Hyaluronidase in NYC

When done right, hyaluronic based dermal fillers look and feel great. But what if you have an unwanted side effect and the fillers don’t look the way they should? Hyaluronidase will save the day (and you)!

• Remove unwanted or displaced fillers
• Works 100% of the time over 24 hours
• Restore your original look
• No downtime & minimally invasive

FAST FACTS:

About: Hyaluronidase is an injectable medication to dissolve previously injected hyaluronic acid based dermal fillers, reversing unsatisfactory results, like overfilled lips or a lumpy or “botched” under eyes.

Safety: After several successful clinical trials hyaluronidase was FDA approved in 2005 to reverse the effects of hyaluronic acid filler injections and is safe when administered by a skilled and qualified injector or board certified cosmetic physician.

Convenience: Due to its minimally invasive nature, hyaluronidase injections require minimal to no side effects or downtime. In addition, the procedure itself is quick and efficient, making it convenient for anyone, especially for those who live in busy cities like NYC and have a limited and busy schedule.

Cost: On average, the cost of Hyaluronidase injections ranges $500 – $1500 per 1 session.

Efficacy: When administered properly by a board certified cosmetic physician, like Dr. Schwarzburg, Hylenex is clinically proven to be an effective method to reverse the effects of hyaluronic acid based dermal fillers.

HYALURONIDASE AND ITS EFFECTS EXPLAINED

Hyaluronidase, also known as Hylenex is an injectable enzyme naturally produced by the body to depolymerize hyaluronic acid, a glycosaminoglycan that is naturally responsible for lubrication of the skin and cushioning in the joints. Hyaluronic acid dermal fillers can be dissolved using hyaluronidase injections for people who are unhappy with their filler results. We’ve all seen botched lips, overfilled cheeks, and lumpy tear troughs. This can happen when filler is injected improperly or by an inexperienced injector, leaving you with puffy, lumpy, or asymmetrical results. If you’ve had a bad experience with a filler and wish you could go back in time – you can! Most facial fillers used in NYC are hyaluronic acid based, and can be dissolved using hyaluronidase.

HOW IS HYALURONIDASE MADE?

Hyaluronidase is a natural substance found in the body and can be extracted from cows or pigs or synthetically manufactured in a laboratory through bovine or human albumin sources. When taken from bovine or sheep testicles, the product is purified to avoid immune responses. The safest way for obtaining microbial hyaluronidase is currently through cultivating and harvesting of streptococcus agalactiae bacteria, which essentially eliminates most dangerous side effects. 

The primary manufacturer of hyaluronidase is Kraeber & Co GmbH, Bioindustria, and Bbi Enzymes. There are several brands including Hylenex, Hydase, and Vitrase, all of which are safe to use if administered by a board certified cosmetic physician. Dr. Schwarzburg uses exclusively Hylenex as he has found it to be the most consistently successful product across his wide range of patients at his medical spa on the Upper East Side of Manhattan, New York.

HOW DO HYALURONIC ACID FILLERS WORK?

Hyaluronic acid (HA) is a glycosaminoglycan (a sugar polymer) that is produced naturally by the body and serves as a component of the extracellular matrix of connective tissues, stimulates collagen production, and provides moisture and hydration in the skin. With HA dermal fillers, such as Juvederm and Restylane, hyaluronic acid is formulated into gel molecules using various cross linking technologies allowing for different consistencies and densities. These formulations allow for a wide selection of appropriate fillers for various regions of the face and body, lasting for several months to over a year. HA fillers can be used for volume replacement in areas that have lost facial adipose tissue under the eyes and cheeks, or to enhance certain features such as the lips. They are also injected along deep wrinkles and folds that cannot be addressed with Botox injections. When dermal fillers are used by proficient and board certified cosmetic surgeon, like Dr. Schwarzburg, hyaluronic acid gel can offer beautiful rejuvenation and facial enhancement. If administered by an inexperienced injector, adverse side effects or an overdone look may be the outcome, in which case Hyaluronidase is there for the rescue!

