Is the rate of breakdown for a dermal filler such as Juvederm Volbella affected by the volume of filler placed?
A patient Staff asked 4 years ago In other words, are these fillers dose-dependent such that 1ml of Volbella would breakdown more slowly than say 0.1 ml of Volbella? I am not referring to the resulting superficial appearance of the filled area, but rather the basic biochemistry behind the enzymatic reaction between the hyaluronic acid filler (Volbella) and our bodies’ naturally-produced hyaluronidase (the enzyme that breaks the filler down).
Dr. Elham Jafari Staff answered 4 years ago Rate of Breakdown of Fillers
Hi and thank you for your question! From a pure biochemical and enzyme kinetic point of view, the dynamics of hyaluronic acid (including hyaluronic acid filler) breakdown by hyaluronidase enzyme can be modeled by the Michaelis-Menten equation, which indicates that with increasing the concentration of the substrate (hyaluronic acid filler in this case), the rate of break-down will increase, until the enzyme is saturated in which case we reach a plateau and the rate won’t further increase. However, in our body (as opposed to inside a test tube), the level of enzyme can change by the cells that produce it and we also have cells continuously making more hyaluronic acid, so it can be more complicated. While in general our body loses hyaluronic acid over time which indicates that the rate of breakdown is higher than the rate of synthesis, given the lengthy nature of the process I think it is safe to assume that the level of substrate is much higher than the enzyme, and therefore my guess is that the enzyme in our body is most often saturated and hence, having more filler will results in more lasting results as it will take longer for the available enzymes to breakdown all the filler molecules. This is indeed a very interesting question and I love to know if there are actual clinical or lab data on it!
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