From the FDA Drug Label
12 CLINICAL PHARMACOLOGY
1 Mechanism of Action Hyaluronidase is a dispersion agent, which modifies the permeability of connective tissue through the hydrolysis of hyaluronic acid, a polysaccharide found in the intercellular ground substance of connective tissue, and of certain specialized tissues, such as the umbilical cord and vitreous humor Hyaluronic acid is also present in the capsules of type A and C hemolytic streptococci. Hyaluronidase hydrolyzes hyaluronic acid by splitting the glucosaminidic bond between C1 of an N-acetylglucosamine moiety and C4 of a glucuronic acid moiety This temporarily decreases the viscosity of the cellular cement and promotes dispersion of injected fluids or of localized transudates or exudates, thus facilitating their absorption.
2 Pharmacodynamics In the absence of hyaluronidase, material injected subcutaneously disperses very slowly. Hyaluronidase facilitates dispersion, provided local interstitial pressure is adequate to furnish the necessary mechanical impulse. Such an impulse is normally initiated by injected solutions The rate and extent of dispersion and absorption is proportionate to the amount of hyaluronidase and the volume of solution.
The time it takes for hyaluronidase to break down lip filler is not directly stated in the provided drug label. However, it is mentioned that the rate and extent of dispersion and absorption is proportionate to the amount of hyaluronidase and the volume of solution. Additionally, the label states that at 24 hours the restoration of the dermal barrier is incomplete and inversely related to the dosage of hyaluronidase; at 48 hours, the barrier is completely restored in all treated areas 1.
Based on this information, it can be inferred that the breakdown of lip filler by hyaluronidase may occur within 24 to 48 hours, depending on the dosage and volume of the solution. However, this is not a direct answer to the question, and the exact time frame may vary.
Key points:
- The rate and extent of dispersion and absorption is proportionate to the amount of hyaluronidase and the volume of solution.
- The dermal barrier is completely restored within 48 hours.
- The exact time frame for breakdown of lip filler is not directly stated.
From the Research
Hyaluronidase typically breaks down lip filler within 24-48 hours, with initial effects often visible within a few hours after injection. The exact timing varies based on several factors including the type and amount of filler present, the specific hyaluronidase formulation used, and individual patient characteristics. For standard lip filler dissolution, physicians typically inject a tailored dose of hyaluronidase, which may be adjusted based on the area being treated and the amount of filler to be dissolved, as seen in a study where 7.5 units of HYAL were injected in 4 points in the ergotrid area before proceeding with HA injection 2. The enzyme works by breaking down hyaluronic acid, the main component of most dermal fillers, by cleaving the glycosidic bonds in the hyaluronic acid molecule. This process causes the filler to lose its structure and be metabolized by the body.
Some key points to consider when using hyaluronidase for lip filler dissolution include:
- The type of filler being dissolved, as biphasic fillers may dissolve more rapidly than monophasic fillers 3
- The concentration and dosage of hyaluronidase used, as higher concentrations may be required for certain types of fillers 3
- The technique used for injection, as direct injection into the filler mass may be more effective than surface application 3
- Potential adverse events, such as injection site reactions, which are typically short-lived and resolve spontaneously, but may require treatment with topical steroids, NSAIDs, or hyaluronidase in some cases 4
Patients should expect some temporary swelling, redness, or bruising at the injection site, which typically resolves within a few days. Complete resolution of the filler may require multiple treatment sessions in some cases, particularly if the filler is older or more cross-linked. It is essential to follow clinical guidelines and use hyaluronidase judiciously to minimize the risk of adverse events and ensure optimal outcomes.