If you have undergone treatment with hyaluronic acid-based dermal fillers, then chances are you are acquainted with hyaluronidase. Administered through injection, hyaluronidase is a naturally occurring enzyme that decomposes hyaluronic acid (HA), enabling it to reduce the volume of overly filled lips or puffy under-eye areas. Although your body will eventually metabolize the filler, hyaluronidase expedites this process to yield immediate outcomes.
However, there are certain disadvantages: for instance, it can be inaccurate and frequently removes more hyaluronic acid filler than intended, especially when in the hands of an unskilled provider. This is where Topilase, a ground-breaking topical form of hyaluronidase, proves beneficial.
If you have never come across Topilase, you are not the only one – we were also oblivious until recently. Developed by French physician Dr. Sandrine Sebban and manufactured by Softfil, Topilase is being utilized in Europe and Asia with remarkable results, but it is not yet accessible in the United States.
Currently, Dr. Yael Halaas, a board-certified facial plastic surgeon in New York City who serves as the head of the Emerging Trends & Technology committee for the American Academy of Facial Plastic and Reconstructive Surgery, is testing Topilase in her practice. She anticipates a demand for it once it arrives, likely commencing in 2024: “Patients desire a gentle approach when dealing with less-than-perfect results from fillers.”
Here is what else you need to be aware of regarding this innovative product.
What is Topilase?
Topilase is a topical solution that encompasses both hyaluronidase as well as herbal components such as lavender, helichrysum, and aloe vera. It presents a needle-free means to obtain the hyaluronic acid-dissolving effects of hyaluronidase – although at a much more delicate level compared to the injectable version. “It definitely doesn't dissolve all the filler, but it seems to reduce it,” Dr. Halaas remarks.
How is Topilase used?
The application is straightforward: the Topilase formula is applied and then massaged into the treatment area. After a few minutes, “you can actually observe a reduction by a small yet perceptible percentage in the overfilled region,” Dr. Halaas states.
Since the solution remains active for two weeks, the patient can return within this two-week period for up to three applications until they achieve the desired outcome. Particularly for thin-skinned areas, she says, “it can take a result that is slightly overfilled and even out some imbalances – or bring down a result that is slightly excessive.”
It also shows early indications of reducing swelling. In France, the physician who created it reports using it on patients immediately after injection, as per Dr. Halaas, because the homeopathic botanicals in the formula may assist in reducing swelling.
While Dr. Halaas does not have sufficient product to test it for this specific purpose, in foreign cases, Topilase has been demonstrated to “minimize all swelling after injections,” she says. “In my practice, I employ a number of herbal topicals afterwards to help reduce swelling, so once this becomes more widely commercially available, this might be something I adopt.”
Topilase vs. hyaluronidase
Topilase is not a straightforward replacement for injectable hyaluronidase. “No topical will substitute an injection,” says Dr. Halaas. “If you have a filler emergency, such as a vascular obstruction, you must have and be prepared to inject hyaluronidase – and that emergency protocol is the reason you need to be injected by a knowledgeable injector.”
Additionally, Dr. Mona Gohara, a board-certified dermatologist based in New Haven, Connecticut, expresses doubt that it would be effective for deep filler. “I truly do not comprehend how something applied topically could genuinely influence the deep dermal placement of HA filler,” she says.
Nevertheless, here lies the advantage: Topilase might be more favorable for certain, more superficial areas of the face. “What is impressive is that for thin-skinned areas, like lips or under-eyes, it did seem to reduce the overfilled effect,” Dr. Halaas says. Since the skin is inherently thinner, there is a considerable possibility that the hyaluronidase can penetrate superficially, thereby performing its function.
Does Topilase cause pain?
Topilase does not cause pain, which gives it another advantage over injectable hyaluronidase, which can be uncomfortable. “Patients sometimes grumble about the burning sensation from injectable hyaluronidase,” says Dr. Halaas. “They prefer to have a needle-free approach.” For certain areas of the face, then, Topilase can offer a far more comfortable alternative.
How much will Topilase cost?
As of the press time, Prollenium has not shared the pricing with providers, so it is uncertain what the cost will be for patients once it becomes available.
