Restylane lumps under eyes

Otto Joseph Placik, MD answers: How long before Restylane bumps in tear troughs go away?

I had Restylane injected in my tear troughs 9 months ago. After I had it done, you could see a little bluish mark under each eye where it had been injected and what looks like half moon ridges there under my eyes as well. There were hard bumps on each side of my eyes as well that I was told to massage with a hot cloth very hard.

The bumps, I thought, went away but recently I can notice them again and they are very hard and the ridges and bluish marks under my eyes never went away.

I am very self-conscious and petrified to see someone, only to have it made worse. Will it ever go away? What should I do? Please help.


Otto Joseph Placik, MD
10 months ago

Of course all the answers below are all excellent and I have only a few comments"

Did the Restylane achieve your goals? Are the lumps visible but not palpable?

  • If the answer is yes then there are a couple of answers. The restylane may be too superficial but then your options are to remove it and suffer the condition which originally occured; I presume hollows below the eyes
  • However, it is also likely affected by the thin quality of your skin which cannot be reversed. It is similar to saying why do you have blue veins on the back of your hand? If your skin is thin you will see nearly anything placed beneath the surface.
  • How do you hide this? Well I would advise you to use camouflage make-up. Although this may seem paradoxical and you may be asking why you had the restylane injected in the first place. Well if the Restylane filled the groove or trough or fold then it achieved  a significant goal and the trade-off is the color. I like analogies so I will use one. IF you have a dent in your car they need to pull the dent out or fill it with bondo. That achieves correction in form but not necessarily in color or surface texture. The car will need painting and you may require make-up. That may be overly simplified but it makes a point.

If the Restylane did not achieve your goals

  • Contemplate having it removed by using hylauronidase (off label) or having it expressed with a needle as described by others.

I hope the helps!

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A: Restylane= Reversible

Anil R. Shah, MD
10 months ago

The placement of restylane under and around the lower eyelids is an advanced application and requires extensive experience in anatomy and aesthetic judgement. The bluish tint under the skin is called the Tyndall effect and occurs when Restylane is placed too superficially under the skin. Persistent half moon shape of restylane is likely the result of persistence of product. Restylane tends to stick around longer in the periorbital area then around the perioral area, as is the case with most facial fillers and facial fat. A study by Vartaninan , et al in Archives of Facial Plastic Surgery examined the use of Hyaluronidase and found it effective in the use of break up of NASHA (Restylane or Restylane like products). After injection with Hyaluronidase the product is no longer palpable after 24 hours if utilized properly. Hyaluronidase is more painful to administer and is more likely to cause a bruise than administration of NASHA agents.

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