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Hyaluronidase Enzyme: Facial Unfilling.

Published on July 22, 2015


The effects of Restylane, Restylane Lyft® & Juvederm long term

The sugar gel Restylane was FDA approved for dermal filling in March 2005. It truly has revolutionized cosmetic treatment. The superiority of this product immediately displaced Collagen from the market. Collagen was a bovine product that only lasted a short period of time after being injected. For this reason, it was truly an expensive service. The real cost was trying to maintain a result. Celebrities and socialites were really the only people who could afford to maintain the result obtained with Collagen treatment, much of which disappeared within weeks of the initial treatment. Unlike Collagen, Restylane lasted longer, much longer. The company that made Restylane initially told doctors and the public that the product lasted about 6 months. After working with the product for a period of time, it was clear that filler effect from Restylane and its thicker version, Restylane Lyft®, was longer than 6 months, possibly lasting 12 months and in some cases longer. Allergan’s Juvederm was approved for clinical use in June 2006. Its longevity profile seemed to be about equal to that of Restylane. This longevity made it feasible for many more people to have this service because the persistence of product made getting the treatment much more practical.

So here is the thing:

These fillers persist much longer in the face than 12 months. The hyaluronic acids can actually persist for years. For many people the filler service does slowly disappear with no issues. For an increasing number of individuals, there is enough persistence of product that it affects the overall appearance long after the original service. This phenomena seems poorly understood by most injectors. The primary areas at issue are lower eyelid ridges and bags, over-filled cheeks, over-filled lips and jowl areas. Typically the effect is an older looking face. Normally services are simply layered over previously placed treatments. This leads to a situation where you and your injector can “loose track” of what the face is suppose to look like. Dr. Steinsapir found that many in this situation end up feeling like it is time for a surgical solution. The answer turns out to be something far simpler. Hyaluronic acid fillers, even product that has been in the face for years can be modified using the injectable enzyme Hyaluronidase. This ability to modify prior service is one of the reasons that hyaluronic acid is so powerful. It does not matter if you were originally treated with Restylane, Restylane Lyft®, Belotero, or Juvederm. Unlike fat, Radiesse, Sculptra, Artefill, Bio Alcamid, or silicone oil, hyaluronic acid fillers can be shaped long after the service has been done. Facial unfilling takes advantage of this property to restore the facial shape.

World famous Beverly Hills based cosmetic surgeon, Dr. Steinsapir has been restoring faces previously treated by these very popular hyaluronic acid fillers. Think of hyaluronidase as an unfilling agent. Removing volume that is not working, powerfully restores the face to its younger contours. The treat is very comfortable. The enzyme only works on the hyaluronic acid filler in the face. The effect of the treatment is seen within minutes. There is swelling from the service that takes a day or two to resolve. Bruising is possible but is not that common. Typically the shaping can be done in a single office service. Approximately 1 week later, filler volume can be placed, if desired, where needed without the overfilled look. Most individuals having unfilling feel that they look years younger.

About Dr. Steinsapir

Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles and Beverly Hills where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice in Beverly Hills and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.

Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician or surgeon and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.

To learn more about procedures and treatments performed by Beverly Hills | Los Angeles Oculofacial Plastic Surgeon, Dr. Kenneth Steinsapir, contact us at 310-274-7422