Hyaluronidase: why it matters so much for filler treatments

Hyaluronic acid fillers are among the most common treatments in aesthetic medicine. To keep them safe, there needs to be a way to dissolve hyaluronic acid if necessary: the enzyme hyaluronidase. In this article, we explain why it is so important, what the supply stop of recent years meant and what happens next.

What is hyaluronidase?

Hyaluronidase is an enzyme that breaks down hyaluronic acid and thus increases the permeability of tissue. In aesthetic medicine, it is used to break down hyaluronic acid fillers in a targeted way – for example in the case of nodules, irregularities or, in an emergency, a suspected vascular complication.

Why is the product so important?

For many years, only one hyaluronidase product was approved in Germany. It is approved for other indications; dissolving hyaluronic acid fillers is therefore off-label, i.e. outside the approved use. Because dosage, onset of action and tolerability have been well documented over the years, many practices and complication clinics have aligned their approach to this product. Foreign hyaluronidase products are not approved in Germany.

Supply stop and relaunch: what happened?

As early as 2023, supply shortages were reported to the German Federal Institute for Drugs and Medical Devices (BfArM). Later, the then marketing authorisation holder stopped production, and the product was no longer regularly available. Practices had to make do with their remaining stocks; there was no equivalent approved substitute.

In the meantime, there is good news: the licence has been taken over by a new company that is rebuilding production in Germany. According to the German Society for Aesthetic Botulinum Toxin and Filler Therapy (DGBT) in July 2026, the product will soon be available again – initially in limited quantities distributed according to medical urgency.

Why hyaluronidase is a safety factor

Hyaluronic acid fillers are considered a well-established treatment method, but they are not free of risks. Possible complications include:

• nodules, hardening and visible filler accumulations,
• asymmetries or unharmonious contours,
• in rare cases, vascular occlusions with a risk of tissue damage.

In many of these situations, hyaluronidase is a key means of counteracting the problem – provided the product, dose and technique are known. Hyaluronidase itself can also have side effects, such as swelling, redness or, rarely, allergic reactions. That is why the treatment belongs in experienced medical hands.

Our approach at Medical Contour

In recent years, Medical Contour in Hamburg has become a point of contact for patients with problems after filler treatments. This includes:

• second opinions on uncertain or unclear results,
• Ultrasound diagnostics, which shows us exactly where the filler is located,
• targeted dissolving with hyaluronidase, which we always perform under ultrasound guidance.

With high-resolution ultrasound, we identify filler deposits, blood vessels and sensitive structures and can place the enzyme where it is needed. This helps avoid breaking down more hyaluronic acid than necessary – including the body’s own. As we specialised in complication management early on and built up stocks in good time, we were able to offer these treatments continuously, even during the supply stop. We use only the product approved in Germany.

What matters to us: every treatment is performed by a doctor after careful information and weighing of benefits and risks. Not every dissatisfaction with a filler result requires dissolving. Sometimes waiting, a small correction or another procedure is the better choice. You can find the procedure and costs on our page on Dissolving hyaluronic acid in Hamburg.

Frequently Asked Questions

When should I seek medical help immediately after a filler treatment?
If you experience severe, increasing pain, noticeable paleness or bluish, blotchy discolouration of the skin, or visual disturbances after a filler injection. In this case, contact your treating practice or the medical emergency service immediately.

Does hyaluronidase also dissolve the body’s own hyaluronic acid?
Yes, the enzyme does not distinguish between filler and the body’s own hyaluronic acid. However, the body replenishes it. With ultrasound guidance, we use the enzyme as precisely as possible.

Does every unsatisfactory filler result need to be dissolved?
No. During the consultation, we clarify whether dissolving makes medical sense or whether waiting, a correction or another treatment is more suitable.

Note: Individual courses and results may vary. Nothing can replace a personal consultation with a doctor.