Use of hyaluronidase in aesthetic procedures of the face with hyaluronic acid

Abstract

The purpose of this review is to demonstrate to the injector the most relevant recommendations for the use of hyaluronidase in complications with the use of hyaluronic acid. This is a bibliographic review of the texts published from 2005 to 2020. The search was carried out in the MEDLINE and LILACS databases. It was observed that even with good anatomical knowledge and correct technique, there is still some non-zero risk of vascular embolic events, although they are rare. Most complications are mild and reversible, however, vascular occlusion can result in serious consequences, such as skin necrosis, blindness and cerebral infarction. So far, hyaluronidase is the only antidote available for hyaluronic acid injections. Adequate knowledge of its use and immediate recognition of signs of complications after injection of the filler are essential for daily practice since there is no closed treatment protocol, but steps that are well established by most authors regarding the use of hyaluronidase: as the immediate interruption of the injection and application of the enzyme at an early stage.