HOW DOES HYALURONIDASE WORK?

If you’re reading this and live in New York, then chances are, you got a filler shot and are unhappy with your results. Unfortunately, this can happen from time to time if your injections were administered poorly or by an inexperienced provider. Whether it be ducky looking lips, lumpy under eyes, or puffy cheeks, most filler brands used in the face are hyaluronic acid based – which is a huge plus, because you can instantaneously get rid of that oversized pout with Hylenex!

Hyaluronidase, is an enzyme naturally found in the body produced by white blood cells to navigate through connective tissues throughout the body. In order to break down hyaluronic acid gel molecules, hyaluronidase depolymerizes hyaluronic acid chains upon subcutaneous injection via microchannels in the interstitial matrix allowing fluids to enter through and dissolve the unwanted product. This phenomenon is called hydrolysis, which translates to the breakdown of hyaluronic acid. Hyaluronidase is the generic name of the enzyme and is commercially sold under various brand names including Hylenex, Vitrase, Amphadase and Hydase and can be injected to disintegrate any HA based filler within minutes, allowing patients to reverse unsatisfactory or botched filler results without damaging any of the natural occurring hyaluronic acid in the body. The process of hydrolysis occurs instantly and will be able to fully disperse the effects of the filler within 24 hours. 

WHAT MAKES HYALURONIDASE SO POPULAR?

We’ve all seen the increase in pouty lips, chiseled jawlines, and contoured cheeks on social media and in our favorite celebrities like Kylie Jenner and Bella Hadid. As a result, many of us have personally indulged in minimally invasive cosmetic treatments including injectable dermal fillers to enhance certain facial features, even out asymmetry, or replace lost volume under the eyes, in the midface, and cheeks. This is especially popular in large cities like New York and Los Angeles, where at attractive physical look is paramount both for personal and professional advancement.

Unfortunately, with the growing popularity of injectables, there is also a growing number of people who end up with botched, lumpy, bumpy, uneven, and overfilled outcomes, and hence, a rise in hyaluronidase injections to reverse them. 

Hylenex injections can instantly dissolve unwanted HA fillers safely and effectively when carried out by a board certified cosmetic physician, like Dr. Schwarzburg. At his NYC clinic, Dr. Schwarzburg treats many patients who want to get their lip fillers, under eye fillers, cheek fillers, or any other HA injection removed and reversed. In most of the cases at Skinly Aesthetics, these areas are then refilled with proper technique, leaving you with the beautiful results that you’ve been wanting for so long in the first place!

WHAT AREAS CAN HYALURONIDASE BE USED ON?

Hyaluronidase can be used on any hyaluronic acid based dermal filler injection whether it be in the lips, jawline contouring, or a non-surgical rhinoplasty. It can also be used for a variety of medical applications, such as hypodermoclysis, a treatment used to infuse fluid through subcutaneous tissues in pediatric medicine. This helps increase the diffusion of other pharmaceutical agents such as medications and anesthetics in children. In some cases it may be administered in cancer patients undergoing chemotherapy, for vitreous hemorrhage and extravasation, which is described as fluid leakage to circumvent damaged dermal cells. Below are the many applicable uses for Hylenex injections.

Medical Applications: The product can be used to absorb and diffuse injected pharmaceutical products and drugs in addition to subcutaneous fluid hydration therapy (hypodermoclysis) and urography for better radiopaque agent absorption. In some cases, hyaluronidase can be used to manage extravasation from intravenous lines and as an addition to local anesthetic for ophthalmic surgeries.

Cosmetic Applications: When it comes to cosmetic medicine, Hylenex is best known for its ability to counteract the effects of dermal filler mishaps, though it has also been used off-label to treat keloid scarring.

Facial regions injected with hyaluronic acid that are often dissolved with hyaluron include the suborbital region, under eyes, and cheeks, midface, such as the nasolabial folds, liquid rhinoplasties, overfilled or asymmetrical lips, chin, or jawline contouring. 

