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Injected hyaluronidase reduces restylane-mediated cutaneous augmentation
A John Vartanian1, Andrew S Frankel, Mark G Rubin
1Department of Otolaryngology--Head and Neck Surgery, University of Southern California, Los Angeles, USA. drvartania@yahoo.com
Archives of Facial Plastic Surgery
|July 20, 2005
Summary
Hyaluronidase injections effectively reduce Restylane dermal fillers. This treatment can reverse unwanted Restylane augmentation, with initial doses of 5-10 units recommended.
Area of Science:
- Dermatology
- Aesthetic Medicine
- Injectable Fillers
Background:
- Restylane, a nonanimal-stabilized hyaluronic acid (NASHA) gel, is widely used for dermal augmentation.
- Managing or reversing the effects of dermal fillers is an important clinical consideration.
Purpose of the Study:
- To evaluate the efficacy of hyaluronidase in reversing Restylane dermal augmentation.
- To determine optimal dosing and potential side effects of hyaluronidase for Restylane reversal.
Main Methods:
- A prospective, randomized study involving two parts: comparison of hyaluronidase and saline, and evaluation of three different hyaluronidase doses.
- A blinded evaluator assessed post-injection skin scores, with each patient serving as their own control.
Main Results:
- Hyaluronidase significantly reduced Restylane augmentation size in all subjects, with skin scores decreasing to 20% of baseline within 4-7 days (P<.001).
- A dose-related response was observed, though not statistically significant.
- Localized, self-limiting hypersensitivity reactions occurred in 25% of patients.
Conclusions:
- Intradermal hyaluronidase injections are effective for reducing Restylane dermal augmentation.
- An initial small dose of hyaluronidase (5-10 U) is suggested for Restylane reversal.