Hyaluronidase: how to dissolve a hyaluronic acid filler

A guarantee that no clinic should be without

One of the biggest advantages of hyaluronic acid, compared to other dermal fillers, is that it is reversible. If a treatment is overfilled, asymmetrical, poorly positioned, or if there is a complication, there is a medical tool that can dissolve it: hyaluronidase, an enzyme that breaks down injected hyaluronic acid and allows the body to reabsorb it.

It is, literally, a clinical safeguard. And that is why, at Santé Clinics, we always have hyaluronidase available and a clear protocol for its use, both for aesthetic corrections and emergencies.

What is hyaluronidase

Hyaluronidase is an enzyme that breaks down the bonds of hyaluronic acid. When injected in a controlled manner into an area with filler, it degrades the product and prepares it for natural elimination. The body absorbs the fragmented hyaluronic acid within hours or days.

It is a regulated medical drug, administered exclusively by medical personnel. Its use is common and safe in expert hands, but requires anatomical knowledge and a dose adjusted to the product and the area.

When it is used

1. To correct an unsatisfactory result

• Obvious asymmetries after treatment.
• Overcorrection: faces with too much product, losing naturalness.
• Product migration to an area where it should not be.
• Small nodules or palpable irregularities.
• A “deformed” or artificial appearance accumulated after several years of poorly placed filler.

In these cases, the use of hyaluronidase is elective: the patient decides and it is planned calmly.

2. In an emergency: vascular complication

This is the most important indication. When, during an injection, the product compromises a vessel (a rare but possible phenomenon), the response must be immediate: high-dose hyaluronidase in the affected area, along with other medical measures. Having the product in the clinic and a trained protocol is the difference between preventing tissue damage and not doing so.

Therefore, a legitimate question when choosing a clinic is: do you have hyaluronidase available? The answer should be yes, without caveats.

3. To “clean” before starting anew

Sometimes, the correct plan is to undo everything previous and start from scratch. Patients with years of poorly accumulated hyaluronic acid in their cheeks, lips, or jawline sometimes benefit more in a month with hyaluronidase than with another round of filler on top.

How we work with hyaluronidase at Santé

Consultation and diagnosis

All hyaluronidase treatments begin with a consultation. We assess what product has been injected (if known), how long it has been there, in which planes, and why it needs to be dissolved. We perform a facial analysis and, if appropriate, ultrasound or careful palpation to locate product pockets.

Allergy test

Although allergic reactions to hyaluronidase are rare, in some cases we perform a prior allergy test depending on the patient's profile and the product.

Application

The session lasts 15–30 minutes. We inject hyaluronidase in small amounts into the areas to be treated, with a dose adjusted to the volume of product and the type of hyaluronic acid (more cross-linked products require more enzyme). The usual sensation is similar to any facial injection.

Post-treatment

• Local inflammation for 24–72 hours.
• Small bruises are possible.
• The product begins to dissolve within hours and is complete within days.
• The result is evaluated at 7–14 days.

Rethinking the plan

After dissolution, we wait at least 2 weeks before considering re-injecting. Dissolving and refilling on the same day is rarely a good idea (except in very specific cases). The goal is for the area to return to its natural state, and from there we decide what it truly needs.

What hyaluronidase does not do

• It does not dissolve other materials. It only affects hyaluronic acid. Biostimulators like Sculptra (PLLA) or Radiesse (CaHA), autologous fat, or permanent materials are not eliminated with hyaluronidase.
• It does not eliminate scars or adhesions that may have remained after a previous treatment.
• It does not always dissolve 100% of the product in a single session. Some highly cross-linked or very old products may require several sessions spaced 1–2 weeks apart.

Why having hyaluronidase changes your safety

A clinic that uses hyaluronic acid must have hyaluronidase, just as an operating room must have a defibrillator. It is basic safety infrastructure, not an extra. Its immediate availability is what separates a well-managed complication from a poorly managed one.

At Santé Clinics:

• We always have hyaluronidase available in the consultation room.
• We have written protocols for vascular, infectious, and allergic complications.
• Our medical team is trained in its use.
• We attend to urgent consultations for our own patients and, in specific cases, for patients who have been treated in other clinics and need correction.

The philosophy behind: aesthetic medicine with natural results

Hyaluronidase is, in a way, the best metaphor for how we understand aesthetic medicine. If it's not seen, it's well done. When a face is overfilled, the correct thing to do is remove product, not add more. Aesthetic medicine that seeks natural results knows how to say “no” and knows how to undo when necessary.

It allows a patient, after years of accumulated treatments, to regain their original face and start anew with discernment.

Why Santé Clinics

• Medical team with specific experience in corrections, complications, and advanced harmonization.
• Hyaluronidase always available.
• Complete protocols for vascular emergencies and infectious complications.
• We also attend to patients with previous treatments in other clinics.
• 10,000+ patients and 4.9 on Google.
• Avenida Diagonal 384, Barcelona. Service in Spanish, English, Portuguese, and Russian. Hours Monday to Friday 9:00–21:00, Saturdays and Sundays 10:00–20:00.

FAQ

How long does it take to see the effect?
Degradation begins within a few hours and is complete within days. The final result is evaluated at 7–14 days.

Is it painful?
It is uncomfortable but well tolerated. We apply topical anesthetic.

How many sessions do I need?
Usually one. For highly cross-linked products or large quantities, 2–3 sessions spaced 1–2 weeks apart may be necessary.

Can I get fillers again afterwards?
Yes. We wait at least 2 weeks after dissolution before planning new treatments.

Does it only dissolve the bad and leave the good?
The enzyme acts where it is injected. That is why anatomical control and dosage are decisive: the doctor injects precisely where needed and respects what should not be touched.

Is there an allergic risk?
It is rare, but it exists. In patients with a history, we test for it beforehand.

Do you attend to emergencies for filler complications done in another clinic?
Yes. If you have had a recent treatment and notice disproportionate pain, paleness, color change, or any strange sign, contact us urgently at +34 699 14 58 87. We have hyaluronidase and an active protocol.

If you need to dissolve a filler

Request your assessment consultation at Santé Clinics, Avenida Diagonal 384, Barcelona, via WhatsApp or phone at +34 699 14 58 87. We attend to elective corrections and, if the situation requires it, emergencies due to filler complications.