closeup of liporase injection

In aesthetic medicine, achieving the perfect look requires a strategic approach that sometimes means undoing previous treatments. Enter Liporase, an enzyme-based filler dissolver that has gained popularity for its ability to safely and effectively correct unwanted filler results. In this article, we will focus on proper Liporase usage, ensuring safe and effective outcomes for practitioners and patients.

Understanding Liporase

Liporase, a product containing the depolymerizing enzyme hyaluronidase as its main ingredient, is a valuable asset in the field of aesthetic medicine. This pharmaceutical antidote not only effectively reverses the effects of hyaluronic acid-based fillers, helping to mitigate the risks of fibrosis and necrosis, but also reinvigorates fibroblast activity, making it an essential tool for practitioners seeking to correct or reverse the outcomes of previous treatments.

Liporase stands out for its effectiveness, versatility, and safety compared to other dermal filler dissolvers. However, while patients may not know how to use Liporase, healthcare providers should, and it’s crucial to stress that proper training and certification are prerequisites for using this powerful tool.

Prerequisites for Using Liporase

  • Education and Training

Before performing any Liporase procedure, medical practitioners must complete the necessary training and certification programs. Only those certified to use Liporase should administer this treatment.

  • Obtaining Liporase

The process of obtaining Liporase demands meticulous attention to detail to safeguard the product’s efficacy and integrity. By selecting a reliable supplier like Medica Depot, medical practitioners can be confident in the quality, purity, and authenticity of the Liporase product. Medica Depot’s commitment to sourcing products from reputable manufacturers and adhering to stringent quality control measures ensures the authenticity of their products.

  • Sterile Environment

Creating a sterile and controlled environment is essential. Ensure all necessary safety measures are in place before starting any Liporase procedure.

Patient Assessment

When it comes to using Liporase for filler correction, starting with a comprehensive patient assessment is more than just good practice – it’s the keystone to achieving the best results. Practitioners must delve into the specifics, such as identifying the filler type used, the quantity employed, and pinpointing the exact injection sites. This meticulous evaluation is the foundation for the subsequent steps, ensuring that the corrective process is tailored to the patient’s needs.

Understanding Patient Goals

Beyond the technical aspects, successful Liporase procedures also hinge on effective communication with the patient. Understanding their expectations and aesthetic goals is absolutely vital. It’s not just about administering the treatment; it’s about guiding the entire process to align with the patient’s vision. In this context, the medical professional transforms into a collaborator, working alongside the patient to achieve the desired outcome.

Preparing Liporase

Liporase, an enzyme used in various medical and cosmetic applications, is typically supplied in powdered form that requires reconstitution before use. Proper Liporase preparation is essential in ensuring optimal results in the intended application.

  • Reconstitution Process

Liporase comes in a powder form that must be reconstituted before use.

  • Storage and Handling

Maintain strict control over the storage and handling of Liporase to prevent contamination or degradation.

  • Correct Dilution

Follow guidelines for the correct dilution of Liporase, as overdilution or underdilution can impact the effectiveness of the enzyme.

Liporase Administration

When dissolving fillers with Liporase, it is crucial to follow precise injection techniques, taking into account the depth and location of the filler.

Preparation and Sterilization:

  • Before initiating the injection, ensure the area is clean and thoroughly disinfected using an antibacterial skin solution.
  • Palpate and mark out the specific area to be treated. This step helps identify nodules or regions containing the cross-linked hyaluronic acid (HA) filler.

Aseptic Technique:

  • Perform the injections using an aseptic technique to minimize the risk of infection or complications.
  • Choose either a cannula or needle that will reach the appropriate depth based on the location of the filler.

Depth and Site of Injection:

  • Carefully consider the depth and site of injection for Liporase, ensuring that it targets the specific area containing the cross-linked HA filler. Palpate and target nodules individually if they are present.
  • If generalized hyaluronic acid-related swelling is present, treat the entire affected area.

Injection Technique for Nodules:

  • In the presence of a nodule, inject directly into the nodule area. There may be resistance to the injection, but it is essential to penetrate the nodule to remove the filler successfully.
  • The amount of Liporase hyaluronidase required for individual nodules can vary. Larger and sometimes repeated doses may be necessary for complete resolution. The patient should be informed that repeat treatment might be needed.

