DM DERMATOLOGY
Hyalase
ABOUT HYALASE
An enzyme injection
that dissolves filler: Hyalase
Hyalase is a treatment that injects an enzyme called hyaluronidase to break down hyaluronic acid (HA) filler. It is considered when filler can be felt as a lump, looks bigger than expected, or shows a bluish tint.
Hyaluronic acid is naturally found in the skin. Hyaluronic acid filler is a product made by cross-linking this substance into a gel. Hyaluronidase cuts the chains of this gel into small pieces.
Hyalase acts only on fillers made from hyaluronic acid. It cannot dissolve fillers made from other ingredients. Dissolving filler is not listed among the approved indications for hyaluronidase (off-label), so the doctor explains the need and the risks before deciding.
Before treatment, DM Dermatology in Apgujeong first checks when, where, and what filler you had. We feel the filler area in person and set how much to dissolve in each area. Results and recovery vary from person to person.
- Hyaluronidase
- For hyaluronic acid filler only
- Treated area by area
5–10min
Injection time (exam and disinfection time not included)
24–48h
When we first check how much has dissolved
2wk
Minimum wait before getting filler again where it was dissolved
When filler needs a second look
If filler has settled differently than you expected,
we first check the filler's ingredients
Hyaluronic acid filler is a filler that can be dissolved with an enzyme. When you are unhappy with the shape, such as lumps, asymmetry, or a bluish tint under the eyes, dissolving and reducing it with Hyalase is an option to consider.
How much and how far to dissolve is decided based on when you had the filler, the amount, and the area.
CHECK
When to consider
Hyalase
If any of these apply, we first examine the filler area at your visit.
- Case01
A filler lump you can feelThe filler area feels bumpy, or you can feel a hard lump when you press it.
- Case02
More volume than expectedYour lips, nose, or chin stand out more than you wanted, or the left and right look different.
- Case03
A bluish tint under the eyesFiller just beneath thin skin scatters light and shows a bluish tint. This is called the Tyndall effect.
- Case04
An area that stays puffyEven though quite some time has passed since your filler, the under-eye area or cheeks still look puffy.
- Case05
You want to clear old fillerYou want to clear filler you had years ago, then make a new plan.
- Case06
Filler you had elsewhereYou do not know the product name and first want to find out whether it can be dissolved.
HOW IT WORKS
How the enzyme cuts
the chains of filler gel
Hyaluronic acid holds water in the dermis and helps maintain the skin's volume and elasticity. The body makes and breaks down the skin's hyaluronic acid every day.
Filler is a gel made by linking hyaluronic acid molecules together (cross-linking) so it stays in the body for several months. Hyaluronidase cuts the linked chains, breaking the gel into small pieces. The small pieces disperse into the surrounding tissue and are absorbed by the body.
The enzyme works for only a short time, about a few hours. So the degree of dissolving is checked 24–48 hours later, and if filler remains, more is injected on another day.
- Different speeds for different fillers
The cross-linking method and concentration differ by product, so how fast it dissolves and how much is needed also differ. Filler that has been in the body for a long time may need a larger amount.
- Your body's own hyaluronic acid
The enzyme also breaks down the hyaluronic acid that was already there. The body replaces this hyaluronic acid, and it is known to usually recover within two days.
- Fat and muscle stay as they are
Hyaluronidase is not a medicine that dissolves fat or muscle.
- 1
Epidermis The outermost layer of the skin.
- 2
Dermis The layer beneath the epidermis that supports the skin. This is where hyaluronic acid is naturally found, and filler is usually placed in the dermis or the layer below it.
- 3
Collagen fibers Protein fibers that support the dermis. Hyaluronidase does not break down collagen.
- 4
Hyaluronic acid chains Long chains that hold water. Hyaluronidase cuts these chains.
- 5
Water molecules Water held by the hyaluronic acid chains.
FILLER TYPE
Fillers that dissolve with Hyalase
and fillers that do not
Whether filler can be dissolved depends on its ingredients. If you had it elsewhere and do not know the product name, please tell us when you had it and in which area.
Dissolvable
Hyaluronic acid (HA) filler
Fillers made by cross-linking hyaluronic acid, and hyaluronic acid skin boosters. They are broken down by Hyalase. Restylane (imported) and Chaeum (Korean-made) on DM Dermatology's filler menu are also hyaluronic acid fillers.
- Restylane
- Chaeum
- Hyaluronic acid skin boosters
Not dissolvable
Fillers with other ingredients
Fillers made from ingredients other than hyaluronic acid. They are not broken down by Hyalase. In products that mix several ingredients, only the hyaluronic acid part is broken down.
- PLLA
- CaHA
- PCL
- PN · collagen
- PMMA · silicone
This grouping is by ingredient only. It does not mean one filler is better.
