Hyaluronic Acid (HA) Filler
User · · Last reply 🌐 한국어
Hello. I have had Hyaluronic Acid (HA) fillers injected and dissolved in my nasolabial folds multiple times. About four years ago, I also used a collagen booster called Juvelook, which caused no issues at that time. However, recently, after getting HA fillers, my face looked unnatural, so I tried dissolving and re-injecting them, but the area around my nasolabial folds remained unnatural. Since then, I have attempted to dissolve them about five times. I even underwent a procedure where the target area was precisely identified using ultrasound, injected with hyaluronidase, and then manually expressed (Pinhole Extraction), but the granules remain in my nasolabial folds and I can still feel the filler. Is it possible to improve this?
When I had an ultrasound, they told me that the filler is distributed across both the deep layers and the muscle layers.
4 Replies
Dr. Ta-Ju Liu · Board-certified dermatologist🌐 繁中 Doctor
Hello, I am Dr. Ta-Ju Liu.
Direct Answer: Based on your description, there is still room for further improvement. Having previously undergone hyaluronidase dissolution and pinhole extraction does not mean the remaining lumps cannot be treated further.
Possibilities That Need to Be Differentiated
Lumps formed by Juvelook are different from residual hyaluronic acid: hyaluronic acid can be treated with hyaluronidase, but hyaluronidase cannot directly dissolve Juvelook's PDLLA particles, nodules, or surrounding fibrotic tissue. What you are currently feeling could be:
1. Residual hyaluronic acid
2. Juvelook (PDLLA) nodules
3. Fibrotic tissue
Different doctors use different removal methods, ultrasound localization, depth of entry, and approaches to treating residual lumps, so previously treated areas may still have remnants. Clinically, we frequently encounter cases where patients have already undergone dissolution or removal elsewhere, but still have localized particles, lumps, or unevenness remaining.
General Treatment Direction
- You mentioned that ultrasound shows the filler has distributed into deep layers or even the muscle layer. In such cases, the location needs to be carefully verified layer by layer; it cannot be resolved simply by administering another round of hyaluronidase.
- During an in-person consultation, bringing your current ultrasound images and photos from before and after treatment allows the physician to first determine whether what is being felt is residual hyaluronic acid, Juvelook nodules, or fibrosis, and then evaluate which areas have room for improvement.
When to Seek Medical Attention Immediately
If the nasolabial fold area suddenly becomes red, swollen, hot, and painful, rapidly enlarges, or shows skin discoloration, please seek medical attention promptly.
This online response is for general health education purposes only and does not constitute a diagnosis, nor can it replace an in-person consultation and ultrasound examination.
Dr. Ta-Ju Liu · Board-certified dermatologist🌐 繁中 Doctor
Additional note: My clinic is located in Taiwan (Taipei and Kaohsiung), not South Korea. If you are currently in South Korea, you can clearly document your ultrasound imaging and descriptions of your before-and-after photos here first. I will reply in the discussion thread with health education information. Based on your records, we can then determine whether an in-person evaluation in Taiwan is necessary, which will save you an unnecessary trip.
Online responses are for general health education purposes only, do not constitute a diagnosis, and cannot replace an in-person consultation and ultrasound examination.
User🌐 한국어
I do not have the ultrasound images. I would like to visit and receive treatment as soon as possible ㅠㅠ Since my job involves being on camera, I cannot undergo surgery at just any time, but I happen to be on leave today, so I was hoping to visit immediately if possible, but I haven't received a response yet.
User🌐 한국어
I am planning to travel to Taiwan. I am a YouTuber in Korea, so my face is frequently exposed on camera. I have an important shoot in about 3 weeks to a month, so I am in a very urgent situation where I need to improve the condition of my face before then. I have read all of your posts thoroughly. Is there any way I can receive a consultation quickly? Please, I beg of you. If possible, I will hop on a plane and visit immediately. I am available to visit this Sunday, or next Monday or Tuesday, and I can go anywhere in Taiwan. If you are busy with many patients and I need to wait, I am willing to wait at the clinic for as many hours as it takes. Please, help me.