Under-eye filler can be puffy for a few days

Brett S. Kotlus M.D., M.S. 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.


Brett S. Kotlus MD, MS
13 months ago

Juvederm is a hyaluronic acid-based filler that is quite soft and well-tolerated in many clinical situations. One consideration in the setting of puffiness after injection is that this type of filler is hydrophillic, meaning it attracts water. For a few days, this can be seen as swelling or puffiness, which generally resolves. Some patients see some benefit by using warm compresses to help the fluid subside. If your swelling is within the first few days after having a filler injection, this may improve spontaneously.

Hyaluronidase is an injectable substance that can dissolve filler in the case that there are lumps or bumps caused by the filler itself, not filler-related swelling. Rarely is a hyaluronidase injection necessary when fillers are placed correctly.

Fillers under the eyes can supplant surgical options in many cases. We now understand that the appearance of under eye bags can be areas of fat that are accentuated by hollowing below. By filling the grooves under the eyelids, surgery may not be required in some cases. In fact, in some cases, removing fat can create an aged or even more hollow appearance to the eyelids! Current techniques may involve fillers alone, a combination of surgery and fillers, or using native fat to restore volume.

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