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Lumpy Ridges and Bruises After Juvederm

I had Juvederm injected under my eyes for hollows. This was done almost 2 weeks ago. I have bruises under both eyes and small pillow-like ridges under both eyes. Is this normal? How long do the bruises last? What are these puffs of pillows?

Doctor Answers 38

Puffiness after Juvederm Injection Under Eyes

I'm sorry to hear you have bruising and puffiness two weeks after Juvederm injection under your eyes. Bruising will pass on its own. The puffiness may need treatment, depending on how bad it is. While I prefer Juvederm to all other fillers in the lower 2/3 of the face, I have stopped using it under they eyes, as I have occasionally seen patients look great at 2 weeks, but "puffy" under the eyes at 2 months, with Juvederm. I have never seen that occur with Restylane.

 

in any case, if the puffiness persists, find a surgeon with experience using hyaluronidase to reverse the Juvederm and you should do well.

 

Best,

Mike Nayak


Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 121 reviews

Lumpiness after Juvederm

Correct hollowness in the lower eyelids with the use of fillers like Juvederm requires a skilled plastic surgeon with a understanding of the anatomy to prevent such problems such as lumpiness and palpability. Injection in the under eye hollows can be tricky and you should consult with an experienced board certified plastic surgeon. 

The three possible solutions for lumpiness are:

1. Massaging the areas where the Juvederm maybe clumped together

2. Wait - Like all hyaluronic acid fillers, Juvederm will be absorbed over time

3. Injections of hyaluronidase to reverse and break down the Juvederm

Ankit Desai, MD
Jacksonville Plastic Surgeon
5.0 out of 5 stars 18 reviews

Juvederm puffiness can be treated...very easily!

Treatment of the area under the eyes ("tear trough hollows") can be fraught with problems.  If injected incorrectly, patients can develop excessive puffiness and lumpiness; and even when injected correctly, there can be bruising.  The good news is that there is a relatively easy way to treat the puffiness.  

I inject an enzyme called hyaluronadase which effectively dissolves the product.  If initial localized massage of this area does not smooth the lumpiness and puffiness, I inject a small amount of this enzyme, massage it into the site, and then have the patient see me again in a few days.  Results generally are seen very quickly and this type of problem can be treated very quickly and inexpensively.

Most importantly, this underscores the importance of seeing an experience injector and not simply going to the cheapest one!

I hope this helps!

Juvederm under the eyes

Typically, treatment under the eyes are more difficult so bruises are more commonplace and can last longer than other injection sights due to the lightness of the skin and sensitivity. If you are still having lumps two weeks after your Juvederm injection, you should have a follow-up with your doctor. The lumps may be a result of accumulations of Juvederm and can sometimes be removed or lessen by massaging those areas. But if the lumps persist, your doctor can inject Hyaluronidase to dissolve them.

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
5.0 out of 5 stars 27 reviews

Swelling caused by Juvederm material

The pillow like swellings are actually Hyaluronic acid (Juvederm) material .

The best way to resolve this is through injection of Hyaluronidase. The procedure is safe and works very well.

The injection can be repeated without any problems until the swelling is entirely gone.

Nissan Pilest, MD
Irvine Dermatologic Surgeon
5.0 out of 5 stars 12 reviews

After two weeks, your issue could be related to uneven distribution...

In the vast majority of patients who undergo lower eyelid Juvederm injections, the results are excellent. Unfortunately, we occasionally see patients who develop lumps, bumps and eyelid discoloration following these procedures. These findings are often associated with bruising as well. This area appears to be susceptible to this type of problem because of its complex anatomy and the thinness of the overlying skin.
Although these problems may be related to swelling in the early post injection period, after two weeks they are more likely related to uneven distribution of Juvederm. In the first 48 hours following treatment, uneven Juvederm can often be corrected with massage of the lower eyelids. After two weeks more aggressive treatment is usually indicated. In most cases this requires injection with the enzyme hyaluronidase.
The best way to address bleeding and bruising following Juvederm injections is to prevent it from happening. Avoidance of aspirin, ibuprofen, Motrin, Aleve and other drugs that cause bleeding is important. Ice compresses pre and post injection can also decrease the incidence of bruising. Once bruising has occurred it resolves on its own over the course of 10 to 14 days.
It’s important to discuss these issues with your plastic surgeon. Your surgeon should be able to address these issues and alleviate your anxiety regarding these problems.

Lumps after filler treatment

Lumps and bumps usually resolve on their own, once the filler starts to get incorporated with your own skin tissue. It would be best if you book a follow up appointment with your injector in 1-2 weeks, and he/she can massage any residual lumps or bumps at that time. By that time swelling will have resolved as well

Juvederm and Lumps under the Eyes

Juvederm is a great facial filler but not ideal for the delicate tissue under the eyes.  Please return to your treating physician since the "puffs" may need to be dissolved with Hyaluronidase.  I much prefer Belotero for the under eye area injection.  It is a much finer hyaluronic acid filler and ideally suited for the area under the eye.

Juvederm

Juvederm or Restylane may be injected with good results by experienced injectors. However, you must be willing to take some risk, including swelling and bruising. Sometimes inappropriate use or overfilling these areas can cause more long-term puffiness & swelling.

Juvederm "swells" under the eyes...

Bruising under the eyes after a hyaluronic acid filler such as Juvederm is injected is not unusual, and usually resolves in a couple of weeks. Lumpiness of juvederm in this location is likely due to this filler "swelling" in size as it absorbs water, (which is usually a "good" thing with this filler).  Unfortunately, this can lead to lumpiness and generalized swelling under the eyes. Hyaluronidase can be injected into the filler to help dissolve it and relieve the lumpiness. Ask your injector if they can do this for you after checking for any allergy you may have to this product.

Debra Irizarry, MD
Crestone Plastic Surgeon
5.0 out of 5 stars 3 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.