The Use of Hyaluronidase in Orofacial Harmonization – Narrative Review

Authors

DOI:

https://doi.org/10.33448/rsd-v11i5.28119

Keywords:

Hyaluronic Acid; Adverse effects; Hypersensitivity.

Abstract

Hyaluronidase is an enzyme responsible for the degradation of hyaluronic acid, which, when applied in a way that generates adverse effects, must be used. The objective of this article was to carry out a narrative review of the literature on the use of hyaluronidase in orofacial harmonization, to present its indications, contraindications, as well as its level of effectiveness. Searches were carried out in scientific databases (PubMed and Google Scholar) and included literature reviews, case reports and clinical studies published between 2016 and 2021, in English and Portuguese. It was concluded that, within the scope of orofacial harmonization, hyaluronidase is indicated for the management of complications related to hyaluronic acid fillers. It is effective in the management of mild or severe complications, and can be applied in the treatment of hematomas, nodules, granulomas, foreign body reactions and inflammatory reactions, as well as for vascular complications such as tissue necrosis and livedo reticularis. Its use is contraindicated in case of hypersensitivity to its components. Side effects caused by hyaluronidase are rare and involve allergic reaction and local itching.

References

Beleznay, K. Carruthers, J. D. A. Humphrey, S. Carruthers, A. & Jones, D. (2019). Update on Avoiding and Treating Blindness From Fillers: A Recent Review of the World Literature. Aesthet Surg J. 16;39(6):662-674.

Weber, G. C. Buhren, B. A. Buhren, B. A. Schrumpf, H. Hoff, N. P. Bölke, E. Hilton, S. & Gerber, P. A. (2016). Hyaluronidase: from clinical applications to molecular and cellular mechanisms. Eur J Med Res. 13;21:5.

Goodman, G. J. Liew, S. Callan, P. & Hart, S. (2020). Facial aesthetic injections in clinical practice: Pretreatment and posttreatment consensus recommendations to minimise adverse outcomes. Australas J Dermatol. 61(3):217-225.

Lee, W. Hwang, S. Oh, W. et al. (2020). Practical Guidelines for Hyaluronic Acid Soft-Tissue Filler Use in Facial Rejuvenation. Dermatol Surg. 46(1):41-49.

Mccann, M. (2019). Intravenous Hyaluronidase for Visual Loss Secondary to Filler Injection: A Novel Therapeutic Approach. J Clin Aesthet Dermatol. 12(12):25-27.

Neto, S. J. M. A. Calado, J. L. T. Melo, M. H. A. S. et al. (2020). Hialuronidase: uma necessidade de todo cirurgião dentista que aplica ácido hialurônico injetável. REAS/EJCH, 39, e. 2296.

Rocha, R. C. C. Castilho, L. B. Blaas, D. M. A. Tavares Júnior, R. Tavares, A. P. & Wanczinski, M. I. (2018). A importância do uso precoce de hialuronidase no tratamento de oclusão arterial por preenchimento de ácido hialurônico. Surg Cosmet Dermatol. 10(1):77-9.

Sito, G. Manzoni, V. & Sommariva, R. (2019). Vascular Complications after Facial Filler Injection: A Literature Review and Meta-analysis. J Clin Aesthet Dermatol. 12(6):E65-E72.

Urdiales-Gálvez, F. Delgado, N. E. Figueiredo, V. Lajo-Plaza, J. V. Mira, M. Moreno, A. et al. (2018). Treatment of Soft Tissue Filler Complications: Expert Consensus Recommendations. Aesthetic Plast Surg. 42(2):498-510.

Vasconcelos, S. C. B. Nascente, F. M. Souza, C. M. D. et al. (2020). O uso do ácido hialurônico no rejuvenescimento facial. Revista Brasileira Militar de Ciencias. v. 6, n. 14.

Wollina, U. & Goldman, A. (2020). Facial vascular danger zones for filler injections. Dermatol Ther. 33(6):e14285.

Zhu, J. Tang, X. Jia, Y. Ho, C. T. & Huang, Q. (2020). Applications and delivery mechanisms of hyaluronic acid used for topical/transdermal delivery - A review. Int J Pharm. 30;578:119127.

