Injected hyaluronidase reduces restylane-mediated cutaneous augmentation.
OBJECTIVE
To determine the effects of injected hyaluronidase in cutaneous areas previously augmented with Restylane (Q-Med AB, Uppsala, Sweden), a nonanimal, stabilized hyaluronic acid (NASHA) gel.


METHODS
A prospective, randomized study was undertaken in 2 parts. First, the effects of hyaluronidase and saline were compared on post-NASHA dermal augmentation. Next, 3 different doses of hyaluronidase were evaluated after NASHA gel dermal augmentation. A blinded evaluator assigned postinjection skin scores. Each patient served as his or her own control.


RESULTS
Hyaluronidase dramatically reduced the size of the augmentation created by injected Restylane in all of our subjects. A comparison of average scores of saline-injected sites vs hyaluronidase-injected sites revealed a statistically significant difference. By 4 to 7 days after hyaluronidase injection, skin scores were at 20% of baseline (P<.001). Dose-related response to injected hyaluronidase was also observed, although it was not statistically significant. A number of patients (25%) demonstrated localized, self-limiting hypersensitivity reactions to injected hyaluronidase.


CONCLUSIONS
Intradermal hyaluronidase injections can be used to reduce dermal augmentation from previously injected Restylane. A small dose of hyaluronidase equivalent to 5 to 10 U may be injected initially.
Vartanian
A John
AJ
Department of Otolaryngology--Head and Neck Surgery, University of Southern California, Los Angeles, USA. drvartania@yahoo.com
Frankel
Andrew S
AS
Rubin
Mark G
MG
D000328:Adult; D001672:Biocompatible Materials / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology; D006821:Hyaluronoglucosaminidase / Q000008:administration & dosage / Q000494:pharmacology*; D007271:Injections, Intradermal; D008297:Male; D008422:Materials Testing; D008875:Middle Aged; D011446:Prospective Studies; D016037:Single-Blind Method
D001672:Biocompatible Materials; D006820:Hyaluronic Acid; D006821:Hyaluronoglucosaminidase; C445361:Restylane