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Can't Get Juvederm Right! Overfill? Do I Start over or Do I Need Something More Aggressive? (photo)

I'm 43 years old, 112 pounds. I have been getting filler for 4 years. Initially was for under eye area and it worked wonderfully. Then we started adding the cheeks as they started to flatten a bit. For whatever reason over past 7 months we just can't get it right. My self-esteem is suffering. My reflection in windows/under flouresent light I look so old and awful. Dr. is patient but doesn't see the issues. New Dr.? Remove all filler and start over? Time for more aggressive treatments?

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12 Doctor Answers | Asked by Nina43

Doctor Answers (12)
Community Comments (1)

Getting Juvederm Right is an Art

Injecting fillers of any kind is really an art. While I understand your frustrations and anguish, please know that in your photos, I see a really beautiful woman who doesn't need that much done to fix the situation. Don't suffer from low self-esteem - the problem just really isn't that bad. Also, please remember that fluorescent lights and certain reflections make everyone look worse - it's really not you. With all of that, what you have is the Tyndall Effect, which occurs from... more

Using fillers for facial volumizing - look at the big picture!

When I evaluate a patient for using fillers, I think the most important thing to do is to take into account the entire face. A lot of injectors will put some filler (Juvederm, in your case) under the eyes or in the cheeks, but will completely ignore many other signs of aging. When this happens, a person can look unnatural or "partially overfilled" because other areas were ignored. Because of your age and weight, you have lost a lot of overall facial volume including in the... more

Juvederm overfilling around the eyes can be easily corrected

I think that what you are seeing is the "Tyndall effect" around your eyes. This is a bluish reflection of light on the Juvederm. There are a few possible causes: Overfilling. If this is the case, wydase can be used to reduce some of the Juvederm. Injecting too superficially. If this is the cause, complete removal is necessary and starting fresh. Wrong product. Occasionally, I have found that patients with very thin skin, no matter... more

Juvederm is not the problem!!

Juvederm is a great product, but placement and injector technique is everything! As long as what is there was placed deep, more in the right places could blend everything. If not deep then dissolve and start over

Sam Naficy, MD

80 reviews

Seattle Facial Plastic Surgeon

www.seattleface.com

Juvederm and Tyndall Effect

What I notice based on the pictures is what is known as the "Tyndall Effect", or a slight blue appearance in the area under your eyes. Often when Juvederm and Restylane (both HA fillers) are injected along the orbital rim, the injection is too superficial or the area is over-injected, leading to visibility of the filler. In the same way as a swimming pool, superficial HA filler looks blue in color. My general preference for enhancing facial volume is Sculptra, which is performed... more

Juvederm to cheeks

Did you only have the Juvederm placed into your cheeks and under your eyes or were other areas treated as well? I believe you do have a few options to help with your problem. One possibility is to dissolve some of the Juvederm (with hyaluronidase injection) to see if this helps to even out your appearance. Another option would be to not dissolve any of it but to have some more placed to even things out. It seems as though your problem is the result of a placement... more

Restylane is better than Juvederm under the eyes

First of all, the good news is you will ultimately get your good results again! Currently, there are several irregularities under the eyes and in the midface that are distracting. My recommendations include: Use Wydase to remove some of the Juvederm, especially directly under the eyes where it may be a little too superficial. Use Restylane instead of Juvederm. The Juvederm doesn't maintain it's shape after being injected as well as Restylane. It also... more

Getting Juvederm and other fillers right

There is a real art as well as science (need to understand & study symmetry, beauty, balance, proportions & anatomy) to injecting fillers like Juvederm, Restylane & Radiesse, injecting botulinum toxins like Botox, and when to know to use resurfacing lasers, chemical peels/microdermabrasion, a great home skin care regimen, or surgery. Best to speak with your dermatologist or get a second opinion to find someone who can work with you to achieve your goals.

Benjamin Barankin, MD

10 reviews

Toronto Dermatologic Surgeon

Juvederm versus Restylane

Juvederm is a great product but not for the tear trough area where it can retain too much water. You should have the Juvederm under your eyes dissolved with hyaluronidase, wait a week or two to see the result, and then consider injecting Restylane if more volume is still needed. You may need it in the midcheek area rather than the tear trough area. If your doctor does not appreciate the issues, you should seek an experienced dermatologist or plastic surgeon. more

Too Much Juvederm

I do not not think that you have too much Juvederm in the areas that you are pointing out. I don't think that Juvederm would have been my first choice of fillers for you as I would have added more volume in other places instead of less where added. I would have considered Sculptra or maybe even Radiesse.

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Comments (1)

Nina43 3 Oct 2012

I'd like to sincerely thank all of you for your inputs. I am fairly thin skinned so I am probably more of a challenge around the eye area than others. I have considered discussing Sculptra in the cheek area but had not considered under the eye. Something else to discuss with Dr. He is well known, highly rated and respected and as I have said before has been very patient and fair in working to get a result that is pleasing (bottom line is not his driver) I just seem to have hit a wall but now I have better wording to discuss my concerns. With that I will also follow-up with another Dr. (in my area there are several good ones). Like everything else, some may be better at doing certain areas/using certain products than others. It is just tough to not be comfortable in your own skin

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