摘要

Objectives: This presentation will provide an overview of the elective uses of hylauronidase (HYAL) for reversing hyaluronic acid (HA) fillers, including management of misplaced product, micro doses for reduction of product volume to improve aesthetic outcome or mitigate swelling, as well as the resolution of early and late-onset nodules. The talk will also review ultrasound guided management of these issues Introduction: One of the key features of HA dermal fillers underlying their success is reversibility. The injectable enzyme HYAL cleaves the linkages between subunits of HA chains, including crosslinked chains present in HA gel fillers, rendering them prone to diffusion and further degradation by native hyaluronidases. In contrast to high-dose protocols for vascular compromise where repeated flooding of the area is needed to completely dissolve the product,2 elective use of HYAL requires a more tailored and/or targeted approach. Materials / method: Findings from the literature are coupled with the author’s clinical experience to develop a review of elective HYAL use. Results: This presentation will provide an overview of the elective uses of HYAL for reversing HA fillers, including management of misplaced product, micro doses for reduction of product volume to improve aesthetic outcome or mitigate swelling, as well as the resolution of early and late-onset nodules.Given that many patients presenting with issues which require the use of HYAL have been injected in other practices, ultrasound represents an especially important development for diagnosis and guided management of these issues. Conclusion: The activity of HYAL makes it a valuable tool for improving the overall safety of filler injection, as well as an important option for managing misplaced or excessive HA filler. Elective use of HYAL provides an important avenue for management of HA filler once it has been injected. Targeted doses, administered with ultrasound are a valuable approach for management of product misplacement and nodules.