Keep in mind that this hyaluronic acid antidote does not work on dermal fillers that aren’t HA based, such as Radiesse or Sculptra. It is best to schedule a consultation with Dr. Schwarzburg at his medical practice in NYC beforehand to confirm that your filler can be undone with hyaluronidase.

WILL HYALURONIDASE DISSOLVE MY FAT OR HYALURONIC ACID IN OTHER TISSUES 

No, hyaluronidase can only target free floating hyaluronic acid (only found in HA fillers) and is unable to break down fat or any other cells. If you are looking for an injectable method to melt away chin fat for example, Kybella is a wonderful option. The medication is made of deoxycholic acid and can be injected into adipose tissue to permanently destroy preplatysmal fat cells which are responsible for double chin appearance.

BEST CANDIDATES FOR HYALURONIDASE INJECTIONS

If you got a filler recently that isn’t to your liking, or have some excess product that has been lingering for longer than you wanted, then hyaluronidase might be your answer. The first step is to confirm with Dr. Schwarzburg whether the filler you have is HA based. If it is not, then hyaluronidase will not work for you. Hyaluronic acid gel typically is metabolized by the body over the course of several months to a year. However, there are some cases in which they can last for years  – under eyes are exceptionally notorious for that because infraorbital fat is relatively avascular with low metabolism. Regardless, you will be able to dissolve your botched filler even after years of the product sitting in the treated area as long as it is composed of hyaluronic acid. 

Conditions that may disqualify you from filler dissolving injections include anaphylaxis, certain medications, or an allergy to an ingredient within the product. It is best to disclose all of your medical history to Dr. Schwarzburg when you visit his medical office in NYC to confirm that your Juvederm filler dissolver is appropriate for you.

IS FILLER REMOVAL NECESSARY?

Hyaluronic acid fillers are gradually metabolized by the body over the course of several months. Being that they are not permanent, you don’t necessarily have to get your filler removed, but if you feel like your results are impeding on your life, making you feel self-conscious to the point that you don’t even want to leave your home, then go for it! Hyaluronidase is safe with zero downtime and little to no side effects and is essentially risk-free. Ultimately the decision is yours; if you want to give it a few weeks or months to see if you feel better about everything before opting for a dissolvant, then wait. If you can’t stand the way you look because of your dermal injections, then your best move is to find a reputable provider, preferably a board certified physician, who can safely and successfully undo your injections.

RESOLVING AN ALLERGIC REACTION TO HYALURONIC ACID WITH HYALURONIDASE

Yes! It is extremely rare for anyone to have hypersensitivity to hyaluronic acid, as it is a glycosaminoglycan sugar derived product that is naturally produced by the body. Nevertheless, in the unlikely occasion that you do have an allergic reaction to the HA product, hyaluronidase can be used to disintegrate the filler, mitigating the allergic reaction. NYC based physician Dr. Schwarzburg explains that depending on the severity of your reaction, you may need additional treatment or steroid medications to fully rectify the issue.

PREPARING FOR HYLENEX TREATMENT 

In terms of preparation, there is nothing you need to do before getting your dermal filler reversed for good. Dr. Schwarzburg recommends that you discontinue blood thinners and alcohol 2 – 5 days before your treatment, as they can exacerbate bleeding and bruising.

PROCEDURAL PROCESS FOR HYALURONIDASE INJECTIONS AT SKINLY AESTHETICS IN NYC

Before the dissolving process can begin, you will have a consultation with Dr. Schwarzburg in which you will discuss the area of concern, your medical history, and aesthetic goals. He will take this time to examine the area to confirm how much filler is present and how much product is needed to get rid of it. Additionally, he will have to confirm that the filler in question is in fact a HA based product, suitable to dissolve using hyaluronidase. 

Once you are a confirmed candidate, Dr. Schwarzburg will sanitize the treatment area with alcohol and apply a topical lidocaine containing numbing agent on a case by case basis, Once the numbing cream has settled, the injection process can begin. Using a very fine needle, typically 30 gauge, Hylenex will be strategically injected into the treatment area within 10 – 20 minutes time. Your filler will begin to disintegrate instantaneously and you are free to go with no restrictions post-procedure, unless you develop an immediate allergic reaction.

