Its recombinant formulation is 100 times purer than bovine preparations [3]
- It has minimal risk of allergic reactions due to its human-based composition [2]
Several factors determine how well Hylenex works. The enzyme starts working within 24-48 hours [3], and your body naturally restores native hyaluronic acid within 15-20 hours after treatment [3]. The rate and extent of dispersion directly relate to the amount of hyaluronidase used and the solution volume [1].
Hylenex targets only hyaluronic acid-based fillers. This means it can dissolve popular brands like Juvederm, Restylane, Belotero, Versa, and RHA fillers effectively [4]. But it’s worth mentioning that Hylenex doesn’t affect non-hyaluronic acid fillers like Sculptra or Radiesse [5].
The way Hylenex interacts with fillers depends on the hyaluronic acid concentration and the number of crosslinks in the filler [4]. The enzyme needs to be injected close to the filler location because it breaks down and becomes inactive in the body quickly [4].
Pre-Treatment Assessment Protocol
A full picture before hylenex injection will give optimal treatment outcomes and ensure patient safety. The foundations of successful treatment depend on understanding available products and protocols.
Different Types of Hyaluronidase Products
The market offers four main hyaluronidase products:
- Hylenex – synthetic, recombinant DNA product from human sources
- Vitrase – derived from pig products
- Amphadase – sourced from cows
- Hydase – sourced from cows [6]
Benefits and Applications in Esthetic Medicine
Hyaluronidase is a vital tool in esthetic practice that provides safe treatment for most hyaluronic acid filler complications [7]. Its immediate effect and 24-48 hour duration work well to address esthetic concerns of all types [7].
Patient Screening and Medical History Review
Drug history evaluation is significant before giving hylenex. Some medications can make tissues resistant to hyaluronidase [7]. These include salicylates, anti-inflammatories, cortisone, herbal medicines, heparin, vitamin C, estrogens, and antihistamines. Medical professionals should review all current medications and supplements carefully.
Identifying Filler Complications Requiring Dissolution
Medical professionals need to spot situations that need Hylenex intervention, especially when you have asymmetry, uneven appearance, or adverse reactions to fillers [6]. Patients with inflammatory nodules should receive antibiotic treatment one week before hyaluronidase to prevent infection spread [4].
Required Testing and Preparations
Skin testing might be optional for non-emergency complications [7]. All the same, patients with bee or wasp sting allergies should get intradermal testing from an allergist due to potential cross-reactivity risks [7]. The test needs a 0.02-0.05 mL hyaluronidase intradermal injection to create a 5mm bleb. Practitioners then watch for local reactions within 5 minutes [7].
Product quality depends on proper storage at cool temperatures (2-8°C) [4]. Users must use the product right after opening and dispose of any unused contents [4].
Expert Hylenex Injection Technique Guide
A successful Hylenex injection demands both precise technique and careful attention to dosing protocols. Practitioners must grasp how concentration relates to effectiveness before achieving optimal results.
Proper Dosing and Dilution Methods
Practitioners prepare the standard Hylenex concentration by diluting it with bacteriostatic sodium chloride 0.9%. This approach reduces injection discomfort [5]. Five units of hyaluronidase breaks down 0.1ml of 20mg/ml hyaluronic acid effectively [1]. Larger volumes of dilution enable more precise dosing for smaller required amounts [4].
Injection Depth and Placement Strategies
The procedure starts with full skin preparation and disinfection [1]. A 27G or 30G needle delivers the most accurate placement [4]. The needle should stay perpendicular to the skin’s surface during injection [4]. Our practitioners follow these steps to achieve optimal results:
- Palpate and mark the treatment area
- Use aseptic technique throughout the procedure
- Target specific nodules or areas of concern
- Massage the treated area post-injection
Multiple Treatment Area Considerations
Each anatomical site might need a different treatment approach. The treatment area size determines the diluent volume, which ranges from 1-10ml based on clinical evidence [1]. Areas with higher filler viscosity and cross-linking might need multiple treatments [1].
The enzyme reaches peak effectiveness within 24-48 hours [1]. Vigorous massage right after injection helps optimize results through mechanical breakdown [1]. Beauty Vault practitioners can evaluate the need for additional treatments during follow-up visits. These should happen at least two weeks apart [1].
