Hi Dr Paul
The recomended approach with 1500 iu hyalsa is as follows:
3.5 ml saline with 0.5ml lignocaine (I prefer without adrenalin)
This gives a total dilution of 4 ml so 1ml will equall to 375 iu hyalsa
In the case of suspected or impending avascular necrosis the recomendation is to inject 150 iu hyalsa (o.4 ml) but titrated doses can be used for removing small lumps of HA filler (between 35 to 70 IU)
I hope the above has helped
Please che the following studies for further info:
Use of Hyaluronidase in the Treatment of Granulomatous Hyaluronic Acid Reactions or Unwanted Hyaluronic Acid Misplacement: HAROLD J. BRODY, MD
• Dermatol Surg 2005; 31:893–897.
Management of Injected Hyaluronic Acid Induced Tyndall Effects: Ranella J. Hirsch, MD, FAAD, Vic Narurkar, MD, FAAD, and Jean Carruthers, MD, FRCS
Lasers in Surgery and Medicine 38:202–204 (2006)
Hyaluronidase in the correction of hyaluronic acid-based fillers: A review and a recommendation for use: Berthold Rzany, MD, ScM, Petra Becker-Wegerich, MD, Frank Bachmann, MD, Ricardo Erdmann, & Uwe Wollina, MD
Journal of Cosmetic Dermatology, 8, 317–323