IS HYALURONIDASE PAINFUL?

Most patients feel a pinching or stinging sensation during the injection process, though it is overall well tolerated with minimal to no pain. For those who have a very low pain threshold, a topical numbing agent is applied beforehand to minimize discomfort. Because the injection process only takes a few minutes, the pain experience will only last as long as the treatment itself. You shouldn’t feel any discomfort beyond the injections once complete, though over-the-counter pain pills may be taken to relieve any tenderness if applicable.

HOW LONG DOES HYLENEX INJECTION TAKE TO PERFORM?

The injection process itself is typically very quick when it comes to hyaluronidase and takes between 5 – 15 minutes. This largely depends on how much product needs to be injected and the area in question. Some patients need a few minutes in between injections to take a sip of water or take a quick breather if their pain tolerance is below average. If there still seems to be some product left within 3 – 5 days post treatment, you may come back for more hyaluronidase.

HOW MUCH HYALURONIDASE WILL I NEED? HOW MANY SESSIONS DOES IT TAKE TO REVERSE DERMAL FILLER?

The average dose is a 1 mL vial of hyaluronidase to dissolve 1 mL of dermal filler. The total amount of product and number of sessions needed are different in each individual case. If you have some asymmetry that you want to even out, or a small lump on your lip, you may only need 0.5 mL of Hylenex, whereas reversing years worth of repeated cheek filler injections may take several vials of hyaluronidase. The type of filler may affect the amount of hyaluronidase needed as well, as a denser, more cross-linked HA filler may require more product in order for intramolecular bonds to be accessed and broken down.

The best way to find out how much you need, is to have a physical consultation with Dr. Schwarzburg in his office in New York, so he can determine how much hyaluronic acid will need to be dissolved.

HOW LONG DOES IT TAKE TO SEE HYALURONIDASE RESULTS?

The process of hyaluronic acid depolymerization is triggered immediately upon injection as hyaluronic acid gel particles are broken down. You will be able to observe the reduction in volume of the treated area within several hours after your appointment, or on the following day. While Hylenex works its magic instantaneously, injections may puncture small blood vessels or irritate the treated area causing minor hematomas and inflammation for up to 2 – 5 days, which may disguise the final result until fully healed. Once this point is reached, you will come in for a follow-up appointment to confirm that all HA gel is eliminated. If there is anything left, additional dissolvant will be administered at Dr. Schwarzburg’s discretion.

WHAT WILL MY HYLENEX BEFORE AND AFTER RESULTS LOOK LIKE?

Everyone has their own unique reason for wanting to dissolve their dermal fillers. You may be stuck with asymmetrical lips or cheeks, an overfilled chin, or generally botched dermal filler. Maybe you got a non-surgical rhinoplasty and realized that you liked your nose better before, or your filler migrated and doesn’t look the way it should. Whatever your reason, hyaluronidase has the ability to reverse any hyaluronic acid based dermal filler, whether it be due to an unsuccessfully administered injection or due to personal discontent with the outcome. After hyaluronidase has settled and broken down the filler, the treated area will appear and feel just as it did before the HA filler was injected.

HOW LONG DOES VITRASE LAST?

Once the filler dissolving enzyme has been successfully administered, hyaluronic acid gel molecules are permanently depolymerized and eradicated. If another filler is injected immediately after your hyaluronidase procedure, the new filler will also get dissolved immediately. Hence, it’s important to wait at least 24 hours before getting a new HA filler injected. 

HOW LONG UNTIL MY FILLER IS DISSOLVED? CAN I GET MORE ONCE IT’S GONE?

Hylenex takes effect instantaneously upon injection. You will notice the disintegration of your filler over the following 24 hours, though it often takes up to 2 days to observe final results as the injection itself may cause minimal edema and bruising which may disguise the effects of the product until fully healed. Hylenex will not prevent a new dermal filler from working, meaning that you are able to get more filler after your treatment, but only after the old filler is gone, which can take up to 48 hours. If a new filler is injected immediately after Hylenex injection it will get dissolved as well. In fact, Dr. Schwarzburg frequently assists his patients from New York and other states who are unsatisfied with their results from previous injectors, dissolves their current lip and cheek fillers, and revises the problem area himself with proper technique to fix any prior filler mishaps.

