Hyaluronidase is an enzyme used to dissolve hyaluronic acid (HA) based dermal fillers. It is used in cosmetic procedures to correct overfill, address lumps or asymmetry, and manage complications like vascular occlusion where filler obstructs blood flow. Understanding how this enzyme works and how long its effects last helps clarify expectations for those undergoing such treatments.
How Hyaluronidase Breaks Down Fillers
Hyaluronidase functions as a “biological scissor,” specifically targeting the long chains of hyaluronic acid. This enzyme acts by cleaving the glycosidic bonds within the HA molecule, breaking it down into smaller, more easily absorbed fragments. This enzymatic action accelerates the natural breakdown process of hyaluronic acid, which otherwise would take months or years for synthetic fillers to degrade. The enzyme depolymerizes hyaluronic acid, reducing its viscosity and allowing it to diffuse more readily through tissues. This degradation increases tissue permeability, facilitating the body’s natural clearance mechanisms to remove the dissolved filler material.
Factors Affecting Its Activity
The activity and duration of hyaluronidase are influenced by several factors. The enzyme concentration or dose administered plays a role, with higher doses generally leading to faster and more complete dissolution of the filler. The exact amount needed can vary depending on the specific filler and the clinical situation.
The type and cross-linking of the hyaluronic acid filler also affect how easily it is broken down. Fillers with a higher degree of cross-linking are more resistant to degradation and may require a greater amount of hyaluronidase or longer exposure to the enzyme for complete dissolution.
Individual metabolism influences how quickly the body processes and clears the enzyme itself. Hyaluronidase is rapidly degraded and deactivated in the body, with its activity diminishing over time due to dilution, diffusion, and deactivation.
The area of injection and the surrounding tissue environment can affect the enzyme’s activity. The vascularity and density of the treated area influence how well the enzyme disperses and interacts with the filler. The presence of inflammation or scar tissue can sometimes impede the enzyme’s ability to reach and break down the filler.
Understanding Its Full Effect
Hyaluronidase typically begins working very quickly upon injection, with visible changes often observed within minutes to a few hours. This rapid onset is due to the enzyme’s immediate action on the hyaluronic acid.
The primary dissolution phase, where most of the breakdown occurs, is generally within the first 24 to 48 hours following injection. Its effects can continue for 24 to 48 hours in tissues.
The enzyme itself is naturally broken down and cleared by the body, with its active effects typically diminishing after a few days. However, once the hyaluronic acid filler is dissolved by hyaluronidase, it is permanently gone from that site. The body’s natural hyaluronic acid, which may also be affected, typically replenishes within days to a few weeks.
In some cases, a second treatment with hyaluronidase may be necessary if not all the filler was dissolved initially. It is often recommended to wait at least one to two weeks after the hyaluronidase treatment before considering new filler injections. This waiting period allows for any swelling to subside and for the full effect of the initial dissolution to be assessed, ensuring a more predictable outcome for subsequent treatments.