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Hyaluronidase. How Many Vials is Enough?

By Jill Charles, MSN, CNP

Filler complications. They can happen to any provider- both new or seasoned. The facial vasculature is highly complex and though we rely on our extensive training, medical backgrounds and safe injection techniques, sometimes luck is just not on our sides. In the event that one of your patients experiences a vascular complication, are you prepared to manage it? Do you have a protocol to follow? How many vials of hyaluronidase do you keep in your practice? There are several variables that can play into determining how many vials are necessary, such as your location. If your practice is located in a rural area and you have no support within your community, then your in-office supply ought to be much higher, perhaps 20 vials. A metropolitan provider may supply 12-18 vials given that they are surrounded by fellow injectors who may provide additional hyaluronidase should they exhaust their own supply. In a recent vascular emergency in my practice, I followed the DeLorenzi protocol and the patient required a total of 14 vials of Vitrase to dissolve 0.5cc of Voluma. This post is not necessarily meant to advise you on how many vials to have on hand, because there really is no right or wrong answer. However after reading this, I hope you will reflect on your current emergency protocol and ask yourself, am I prepared?

See how Jill was was able to treat this patient’s vascular emergency here:

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