AFTERCARE FOR HYALURONIDASE

There is no aftercare for hyaluronidase as side effects are minimal to none. On your first day, you will be provided with an ice pack to minimize any possible swelling. In some cases, minor bleeding under the skin may occur, in which case a hot compress can be applied on day 2 to reduce bruising and speed up the healing process for optimal results.

WHAT ARE THE RISKS AND SIDE EFFECTS ASSOCIATED WITH HYLENEX FILLER DISSOLVING MEDICATION?

Dissolving a filler comes with very limited risks and side effects. As any other injectable, hyaluronidase poses the mild risk of punctured blood vessels causing temporary hemorrhage or bleeding underneath the skin. This bruising can last 3 – 5 days and has no further consequences once healed. 

Hypersensitivity related swelling and erythematous edema or inflammation, do infrequently occur due to impurities present in hyaluronidase or if it was manufactured from organic sources. Dr. Schwarzburg warns his NYC patients that the adverse effects can be so severe the entire face can swell up and look like a pumpkin. If you have a strong reaction resembling anaphylaxis it must be immediately treated with an intramuscular dose of steroids or IV Benadryl. Minor hypersensitivity reactions can be treated with ice and will subside within 2 – 24 hours. Keep in mind that hyaluronidase injections have a minor and very rare risk of pruritus and allergic reactions, with only 0.05% of reported incidents. As long as the drug is administered by a skilled and experienced board certified physician, the possibility of complications is limited.

WILL HYALURONIDASE AFFECT MY BODY’S NATURAL HYALURONIC ACID?

No! Dr. Schwarzburg frequently addresses a common fear and misconception amongst his patients from New York that Hylenex will dissolve hyaluronic acid beyond the gel filler itself and affect the body’s naturally occurring hyaluronic acid. This has been clinically tested and proven to be untrue. The human body produces various forms of hyaluronidase in the organs, body fluids, plasma, and bone marrow. The type of hyaluronidase used to dissolve dermal fillers specifically targets hyaluronic acid gel molecule cross linkage, which does not exist in the body’s natural tissue. In other words, because the hyaluronic acid produced by the body is contained within individual cells and is not freely floating, as a gel filler is, it remains unaffected by Hylenex. 

ALTERNATIVES TO HYALURONIDASE

Hyaluronidase comes in many forms and is sold under various brand names including Hylenex, Vitrase, Hydase, and Amphadase. Hyaluronidase is the only effective hyaluronic acid filler dissolvant, if you want to get rid of your filler as quickly as possible. You might be wondering if your puffy cheeks will stay around for a long time and how to dissolve filler naturally, speeding up the process without another injection. HA fillers can take 6 months to 2 years to be metabolized by the body, so it’s up to you whether you want to wait it out or get Vitrase injections.

In some cases, promptly upon injection, filler can be aspirated using a larger bore needle, which is the process of manually pulling the filler back out using a syringe as a suctioning tool by pulling back on the plunger. However, this only works in rare cases in which you change your mind during the injection process and will not be a possibility if you’ve had the filler for over a few minutes as it gets dispersed through the tissues.

CAN I GET FILLER AGAIN AFTER HYLENEX?

Yes! You can get a new filler after dissolving an old one and refill the treated area for a more favorable result. Dr. Schwarzburg frequently sees patients who come in to get an older filler removed and replaced using his advanced injection techniques for optimal aesthetic outcomes. You will need an evaluation 2 days post-treatment to confirm that no additional rounds of Hylenex are needed before adding more filler, and that both swelling and bruising have subsided for ultimate accuracy while injecting the new product.

HYALURONIDASE COST – HOW MUCH DOES HYLENEX COST IN NYC?