PROCESS
Hyalase
treatment process
Below is the general flow. We explain the actual steps and method after your examination.
step 01
Exam and filler history check
We ask when, where, and what filler you had. If you do not know the product name, just telling us when you had it and in which area is enough. We also check allergies, including to bee or wasp stings, medications, pregnancy or breastfeeding, and any Botox (botulinum toxin) in the last 48 hours.
step 02
Deciding how much to dissolve
Looking in a mirror, we decide together which areas bother you and which you want to keep, and we mark the areas to dissolve on the skin. If needed, a very small amount is injected into the inner arm, and we watch for redness, swelling, or itching for 20–30 minutes.
step 03
Disinfection and injection
We disinfect the skin and use a fine needle to inject the enzyme in portions where the filler is. If there is a part you want to keep, we start with a small amount.
step 04
Reaction check and next plan
You rest at the clinic for a while so we can check for allergic reactions. A day or two later, we look at how much has dissolved and decide whether to dissolve more and whether to have filler again.
INFORMATION
What to know
before your treatment
- Procedure time5–10 min of injection
About 30 min in total, including the exam, disinfection, and reaction check - NumbingUsually not needed
If you are worried about stinging, we use an ice pack or numbing cream (20–30 min) - Checking resultsAfter 24–48 hours
We keep watching the shape for up to 2 weeks, as the swelling goes down - Interval for more injectionsFrom 48 hours after
Injected again only if filler remains - Repeat fillerAt least 2 weeks later
If swelling remains, we wait longer - Daily lifeFace washing the same evening · makeup the next day
Avoid alcohol on the day, and skip saunas and strenuous exercise for 2–3 days
These are general guidelines and vary from person to person. DM Dermatology sets your treatment schedule after an examination.
Caution
Aftercare and
what you should know
Until swelling and redness settle, limit irritation to the treated area.
- 01Leave the injection sites alone
Unless the clinic tells you otherwise, do not rub or press hard on the injection sites.
- 02Cold compress for swelling
If there is swelling, on the first day wrap a cold pack in a towel and apply it for 10–15 minutes at a time. Do not put ice directly on the skin.
- 03No alcohol on the day of treatment
The approved labeling for hyaluronidase states that you should not drink alcohol during or right after administration. Avoid alcohol on the day of treatment.
- 04Avoid heat and sweating
Take a few days off from saunas, Korean spas (jjimjilbang), hot baths, and exercise that makes you sweat a lot. Heat can make swelling and redness last longer.
- 05Swelling and bruising last a few days
Because of the injected fluid, the area may look more swollen on the day. Swelling settles within 1–3 days, and bruises, if any, fade within 1–2 weeks.
- 06Contact us right away about warning signs
If hives, swelling of the lips or eyelids, shortness of breath, or dizziness occur, contact the clinic right away; if you are short of breath, call 119. Also let us know if the injection site becomes red, itchy, or swollen again a few days later.
- Redness, swelling, itching, stinging, or bruising may occur at injection sites. These usually settle within a few days.
- Allergic reactions to hyaluronidase may occur. The common type is a local reaction in which the injection site becomes swollen, red, and itchy; it can also appear a few days later. Hives or major facial swelling are rare, and severe allergic reactions with shock (anaphylaxis) are very rare. If you have ever had an allergic reaction to a bee or wasp sting, be sure to tell us before treatment.
- The spread of the enzyme cannot be confined to a single point. Nearby filler may dissolve as well, or more may dissolve than you wanted, so the left and right may look different. On the other hand, too little may dissolve, and you may need another injection.
- There are reports of the area looking hollow or loose after a large amount of long-standing filler was dissolved. If you had the filler a long time ago or in a large amount, we discuss this in advance at your visit.
- Fillers that are not hyaluronic acid do not dissolve. A red, warm, painful lump may be inflammation or infection, so we look for the cause before dissolving.
- After filler, sudden severe pain, skin that turns white, or bluish-purple patches that spread can be a sign of a blocked blood vessel. Contact the clinic where you had the treatment right away. If your vision becomes blurred or you cannot see, call 119 or go to the nearest emergency room. If the cause is hyaluronic acid filler, an emergency treatment that injects hyaluronidase widely and repeatedly is used.
- Tell us before treatment if any of the following apply: infection or inflammation in the treatment area; pregnancy or possible pregnancy; breastfeeding (the approved labeling in Korea states that it should not be given during breastfeeding); or Botox in the same area within the last 48 hours. If you take salicylate medicines such as aspirin, steroids, female hormones, or antihistamines, the enzyme may work less well, so please tell us about all the medicines you take.
How much dissolves, the number of sessions needed, and recovery time vary from person to person with the type and amount of filler, how long ago you had it, and your skin condition.