Use of Ultrasound:

  • Ultrasound-guided dissolution can be helpful in cases where it is challenging to penetrate a filler pocket, especially with a blunt cannula.
  • Ultrasound can help dissolve arterial occlusions and enhance the accuracy of injecting Liporase into nodules or areas with unwanted residual cross-linked HA.

Massage After Injection:

  • After the injection, firmly massage the treated area. Massaging aids in the breakdown of the cross-linked HA filler, promoting its dissolution.

Cautionary Notes:

  1. Do not inject Liporase in an area where botulinum toxin has been administered in the past 48 hours, as this may interfere with the toxin’s effectiveness.
  2. Do not inject Liporase into an area with infective sequelae unless there is suspected biofilm formation and the patient is stabilized with antimicrobial treatment.

Potential Side Effects and Complications

Liporase, the enzyme that dissolves hyaluronic acid-based fillers, can lead to some common side effects. These are typically mild and temporary. They include:

  • Redness: Redness at the injection site is one of the most common side effects. It often results from the injection itself and usually subsides within a few hours to a day.
  • Swelling: Another frequent side effect, typically localized to the injection area. This swelling can be more noticeable during the first 24 to 48 hours after the procedure but usually diminishes gradually.
  • Bruising: Bruising can occur at the injection site, especially if blood vessels are damaged during the procedure. Bruising can vary in severity, and it may take a few days to a week to resolve.
  • Pain or Discomfort: Some patients may experience some discomfort or pain at the injection site. This discomfort is often manageable with over-the-counter pain relievers and typically subsides quickly.

Less Frequent but Severe Complications:

While the common side effects of Liporase are usually mild and transient, there can be less frequent but more severe complications. These include:

  • Infection;
  • Allergic Reactions;
  • Tissue Damage;

Aftercare and Follow-Up

Results are often immediate, but denser, cross-linked products may require up to 48 hours for full effect. After administering Liporase, observe the patient for 60 minutes to check for adverse reactions and provide aftercare instructions. If there is any delayed reaction, promptly schedule a follow-up appointment.  Here are some aftercare pointers to give to your patients:

  • Expect swelling and bruising;
  • Apply cold compresses to reduce swelling;
  • Avoid makeup for at least 24 hours;
  • Gently cleanse the area with a mild, non-alcoholic cleanser;
  • Protect yourself from sun exposure;
  • Limit strenuous activities for 24 hours;
  • Follow any prescribed topical treatments;
  • Stay hydrated;
  • Attend follow-up appointments;
  • Avoid premature retreatment.

Conclusion

The ability to safely and effectively dissolve dermal fillers with Liporase makes it a powerful tool for correcting all manner of filler mishaps. However, Liporase should only be administered by certified professionals in a sterile and controlled environment. Effective patient communication, proper training, and ethical considerations are key to ensuring successful outcomes.

FAQ

How long does it take for Liporase to work?

The onset of Liporase’s action typically occurs within a few hours to a day after administration.

How much Liporase does it take to dissolve fillers?

The amount of Liporase required to dissolve fillers varies based on the specific case and the type and amount of filler. It is typically administered in small increments, with dosages tailored to individual patient needs.

Does Liporase dissolve fat?

Liporase primarily targets hyaluronic acid-based fillers and does not dissolve fat.

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References

  1. Lee W. Comments on “Hyaluronidase: an overview of its properties, applications, and side effects”. Arch Plast Surg. 2020;47(6):626-627. doi:10.5999/aps.2020.01571
  2. King M, Convery C, Davies E. This month’s guideline: The Use of Hyaluronidase in Aesthetic Practice (v2.4). J Clin Aesthet Dermatol. 2018;11(6):E61-E68.
  3. Jung H. Hyaluronidase: An overview of its properties, applications, and side effects. Arch Plast Surg. 2020;47(4):297-300. doi:10.5999/aps.2020.00752
  4. Murray G, Convery C, Walker L, Davies E. Guideline for the Safe Use of Hyaluronidase in Aesthetic Medicine, Including Modified High-dose Protocol. J Clin Aesthet Dermatol. 2021;14(8):E69-E75.
  5. King M, Convery C, Davies E. This month’s guideline: The Use of Hyaluronidase in Aesthetic Practice (v2.4). J Clin Aesthet Dermatol. 2018;11(6):E61-E68.