Hyaluronidase in the correction of hyaluronic acid-based fillers: a review and a recommendation for use.

BACKGROUND Hyaluronic acid (HA) preparations are the most commonly used injectable fillers in esthetic medicine. In contrast to other injectable fillers with hyaluronidase, there is a tool available to reduce unwanted depots of this filler. AIMS The aim of this paper is to give an overview on the present literature and in addition to give some recommendations for use based on the experience of the authors. METHODS The overview is based on a literature search. RESULTS There is some evidence from two smaller clinical trials that hyaluronidase will effectively decrease injected depots of HA. It has further been shown from case series and case reports that this reduction is clinically relevant. There is less evidence that hyaluronidase is also helpful in adverse reactions to HA-based fillers. CONCLUSIONS The reports suggest that the treatment is safe. However, adverse reactions to hyaluronidase such as allergic reactions have been reported. Patient should be informed about that before treatment.