DM DOCTOR
A board-certified dermatologist as medical director
Personal diagnosis · Accountable care
Thorough care from a board-certified dermatologist with over 20 years of treating skin
At DM Dermatology, our medical director, a board-certified dermatologist, examines your skin in person and plans treatment around your concerns and daily life.
Dr. Shin Young-ik Medical Director · Board-Certified Dermatologist
- M.S., Hanyang University College of Medicine
- Adjunct Professor, Hanyang University
- Full Member, Korean Dermatological Association
- Clinical Fellowship in Dermatology, Jefferson Medical College (Thomas Jefferson University), USA
Care by a board-certified dermatologistPatients here are seen by a dermatologist certified by the Ministry of Health and Welfare
DM DERMATOLOGY
Related treatments
FAQ
01What is Hyalase?
Hyalase is a treatment that injects an enzyme called hyaluronidase to break down hyaluronic acid filler. The enzyme cuts the chains of the filler gel into small pieces, and the body absorbs those pieces. It is considered when filler has clumped, looks excessive, or shows a bluish tint.
02When does Hyalase start to work?
The enzyme starts working within a few hours after injection. How much has dissolved is usually first checked after 24–48 hours. The shape settles as the swelling at the injection sites goes down, so we watch the final look for up to 2 weeks.
03How many Hyalase sessions will I need?
One session is often enough, but if the filler is firm or there is a lot of it, it is sometimes dissolved over 2 or more sessions. Repeat injections are spaced at least 48 hours apart. If there is a part you want to keep, we start with a small amount and add more while checking the result.
04When can I have filler again after Hyalase?
To have filler again where it was dissolved, wait at least 2 weeks. The enzyme finishes working within a few hours, but while swelling remains it is hard to judge the amount needed. If the swelling is significant, we wait longer and decide again at your visit.
05Can every filler be dissolved with Hyalase?
No. Hyalase breaks down only hyaluronic acid (HA) filler. Fillers made from other ingredients, such as PLLA, CaHA, PCL, PMMA, and silicone, do not dissolve. If you had filler elsewhere and do not know the product name, tell us when you had it and in which area, and we will look into it together at your visit.
06Will Hyalase also dissolve my own hyaluronic acid?
The enzyme breaks down both filler and the hyaluronic acid that was already in your skin. Because the body makes new hyaluronic acid every day, your own hyaluronic acid is known to usually be replenished within two days. Hyaluronidase is not a medicine that dissolves fat or muscle.
07What are the side effects of Hyalase?
Redness, swelling, itching, and bruising at injection sites are common and usually settle within a few days. Allergic reactions occur rarely, and severe allergic reactions with shock are very rare. More or less may dissolve than you wanted, and there are also reports of the area looking hollow after a large amount of old filler was dissolved.
08I have had an allergy to bee stings. Can I still get Hyalase?
Bee and wasp venom also contain hyaluronidase, so if you have a bee-sting allergy, your risk of an allergy to this medicine may be higher. Be sure to tell us before treatment. At your visit, we decide together whether a skin test or care from an allergy specialist is needed.
09Is Hyalase approved by Korea's Ministry of Food and Drug Safety?
Hyaluronidase injection is approved in Korea as a prescription medicine. Its approved indications are helping other injected medicines spread through tissue, and helping the absorption of fluid and blood that have collected in tissue. Dissolving filler is not listed separately in the approval, so the doctor explains the need and the risks before deciding to use it.
10Which symptoms after filler mean I should contact you right away?
If you have sudden severe pain, skin that turns white, or bluish-purple patches that spread, it may be vascular occlusion, so contact the clinic where you had the treatment right away. These symptoms can appear a few hours later rather than right after the injection. If your vision becomes blurred or you cannot see and your eye hurts, call 119 or go straight to the nearest emergency room.
CONSULTATION
Consultation comes first
Before any treatment is chosen, a board-certified dermatologist checks your skin in person.
DM Dermatology, 4F, 579-1 Sinsa-dong, Gangnam-gu, Seoul
From Apgujeong Station (Line 3) Exit 5, walk straight for 50 m. 4th floor of the A Twosome Place building
- Weekdays
- am 10:00 - pm 07:00
- Saturday
- am 10:00 - pm 04:30
- Lunch break
- pm 01:00 - pm 02:00
- Sun & holidays
- By appointment only
- Subway
3Apgujeong StationExit 5
Walk straight for 50 m · 2 min on foot · 4th floor of the A Twosome Place building
- Bus
Apgujeong Station Exit 4 · Exit 32310523429
Blue bus147 · 148 · 240 · 463 · 343Green bus4211
Kwanglim Church · Hyundai High School2310323104
Blue bus143 · 240 · 345 · 472Green bus3011 · 4312 · 4318
- By car
Search in your navigation app158 Apgujeong-ro, Gangnam-gu디엠피부과의원
Use the building’s underground parking · Parking available in the building
