Hyaluronic acid fillers have an advantage that many other materials do not offer: they can be corrected afterwards. This is made possible by an enzyme called hyaluronidase, often known in Germany under the product name Hylase. Whether a result does not look as desired, a filler has shifted or there is an emergency – Hylase can break down hyaluronic acid in a targeted way.
This article explains when Hylase is used, how the treatment works, what it can do and where its limits lie.
What is Hylase?
Hyaluronidase is an enzyme that also occurs in the body itself. It splits the long chains of hyaluronic acid into small fragments, which the body carries away via the lymphatic system. In medicine the enzyme has been used for decades, for example to make it easier for other medicines to spread in tissue.
Important: Hylase acts only on hyaluronic acid. Fillers made of other materials such as calcium hydroxylapatite, polylactic acid or silicone cannot be dissolved with it.
When Hylase is used
- Too much volume: lips, cheeks or tear trough look overfilled.
- Uneven result: one side is fuller than the other, or the filler is unevenly distributed.
- Nodules: palpable or visible bumps that do not improve with massage.
- Shifted filler: material has migrated, for example beyond the lip border.
- Bluish tint: if filler lies too superficially, for example under the eye, the skin can look bluish.
- Fresh start: old fillers are dissolved before a new, better-fitting treatment is planned.
- Emergency: if filler blocks a blood vessel, Hylase is used immediately and generously to restore blood flow.
Also for fillers from other practices
Hylase can also dissolve fillers that were placed elsewhere – provided it is hyaluronic acid. Information on the product, amount and date of the treatment is helpful, for example from a treatment passport. If this information is missing, the physician will discuss with you how best to clarify it.
How the treatment works
- Conversation and examination: The physician looks closely at the area and clarifies which filler was placed when and where.
- Tolerance test: At the first treatment a tiny amount is usually given into the skin of the forearm and the reaction observed for about 20 to 30 minutes.
- Treatment: Hylase is injected with a fine needle into the affected area in a targeted way. This usually takes only a few minutes.
- Check-up: After one to two weeks it is assessed whether the goal has been reached or whether a further small treatment makes sense.
How quickly Hylase works
The enzyme starts working within a few hours; after 24 to 48 hours the effect is usually clearly visible. Highly cross-linked, long-lasting fillers sometimes need a second session. It is often not necessary to dissolve everything: the amount can be chosen so that only the excess disappears.
Hylase can also temporarily break down some of the body's own hyaluronic acid. The body rebuilds it within a short time. Straight after the treatment the area can therefore look slightly sunken for a short time.
Side effects
Redness, swelling, slight burning or itching at the injection site are common and usually subside within one to two days. Small bruises are possible. Allergic reactions occur rarely; hence the test before the first treatment and a short period of observation afterwards.
When treatment is not carried out
Treatment is not carried out in cases of a known allergy to hyaluronidase. If you are allergic to bee or wasp stings you should definitely say so, as their venom contains a similar enzyme. Treatment is also not carried out in cases of inflammation or infection in the treatment area and during pregnancy and breastfeeding – except in an emergency.
When fillers are possible again
After dissolving, the tissue should be allowed to settle. A new filler treatment is usually possible after two to four weeks. This allows the result of the correction to be assessed calmly and the new treatment to be planned better.
Frequently asked questions
Does the treatment hurt? The needle pricks are felt briefly, and Hylase itself can burn briefly. Cooling helps.
Can only part of the filler be dissolved? Yes. Amount and location are chosen so that the correction is targeted.
Does health insurance pay? Not usually after aesthetic treatments. In the case of complications this can be different in individual cases.
How do I recognise an emergency after a filler treatment? Severe, increasing pain, white, bluish or blotchy skin or visual disturbances are an emergency. Contact the treating physician or the emergency services immediately.
How long does it take until I see the result? Usually one to two days. The final assessment is made at the check-up appointment.
Can I work normally afterwards? As a rule yes. Slight swelling or redness is usually hardly noticeable after a short time.
Cost and consultation
A Hylase treatment at Alpha Skin starts from €100; the price follows the German medical fee schedule (GOÄ) and the amount needed. More on procedure and prices on the page Hylase. If you are thinking about a filler, you will find background information under fillers and facial contouring as well as in the articles lip filler and tear trough filler. The practice is located at Theaterplatz 1b in Bonn-Bad Godesberg.
Important medical note
The information described is for general education and does not replace personal medical advice, examination or consultation. Whether a treatment is suitable depends on skin type, initial findings, pre-existing conditions, medication and individual goals.
Effect, durability, tolerability and possible side effects can vary from person to person. Specific results or a particular time course cannot be guaranteed.