Hyaluronidase: What It Is and When to Use It in HOF

Hyaluronidase is an enzyme that breaks the bonds of hyaluronic acid, both the natural kind in the tissue and the cross-linked gel used in fillers. It is what makes HA filler reversible, something that does not hold for most other fillers.

In orofacial harmonization, hyaluronidase has two roles. The first is elective: correcting excess product, irregularity, a nodule, migration or the Tyndall effect. The second is urgent: it is the main resource in managing vascular occlusion caused by hyaluronic acid, when the speed of care affects the outcome.

Why should it always be on hand?

A vascular complication can happen even with careful technique and an experienced professional. Having the enzyme in the office, knowing how to prepare it and having a defined response protocol is part of the safety of anyone who injects HA, especially in high-risk areas such as the glabella, nose, nasolabial fold, temples and tear trough. The topic is covered in more depth in safety and complications.

What precautions apply to its use?

Hyaluronidase can cause allergic reactions and, because it also breaks down natural HA, the area may temporarily look emptier. The dose, the dilution and the protocol are set by the qualified professional, according to the clinical situation and the rules of their professional council.

Also called: hyaluronidase enzyme.