Hyaluronidase Protocol

Emergency

1500iu/1ml.

Inject volume equal to filler injected. Direct into area of filler and necrosis. Massage and heat.

Repeat at 30min intervals, max 4 cycles. Re-assess signs (pain/capillary refill). Refer to A&E if not resolving.

No forearm dermal test patch needed.

Cosmetic Revision

1500iu/4ml.

Inject small volumes (0.1-0.2ml) in centre point of affected area. Use 30G needle or smaller (e.g. FMS)

Majority of effect seen within 12h. Repeat if necessary (min 48h, ideally 1-2 week intervals).

No forearm dermal test patch needed

Using higher concentrations but smaller volumes more successfully dissolves filler HA rather than native HA (as opposed to more dilute/higher volume)