Vitrase vs Hylenex for Filler Correction: Key Differences Patients Should Understand

Filler correction isn’t a “quick fix”—it’s a medical decision that can affect skin quality, symmetry, and, in rare cases, circulation. In our Sherman Oaks medical spa, we approach dissolving filler with the same restraint and diagnostic discipline we use when placing filler: identify what’s actually causing the problem, correct only what needs correcting, and protect long-term tissue health.

At Cosmetic Injectables Center Medspa, Dr. Sherly Soleiman, MD—Founder & Medical Director, Board-Certified Physician with 25+ years of medical experience and training—provides on-site, physician-led oversight across the full scope of nonsurgical medical aesthetic care, directing protocols, sterility standards, provider training, and complication management at our Sherman Oaks practice. (See Dr. Sherly Soleiman, MD.)

First: what “filler correction” can (and cannot) dissolve

Vitrase and Hylenex are both forms of hyaluronidase, an enzyme used to break down hyaluronic acid (HA). That matters because:

• They can dissolve HA-based fillers (many common fillers used for lips, cheeks, under-eyes, jawline, etc.).
• They do not dissolve non-HA fillers, such as:
  • Sculptra (poly-L-lactic acid)
  • Radiesse (calcium hydroxylapatite)
  • Bellafill (PMMA)

So the first “difference” patients should understand isn’t Vitrase vs Hylenex—it’s what product was injected in the first place. When patients aren’t sure, we often start by verifying records and performing a careful exam before discussing a dissolving plan.

For patients researching dissolving options in more detail, we also discuss this directly in our practice information on Hylenex and Vitrase.

The practical difference: Vitrase vs Hylenex (what patients should know)

Both products can be effective for HA filler correction. In real clinical practice, the “better” choice is usually the one that best matches the patient’s risk profile and the clinical scenario—and is used by a team with the right complication protocols.

Hylenex vs Vitrase (Patient-Facing)

Clinical takeaway: Patients often ask, “Which one is stronger?” The more useful question is: “How much dissolving is needed, in what exact location, and how do we avoid overcorrection?” That’s where physician judgment matters most.

Clinical judgment that matters: when we dissolve—and when we don’t

A thoughtful dissolving plan starts with identifying what you’re seeing:

1) Overfilled or “puffy” result (elective correction)

• Best approach: conservative dissolving in staged sessions rather than “wipe it all out.”
• Why we’re careful: aggressive dissolving can create hollowness or reveal volume loss that the filler was partially masking.

2) Asymmetry

• What works: targeted correction—sometimes dissolving a small area on one side is better than adding more filler to the other.
• What fails: “chasing symmetry” with repeated filler on top of a structural problem.

3) Lumps / nodules

Not every bump is dissolvable filler. Common culprits include:

• product sitting too superficially
• swelling/inflammation
• fibrosis/scar-like firmness
• less commonly, infection or biofilm-like inflammation

If we suspect inflammation or infection, we don’t reflexively dissolve first. We evaluate, because dissolving can sometimes worsen tissue irritation if the real problem wasn’t “excess HA.”

4) Urgent scenarios: circulation compromise (vascular concern)

This is the category patients should take most seriously. If there is significant pain, blanching/pale skin, dusky discoloration, or rapidly evolving skin changes after filler, it’s an urgent evaluation. Hyaluronidase is a key tool in emergency reversal protocols when HA filler is involved—but time, recognition, and protocol-driven treatment are what protect skin.

What the dissolving appointment is actually like (and what to expect)

Most patients want to know two things: how fast it works, and how they’ll look afterward.

• Onset: Many patients notice change the same day, but the final look can take longer because swelling and local irritation can temporarily mask the endpoint.
• Number of sessions: Some corrections are one visit; others require staged sessions to avoid overcorrection.
• Downtime: Expect the possibility of swelling, tenderness, and bruising—especially in delicate areas (lips and under-eyes).

Sherman Oaks–specific insight: Because our patient population is exposed to year-round sun and often returns quickly to outdoor routines, we’re strict about post-treatment guidance (sun protection and avoiding heat/exertion early). Bruising and inflammation don’t just “look worse” in bright daylight—they also tend to linger when patients push heat, exercise, or sun too soon.

Risks and limitations patients should understand upfront

Even when done well, dissolving is not “nothing.”

Potential risks include:

• Overcorrection (too much filler dissolved)
• Temporary swelling, bruising, tenderness
• Asymmetry during the settling period
• Rare allergic reaction
• Incomplete correction if the issue isn’t HA filler (or isn’t primarily filler)

A common misconception: hyaluronidase “only dissolves the bad filler.” In reality, it dissolves HA where it’s placed—which is why precise placement and conservative dosing strategy matter.

Who may not be a good candidate for immediate dissolving

We slow down—and sometimes defer—dissolving when:

• You don’t know what filler was used and records aren’t available (we first confirm what’s realistically correctable).
• The area is actively inflamed (significant redness, warmth, escalating pain) and needs evaluation for infection or another cause.
• You have a history of a true allergic reaction to hyaluronidase (this changes the risk–benefit discussion).
• You’re seeking dissolving to correct a problem that is really skin laxity or structural aging (dissolving may worsen the appearance by unmasking volume loss).

FAQs

For patients considering filler correction or dissolving, decisions are best made in person with a full assessment and physician-guided planning at our Sherman Oaks location at Cosmetic Injectables Center Medspa.