Swelling versus too much filler

Jordana S. Gilman, MD answers: Puffy eyes after Juvederm injections in under eye hollows

I had Juvederm injected below my eyes to fill in hollows, and now I have pillows instead. It looks horrible. My doctor said that only surgery would fix this and he stated I should have had eyelid surgery all along. He suggested I initially try the injection because I cannot afford surgery right now.


Jordana S. Gilman, MD
13 months ago

When did you have the injections? You may be swollen for several days after the injections, and bruising may also cause some swelling. If there was too much filler injected causing the "pillows" the best treatment is hyaluronidase. Hyaluronidase is injected into an area with too much filler and it dissolves the filler away completely.

Also, the fat pad that is under the eye can itself puff out with time and look like a little pillow. If you then have filler placed in the groove below the eye (and below that fat pad) it may look like the pillow is larger because the groove is now gone. If the fat pad is your problem than only surgery will fix it. But if the pillow is from the filler than you need hyaluronidase.

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A: Good news: Excess Juvederm can be removed

George J. Beraka, MD
13 months ago

It sounds like you now have 2 problems: your original hollows and a new deformity caused either by too much Juvederm or by incorrectly injected Juvederm.

I think you need to deal with the Juvederm first. There is a medication called Hyaluronidase injections and these can dissolve the Juvederm. This excess Juvederm cannot be removed with surgery.

Once you are back to your original hollows, you can save your money for corrective surgery. I should also tell you that surgery to correct lower lid hollows is difficult and has inconsistent results. So get more than one opinion and ask to see lots of before and after pictures.

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A: Puffy under eyes after Juvederm

Steven Wallach, MD
7 months ago

First, Juvederm absorbs water during its resorption. This may h ave translated to lower eyelid swelling.  If you truly have eye bags, then I suggest you wait to have those treated until after the Juvederm dissolves.

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