The injection depth must match the filler material’s location to ensure success [5]. Some areas show resistance during injection, and practitioners must carefully penetrate nodules to achieve complete dissolution [5]. The filler’s specific characteristics and tissue distribution might require adjustments to the treatment protocol [4].
Managing Emergency Complications for Hylenex
Safe Hylenex administration depends on quick recognition and management of complications. Medical teams need to understand emergency protocols to ensure the best patient outcomes in tough situations.
Vascular Occlusion Protocol
Tissue necrosis can develop faster when vascular occlusion happens, so immediate intervention is vital [8]. A patient’s first signs of vascular compromise often include:
- Blanching or discoloration of skin
- Delayed capillary refill (beyond 3 seconds)
- Pain or coolness in the affected area
- Dusky or blue-gray appearance
- Immediate onset of severe pain
Medical teams should start a high-dose pulsed hyaluronidase protocol right after spotting these symptoms [9]. Treatment within 4 hours gives patients the best chance to prevent tissue damage [4]. Of course, you should inject 1,500 units of hyaluronidase, diluted with bacteriostatic saline or lidocaine, over the affected area [5].
Treating Acute Allergic Reactions
Allergic reactions to Hylenex are nowhere near as common as other complications, occurring in less than 0.1% of patients [10]. Medical teams should watch for signs of hypersensitivity carefully. These reactions can show up as chest tightness, difficulty breathing, or facial swelling [11].
The severity of the reaction needs quick assessment to implement the right interventions. Emergency medications should be accessible nearby [12]. Quick action is important since delayed treatment could lead to serious complications.
Emergency Response Guidelines
A well-laid-out approach works best in emergencies. Start by recording the affected area on video with good lighting [5]. Then mark and measure the whole region of ischemia. The CMAC board suggests vigorous massage after hyaluronidase administration to help mechanical breakdown [8].
Keep monitoring daily until you see satisfactory resolution [4]. Continue follow-up assessments if symptoms haven’t cleared completely. Detailed records of all interventions and patient responses throughout treatment help achieve optimal outcomes.
Post-Treatment Care and Monitoring
The success of Hylenex treatments depends by a lot on proper aftercare. Patients who understand the recovery process get the best results and face fewer complications.
Immediate Post-Procedure Instructions
Hylenex injections usually cause mild swelling, redness, or slight bruising at the injection sites [4]. Here’s everything you need to know about optimal healing:
- No makeup for 12 hours [13]
- Clean ice packs help manage swelling
- Leave the treated area untouched for 24 hours
- Skip alcohol
- Take a break from heavy exercise
Important: Your practitioner needs to know right away if bruising spreads beyond the injection area [14].
Follow-up Assessment Timeline
We check your progress within 48 hours after treatment [5]. The enzyme works to break down the dermal filler during this time. Your practitioner will review your progress and decide if you need more treatments at these follow-up visits.
The filler takes about two weeks to dissolve completely [15]. You should watch for these signs that need immediate medical help:
Urgent Warning Signs:
- Severe swelling or pain
- Unusual skin reactions
- Signs of infection
- Allergic responses [4]
Managing Patient Expectations
A clear understanding of the recovery timeline helps set the right expectations. Local reactions show up in 0.05 to 0.69 percent of cases [4]. Some patients might notice temporary overcorrection from natural hyaluronic acid loss, but this fixes itself in days [16].
You’ll see the final results after two weeks [16]. Your Beauty Vault practitioner will ask you to wait at least two weeks before trying new filler treatments [17]. This waiting period will give:
- Complete resolution of swelling
- A full picture of results
- Optimal tissue healing
- Better esthetic outcomes
Beauty Vault Med Spa offers tailored care and expert Hylenex treatments. Our board-certified practitioners give complete aftercare support and monitoring to keep you safe and satisfied.
Visit Beauty Vault Med for a Hylenex Lip Filler Treatment
Beauty Vault Med’s dedicated team excels in Hylenex injection treatments. We provide expert care in our modern, well-equipped facility. Our board-certified practitioners create individual-specific treatment plans that match each patient’s needs [3].
