Objectives: To understand the potential causes of non-vascular hyaluronic acid filler complications and the way to use hyaluronidase in a sefe way to mend these complications
Introduction: Hyaluronidase (HAse) is your best friend when working with hyaluronic acid (HA) fillers. It is an emergency drug for vascular complications and it should be in your office at any time during treatment. For other HA filler related complications, time is not so essential. But the use of HAse remains the cornerstone of therapy.
Materials / method: In Erasmus University Medical Center we deploy out-patients clinical hours for filler complications. The long-banned non-resorbable (permanent) fillers are most frequently sees as group of offending substances. HA fillers seems to be quite safe. We estimated that about 50% of the HA fillers complications that are referred are caused by flaw in technique of the doctor. A smaller percentage forms the HA filler injections in the vicinity of permanent fillers. These lead to inflammatory reactions that are difficult to mend. Seldomly we acute swelling after treatment or a late-onset inflammation.
Results: Most of the patients from the latter groups have already been treated with HAse by their physician with none or without much effect. We treat them with ultrasound guided injections of Hase. Probably this works better than random injections, since most of our patients are cleared from symptoms after 3-5 treatments. HA fillers longer in situ react more poorly.
Conclusion: Hyaluronidase seems to be exceptionally safe, but we recently saw one patient with slimming of the nose following a small dosage of Hase injections.
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