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David Shafer, MD answers: What to do about Restylane bruising?

I had Restylane injected under my eyes, just above my cheeks. I developed severe bruising that lasted for almost 6 weeks. It has been 6 months since the procedure, and I still have what looks like lingering bruises where the Restylane was injected. Also, the doctor who did this over-filled the right side and you can clearly still see the filler bulging out in a line under my eye where he injected it.

Will the bruising and bulging go away? What can I do about it? Do I need to have other treatments? I don't want to have any injections to dissolve it at this point because of the bruising.


David Shafer, MD
11 months ago
By David Shafer, MD - Manhattan Plastic Surgeon

First of all, please be very cautious before having anyone inject anything around your eyes. The skin around your eyes is much thinner than elsewhere on your face and body. Therefore, having injections in this area has a higher incidence of visible material and side-effects from the injections - such as bruising. The discoloration you are describing may be bruising which should resolve over time. However, the discoloration may actually be the injected material as well. If the injectate is too superficial or in too large of droplets, then the light hitting your skin may refract differently causing a bluish hue which may be confused with bruising. As the material is metabolized and disappears, then the discoloration should go away as well. You are correct to not have any further injections - especially until your current problem is resolved.

I hope this is helpful.

David Shafer, MD
Manhattan

Web reference: http://www.RealCosmeticSurgery.com
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More answers to “What to do about Restylane bruising?”

A: It may not be bruising.

George J. Beraka, MD
11 months ago
By George J. Beraka, MD - Manhattan Plastic Surgeon

Injections under the eyes can be very tricky, even though I do use them in selected patients with good results. 1) When Restylane is injected too superficially, it can create a bluish discoloration in the skin which can look like bruising. This is called the Tyndall effect. Successful treatment of this has been reported with lasers. 2) Long term "bruising" can also happen in this area (blood pigments in the skin) and this doesn't always go away. I have seen this. Laser treatment (different laser) can also help this condition. I suggest you consult a dermatologist experienced with lasers. 3) Restylane can last a long time under the eyes (this is usually a good thing). So if the bulges bother you, they can be dissolved with hyaluronadase injections. This will probably not cause you more bruising. 4) I know this is not what you wanted to hear, but it sounds like you will need additional treatment. Good luck!

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A: Most likely

Steven Wallach, MD
11 months ago
By Steven Wallach, MD - Manhattan Plastic Surgeon

The bruising and bulging for the most part will probably go away. If there was significant bruising and it has lasted for now more than 6 months, then some of the them may not have resorbed. This is not very common but can happen. GIve it some more time for the restylane to be resorbed.  It may still go away. Patience is a virtue.

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