Hyaluronidase Dosing for Dissolving Restylane Defyne
For dissolving Restylane Defyne, 20-40 units of hyaluronidase (Hylenex) per 0.2 mL of filler is recommended, as Restylane Defyne is among the more resistant hyaluronic acid fillers to dissolution. 1
Understanding Hyaluronidase for Filler Dissolution
Dosing Considerations
- Restylane Defyne requires higher doses of hyaluronidase compared to other Restylane products due to its more robust cross-linking properties 1, 2
- The standard approach is to use 1 mL of hyaluronidase solution for each 1 mL of extravasated or injected filler material 3
- Research shows Restylane Defyne falls into the "moderately resistant to more resistant" category of hyaluronic acid fillers, requiring more aggressive dissolution protocols 1
Specific Dosing Recommendations
- For Restylane Defyne specifically, studies indicate 20 units of hyaluronidase per 0.2 mL of filler as a starting dose 1
- For complete dissolution, up to 40 units per 0.2 mL may be required for resistant areas 2
- Multiple treatments may be necessary, with reassessment after 30 minutes to 3 hours (when the most dramatic changes typically occur) 4
Administration Technique
- Inject hyaluronidase directly into the area where the Restylane Defyne was placed 5
- A "feathering" technique may be used to ensure even distribution of the enzyme throughout the treatment area 6
- For larger areas, multiple small injections are more effective than a single large bolus 3
Clinical Considerations
Patient Safety
- Hyaluronidase should not be administered to patients with known bee venom allergy due to potential cross-reactivity 3
- When allergy to hyaluronidase is suspected, prick testing may be used for confirmation before proceeding 3
Expected Results
- The most significant dissolution typically occurs between 30 minutes and 3 hours after hyaluronidase injection 4
- Complete dissolution may require follow-up treatments, particularly with resistant fillers like Restylane Defyne 1
- Continued gradual degradation may be observed through the second week post-injection 4
Common Pitfalls to Avoid
- Underdosing is the most common mistake when treating resistant fillers like Restylane Defyne 1
- Failure to wait an adequate amount of time before reassessing and potentially reinjecting can lead to overdissolution 4
- Not accounting for the specific resistance profile of the particular filler being treated (Restylane Defyne being more resistant than other Restylane products) 1, 2
Remember that individual patient factors and the specific location of the filler may influence the required dose, and clinical judgment should guide any adjustments to these recommendations.