Episode Synopsis "Podcast hyaluronic acid - Episode 08- When can I see the results? What happens if I think that there was too much of a product that was used? Can I get it out?"

The initial result is seen immediately. Then the resorption of the edema and the distribution of the product over time must be taken into account, so that the final result can be evaluated approximately 2 weeks after the injection.  We think it's stupid to inject the whole amount and have the patient see the end result. We proceed that during the treatment we show intermittently and alternatively what is obtained and thus the patient can tell us if she sees a difference, if we still need to add volume or we can stop. In any case, if the injection is done correctly and a large amount of product is not stored, there is no need to think about removing the product. If there is a medical problem of ischemia of a tissue due to intravascular injection or due to the pressure created by the acid, we must be prepared to remove the product by injecting hyaluronidase.  Another situation in which the melting of hyaluronic acid by using hyaluronidase can be considered is when the product has been injected too superficially and created the so-called Tyndall effect. This usually happens at the level of the circles. This would result in the impossibility of proper drainage of the lymph, due to the pressure of hyaluronic acid on the lymphatic vessels. This effect will create an appearance of fluffy and more swollen eyelids, which may be more pronounced during the morning or after a water retention and which may diminish during the day and in the evening.  This translates into movements of the eyeballs that will release some of the lymph from the lymphatic vessels. This can last for years and if it produces an unsightly effect, it must be corrected by enzymatic digestion using hyaluronidase. Another condition by which hyaluronidase can be used is when nodules or granulomas appear after the injection. Nodules appear due to the technique of injection or dislocation of the acid and its conglomeration following special conditions that must be known by the patient and granulomas can occur both due to the quality of hyaluronic acid and the effect of thermogenic treatments that were made after hyaluronic acid injection. Under these conditions, the injection of hyaluronidase should be considered, which in most cases will definitely solve the problem. But we consider it foolish to inject hyaluronidase to melt the acid because it has been put in excess, either because of the patient or because of the doctor. We do not encourage such practices when using large amounts of hyaluronic acid on the grounds that the patient wants very large lips or extraordinary cheekbones. These treatments do not categorize us as responsible and experienced doctors, so we do not accept such requirements from our patients, but we do not face such a thing, except quite rarely. Even when we have a patient who wants an artificial result, it is very possible to refuse treatment, explaining its implications. It is not the excessive volume that makes us more beautiful and attractive, but the result by which, for example, the lips seem bigger, but it does not seem to have been treated.

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• Podcast hyaluronic acid - Episode 08- When can I see the results? What happens if I think that there was too much of a product that was used? Can I get it out?
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• Podcast Hyaluronic acid - Episode 05- What regions of the face can we improve with hyaluronic acid?
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