Chauhan, A. & Singh, S. (2019). Management of Delayed Skin Necrosis Following Hyaluronic Acid Filler Injection Using Pulsed Hyaluronidase. J Cutan Aesthet Surg. 12(3):183-186.

Baley-Spindel, I. Villaseñor-Villalpando, E. Márquez-Espriella, C. Rivera-Salgado, M. I. & Dávila-Díaz, R. (2020). Perivascular Hyaluronidase With Alteplase as Treatment for Hyaluronic Acid Thrombosis. Aesthet Surg J. 14;40(5):551-559.

Paap, M. K. Milman, T. Ugradar, S. Goldberg, R. & Silkiss, R. Z. (2020). Examining the Role of Retrobulbar Hyaluronidase in Reversing Filler-Induced Blindness: A Systematic Review. Ophthalmic Plast Reconstr Surg. 36(3):231-238.

Weber, G. C. Buhren, B. A. Schrumpf, H. Wohlrab, J. & Gerber, P. A. (2019). Clinical Applications of Hyaluronidase. Adv Exp Med Biol. 1148:255-277.

Zhang-Nunes, S. Ryu, C. Cahill, K. Straka, D. Nabavi, C. Czyz, C. & Foster, J. (2021). Prospective in vivo evaluation of three different hyaluronic acid gels to varying doses of hyaluronidase with long-term follow-up. J Plast Reconstr Aesthet Surg. 74(4):874-880.

Ryu, C. Lu, J. E. Zhang-Nunes, S. (2021). Response of twelve different hyaluronic acid gels to varying doses of recombinant human hyaluronidase. J Plast Reconstr Aesthet Surg. 74(4):881-889.

Rauso, R. Zerbinati, N. Franco, R. Chirico, F. Ronchi, A. Sesenna, E. Colella, G. & Tartaro, G. (2020). Cross-linked hyaluronic acid filler hydrolysis with hyaluronidase: Different settings to reproduce different clinical scenarios. Dermatol Ther. 33(2):e13269.

Ors, S. (2020). The Effect of Hyaluronidase on Depth of Necrosis in Hyaluronic Acid Filling-Related Skin Complications. Aesthetic Plast Surg. 44(5):1778-1785.

Lee, W. Oh, W. Oh, S. M. & Yang, E. J. (2020). Comparative Effectiveness of Different Interventions of Perivascular Hyaluronidase. Plast Reconstr Surg. 145(4):957-964.

Santaella-Sosa, E. R. (2020). Outstanding efficacy of bacterial recombinant hyaluronidase concerning a subaccute filler complication clinical case. Dermatol Ther. 33(4):e 13726.

Diwan, Z. Trikha, S. Etemad-Shahidi, S. Virmani, S. Denning, C. Al-Mukhtar, Y. et al. (2020). Case Series and Review on Managing Abscesses Secondary to Hyaluronic Acid Soft Tissue Fillers with Recommended Management Guidelines. J Clin Aesthet Dermatol. 13(11):37-43.

Zhang, L. Luo, Z. Li, J. Liu, Z. Xu, H. Wu, M. & Wu, S. (2021). Endovascular Hyaluronidase Application Through Superselective Angiography to Rescue Blindness Caused by Hyaluronic Acid Injection. Aesthet Surg J. 41(3):344-355.

Munavalli, G. G. Guthridge, R. Knutsen-Larson, S. Brodsky, A. Matthew, E. & Landau, M. (2021). "COVID-19/SARS-CoV-2 virus spike protein-related delayed inflammatory reaction to hyaluronic acid dermal fillers: a challenging clinical conundrum in diagnosis and treatment". Arch Dermatol Res. 9:1–15.

Published

02/04/2022

How to Cite

MENA, M. A. .; MENA, G. C. P. .; MUKNICKA, D. P. .; SUGUIHARA, R. T. .; PIMENTEL, A. C. . The Use of Hyaluronidase in Orofacial Harmonization – Narrative Review. Research, Society and Development, [S. l.], v. 11, n. 5, p. e17411528119, 2022. DOI: 10.33448/rsd-v11i5.28119. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/28119. Acesso em: 25 apr. 2024.

Issue

Section

Health Sciences