The cost of a hyaluronidase treatment in New York is completely variable and can range anywhere from $500 to $2000 or more per single session. This is based on several factors, including how much product needs to be dissolved, the type of filler and its density, and the qualifications and level of expertise of your provider. Your geographical location may also play a role, as larger cities such as NYC generally tend to charge higher than more suburban areas. 

IS IT COVERED BY INSURANCE?

Hyaluronidase can be used medically in which case it may be covered by insurance. However, used cosmetically to reverse the effects of a dermal filler, it is not covered by insurance as it is not medically necessary. At Skinly, we do accept flexible spending FSA and HSA cards as well as certain payment plans!

DOES HYALURONIDASE WORK? IS IT SAFE?

Yes! Hyaluronidase has been clinically studied and proven to be extremely effective in dissolving unwanted hyaluronic acid based dermal fillers via intradermal injection. There are several brands that may be used for this purpose, all of which work to break down HA gel molecules within 24 hours. The treatment is offered by most medical spas but should be administered by a board certified plastic surgeon, like Dr. Schwarzburg at his clinic on the Upper East Side of Manhattan, NYC to ensure the procedure’s safety and efficacy. Hyaluronidase is FDA approved and safe to inject and does not affect your skin or naturally occurring hyaluronic acid.

HYALURONIDASE PROS AND CONS

Hyaluronidase comes with many benefits, primarily being the best product in NYC to dissolve fillers instantaneously. The treatment is minimally invasive leaving you with zero downtime and limited to no risks and side effects. The only downsides are that hyaluronidase can only dissolve hyaluronic acid based fillers, meaning that it will not work on Poly-L-lactic acid based, or calcium hydroxylapatite fillers like Sculptra or Radiesse. In addition, it is possible that more than one session will be needed to fully get rid of any remaining HA product.

WHERE CAN I BUY HYALURONIDASE IN NEW YORK?

Hyaluronidase is a controlled medication and is only distributed by manufacturers to licensed medical professionals and doctors in NYC and all other states. The administration of hyaluronidase is only possible when performed by a board certified cosmetic physician or another qualified professional in NYC. If you do not have the medical qualifications necessary to purchase or administer hyaluronidase, you will have to seek out a reputable provider who will carry out the treatment for you. Skinly Aesthetics on the Upper East Side of Manhattan is one of the best hyaluronidase practices in New York.

TAKEAWAY

Hyaluronidase is an injectable enzyme that depolymerizes hyaluronic acid fillers by accessing intramolecular bonds within the HA. Upon injection, the product directly begins to break down HA gel molecules, fully disestablishing the hyaluronic acid product within 24 hours. Minor swelling and bruising may occur for the first 3 days, though risks and side effects are otherwise limited, making the treatment safe and effective when performed by a board certified plastic surgeon like Dr. Schwarzburg. Whether it be to dissolve a poorly placed under eye filler, a small lump on the lips, or a change of heart after a non surgical rhinoplasty, hyaluronidase will successfully dissolve any HA based filler.

WHERE CAN I GET MY HYALURONIDASE TREATMENT IN NYC?

Are you unhappy with your HA filler results? Maybe your lips turned out ducky or uneven and you never want to go back to the place you got them done – don’t worry, Dr. Schwarzburg at Skinly Aesthetics is here to help. At his beautiful NYC medical spa located on the Upper East Side of Manhattan, New York, Dr. Schwarbzurg is board certified with over a decade of experience in minimally invasive cosmetic treatments, injectables, and of course, dissolving them! No matter what your concern is, Dr. Schwarbzurg will give you a thorough consultation and evaluation to make sure that you can reverse your unsatisfactory filler results and get them redone properly if you’d like. Dr. Schwarzburg’s top priority is the safety of his patients, which is why a one on one consultation is where you need to start so he can have a full understanding of the issue at hand and treat your unique concern with the utmost care and cater your treatment to your individual needs. You can schedule your one on one consultation with Dr. Schwarzburg via text or call at (212) 774-4264 or email the clinic at info@skinlyaesthetics.com.