How Should We Use Hyaluronidase for Dissolving Hyaluronic Acid Fillers?

作者：Gi‐Woong Hong, Hyewon Hu, Jovian Wan, Kathleen Chang, Young‐Jin Park, Massimo Vitale, Giovanni Damiani, Kyu‐Ho Yi · 发表于：Journal of Cosmetic Dermatology · 年份：2025 · DOI：10.1111/jocd.16783 · 被引用次数：14 · 研究领域：Facial Rejuvenation and Surgery Techniques、Nasal Surgery and Airway Studies、Ocular Disorders and Treatments

BACKGROUND: Hyaluronic acid (HA) fillers are commonly used in esthetic medicine for facial contouring and rejuvenation. However, complications such as overcorrection, vascular occlusion, and irregular filler distribution necessitate the use of hyaluronidase to dissolve the fillers. This study aimed to evaluate the efficacy of hyaluronidase in degrading different types of HA fillers and provide clinical guidelines for its use based on filler type, dosage, and application techniques. METHODS: A series of in vitro and in vivo experiments were conducted to assess the dissolution of biphasic and monophasic HA fillers using varying concentrations of hyaluronidase. The in vivo component used animal models to determine the duration of hyaluronidase activity in biological tissues, whereas the in vitro study examined the dissolution rates of HA fillers in response to different hyaluronidase concentrations and application methods. A control study using saline was also performed to compare the natural hydration process of the fillers. RESULTS: Hyaluronidase efficacy was found to vary based on the type of HA filler and the enzyme's concentration. Biphasic fillers dissolved more rapidly at lower concentrations of hyaluronidase compared to monophasic fillers, which required higher concentrations and longer exposure times for effective breakdown. The study also demonstrated that direct injection of hyaluronidase into the filler mass was more effective than surface application. Pharmacokineti...