Dissolving hyaluronic acid via hyaluronidase

Hyaluronic fillers are sterile gels containing stabilized hyaluronic acid of non-animal origin to inject in the skin. They are used to conjugate face lines, wrinkles and creases, to fill up lips and shape the facial contour. Sometimes, it is necessary to dissolve a filler. The reason for this could be that the aesthetic treatment hasn’t achieved the desired effect or there is a likelihood of vascular obstruction or impending necrosis (tissue death), which poses a risk of compromising the healthy tissue.

In aesthetic medicine, hyaluronidase is used only in emergencies, and the patient is advised to take a skin test at least twenty minutes before the procedure. The test is performed by injecting the hyaluronidase in the forearm’s subcutaneous tissue, then monitor for any signs of a reaction (such as urticaria). If the results are positive, you shouldn’t undergo hyaluronidase treatment. Hyaluronidase is a medical solution, an enzyme that dissolves hyaluronic fillers. Since it is a strong allergen, applying it poses a risk of causing an anaphylactic reaction. (This is a severe allergic reaction which is life-threatening in itself and requires urgent medical attention.)

Hyaluronidase may be applied in various areas: the lips, the cheekbones, the area around the mouth, the forehead, the chin, the temples, the area around the eyes, the lower jaw, the neck, the hands and more.

The patients undergoing this treatment attend a thorough consultation where they are familiarized with the procedure and the possible side effects from it. Such reactions most commonly include redness, swelling, pain, itchiness, bruises, and tenderness at the injection site. These don’t usually require medical attention and pass with time.


Your dermatologist must verify the safety and quality of the substances used in the procedure. AestheLine Dermatology Clinic uses only solutions that have been officially registered for use in Bulgaria, clinically tested, and passed quality certification.

The in-clinic dermatologist, who has been trained and certified to use the solution, will prepare the patient for the procedure and strictly observe an established clinical protocol. Injecting hyaluronidase does not require local anesthetic but in especially sensitive cases, we may apply an anesthetic cream. A needle is used to inject the hyaluronidase in the area where the filler needs to be dissolved.
The effect takes place from a few minutes to 48 hours after the procedure. Depending on the treated areas, the injection procedure may take between 15 and 20 minutes. The amount of hyaluronidase injected depends on the amount of filler in need of dissolution.

This treatment is not recommended for patients with a proven hyaluronidase allergy. When applied, the hyaluronidase may dissolve part of the body’s own hyaluronic acid along with the filler.
This may result in loss of volume or sagging of the skin, and at least 14 days need to pass to see the treatment’s definitive effect. The solution may require reapplication.
The most common reactions after the procedure include redness, swelling, pain, itchiness, bruises, and tenderness at the injection site. These don’t usually require medical attention and pass with time.
You should immediately inform your physician if you are taking any medications or if you are suffering from any condition.

The results achieved from the treatment are individual and depend on the person’s physiology and habits. You can determine how well the treatment has worked after the traumatic reactions pass. The procedure can be repeated if necessary.

We recommend that you only have light meals for about an hour before the procedure.
For prevention and to reduce the likelihood of developing bruising as a result of the injection, you should take the Arnica food supplement starting the day of the procedure.

You shouldn’t wet or contaminate the injection sites for up to 2-3 hours after the procedure. Do not press or massage the treated areas, and do not undergo cosmetic procedures, peeling, massages or cosmetic cleaning during the next 2 weeks. It is recommended to have a follow-up appointment 2 weeks after the procedure. Then, if deemed necessary, we may apply more of the product.