Our qualified team has years of experience with Hylenex treatments. We focus on getting the best results while keeping patient safety first [3]. Choosing the right provider for your Hylenex treatment is one of the most important decisions in your esthetic trip.
Here’s what makes Beauty Vault different:
- Modern technology and facilities that boost treatment precision [3]
- Care plans customized to your esthetic goals [3]
- Full pre-treatment consultations and assessments
- Detailed aftercare support and monitoring
Our expertise goes beyond simple filler dissolution. Our practitioners handle esthetic concerns of all types, from small adjustments to complete filler removal [2]. We look at each case and decide the best treatment approach based on your situation.
Your safety and satisfaction are our top priorities. Beauty Vault Med Spa regularly performs Hylenex treatments for patients who want filler dissolution or correction of previous treatments [2]. We follow strict protocols and use only FDA-approved products to ensure the best results.
Contact Beauty Vault Med Spa today to discuss your Hylenex treatment options. Our team is ready to help you reach your esthetic goals in a safe, comfortable environment. We serve patients across the Los Angeles area from our West Hollywood location with exceptional care and expertise [3]. Schedule a free consultation with us today.
FAQs
Q1. What are the common side effects of Hylenex injections? Common side effects include mild swelling, redness, and slight bruising at the injection sites. These effects are typically temporary and resolve within a few days.
Q2. How long does it take to see results after a Hylenex treatment? The enzyme’s effectiveness peaks within 24-48 hours after injection. However, the complete dissolution process typically spans two weeks, with final results becoming apparent after this period.
Q3. Is Hylenex safe for dissolving all types of dermal fillers? Hylenex is specifically designed to dissolve hyaluronic acid-based fillers like Juvederm, Restylane, and Belotero. It does not affect non-hyaluronic acid fillers such as Sculptra or Radiesse.
Q4. What should I avoid after receiving Hylenex injections? After treatment, avoid applying makeup for 12 hours, touching the treated area for 24 hours, consuming alcohol, and engaging in strenuous physical activities. It’s also important to postpone any new filler treatments for at least two weeks.
Q5. How does Hylenex compare to other hyaluronidase products? Hylenex is the only FDA-approved hyaluronidase without animal-derived materials. Its recombinant formulation offers 100 times higher purity than bovine preparations, and the risk of allergic reactions is minimal due to its human-based composition.
References
[1] – https://aestheticmed.co.uk/how-to-administer-hyaluronidase
[2] – https://beautyvaultmedspa.com/education/can-you-dissolve-reverse-a-lip-filler-a-guide/
[3] – https://beautyvaultmedspa.com/services/filler-injection-treatments/lip-filler-treatment-in-west-hollywood-ca/
[4] – https://pmc.ncbi.nlm.nih.gov/articles/PMC6011868/
[5] – https://pmc.ncbi.nlm.nih.gov/articles/PMC8570661/
[6] – https://www.sanovadermatology.com/dermal-fillers/what-are-the-different-typesbrands-of-hyaluronidase-used-to-remove-dermal-fillers/
[7] – https://pmc.ncbi.nlm.nih.gov/articles/PMC10836581/
[8] – https://jcadonline.com/cmac-guideline-hyaluronic-vascular-occlusion/
[9] – https://pmc.ncbi.nlm.nih.gov/articles/PMC3366448/
[10] – https://hylenex.com/important-safety-information/
[11] – https://www.mayoclinic.org/drugs-supplements/hyaluronidase-injection-route-subcutaneous-route/description/drg-20064183
[12] – https://www.aaaai.org/allergist-resources/ask-the-expert/answers/old-ask-the-experts/hyaluronidase
[13] – https://www.thebeautyclinic.la/blogs/news/hylenex-after-your-treatment-care
[14] – https://www.beyondharmony.com/hylenex-instructions
[15] – https://www.michelegreenmd.com/hyaluronidase
[16] – https://www.scottsdaleskinboutique.com/hyaluronidase-treatment-post-care/
[17] – https://www.dermatologist-nyc.com/blog/when-can-i-have-dermal-filler-after-hyaluronidase-timing-and-recovery-guidelines-42555/
