How to Communicate the Need for Hyaluronidase to the Patient

If you work with hyaluronic acid, hyaluronidase is part of your toolkit. But telling the patient it will have to be used is one of the most sensitive conversations in the practice. It can sound like an admission of error, like a step backward or, at worst, like the alarm of a serious complication.

How you explain it determines whether the patient sees hyaluronidase as a safety and adjustment tool, or as a sign that something went wrong. This guide offers scripts for the two main scenarios: the emergency and the planned correction. It is neither a clinical protocol nor a legal document.

What is hyaluronidase, in words the patient understands?

Hyaluronidase is an enzyme that breaks down hyaluronic acid. For the patient:

This framing is true, reassuring and useful. But be careful with "undoes everything": the effect depends on the case and should not be promised.

When does hyaluronidase come into the conversation?

There are two main scenarios, and they call for different tones.

There is also the scenario in which the patient asks to undo the filler on their own initiative, which has its own conversation. See patient who wants to undo the filler and explaining hyaluronidase to the patient.

How do I communicate in an emergency?

When a vascular occlusion is suspected, hyaluronidase may be an essential part of the response, and time matters. The communication needs to be short, firm and must not delay action.

Details on what to say in this situation are in communicating a suspected vascular occlusion. Never delay the response to complete a form; record what was communicated and formalize it as soon as possible.

How do I communicate in a planned correction?

Here there is time. Use the conversation to take the weight off the word "dissolve" and place it as an adjustment resource.

1. Acknowledge the concern. "I understand you're bothered by [concern]."
2. Explain the finding. "From what I see, [excess, irregularity, asymmetry]."
3. Present the option. "One alternative is to use an enzyme that reduces the product."
4. Say what it does and what it does not do. It reduces hyaluronic acid; it does not fix causes other than the product.
5. Talk about the risks and the variable result. No promise of an exact result.
6. Offer alternatives, including waiting.
7. Ask for specific consent.

What should I say about risks and limits?

Be honest without alarming:

• There may be swelling, redness and local tenderness.
• Allergic reactions are possible, although uncommon.
• The result varies and may be partial.
• In some cases, it may need to be repeated.
• A dissolved area may look different for a while.
• New filler, if desired, usually waits for an interval, at the professional's discretion.

How do I keep the patient from feeling guilty, or blaming you?

The word "mistake" often appears in the patient's mind. Avoid both extremes: "it was your fault" and "it was bad luck." Prefer describing what happened and what can be done.

If the need for correction came from a decision of yours that you recognize as inadequate, honesty is the best path. The subject is in how to own up to a mistake with the patient.

How do I check that the patient understood?

What should I record?

See also recording the risk communication.

Hyaluronidase, well communicated, reinforces the safety of hyaluronic acid. Poorly communicated, it becomes a synonym for error. The difference lies in when and how you talk about it.