Dissolving hyaluronic acid.

Hyaluronidase is an enzyme that splits hyaluronic acid into small fragments the body breaks down quickly. A small amount is injected directly into the area where the material lies. The effect starts within minutes to hours; the final picture shows after one to two days.

When it is used: for over-correction or asymmetry, for nodules or hardening, for material that has migrated, and – as an emergency measure – when a vascular occlusion is suspected. In the latter case every hour counts, which is why hyaluronidase belongs in every practice that injects fillers.

What it cannot do: hyaluronidase only dissolves hyaluronic acid. Other fillers (such as calcium hydroxylapatite or polylactic acid) and fat transfer cannot be removed with it. The body's own hyaluronic acid in the tissue is temporarily broken down as well – the area can briefly look a little 'emptier' than before the filler treatment. This usually evens out within a few weeks.

Process: examination, consultation, with some products an allergy test, then injection in small steps. Often not everything is dissolved at once but in stages, to avoid removing too much. A new filler treatment is usually possible after two to four weeks.

Risks: swelling, redness, bruising; rarely allergic reactions up to anaphylaxis – which is why it is only used by a physician with emergency equipment. Particular caution applies with a known bee or wasp venom allergy.