Restylane: Q&A

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Recurrent Swelling 4 Months After Restylane to Tear Troughs? (photo)

2 months after Restylane, I started experiencing recurring swelling under eyes. Each episode leaves area lumpy & bruised. I've read horror stories about hyaluronidase making matters worse. I'd like to wait it out, but I’ve read fillers under eyes can last for years. Doc wants to dissolve, but I'm wary. I’ve read accounts of the swelling recurring even after hylase. Would love to hear from doctors who've seen this phenomenon & successfully treated it.

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tear trough swelling 4 months post-op

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8 Doctor Answers | Asked by Sallify

Doctor Answers (8)
Community Comments (7)

Swelling of lower eyelid area after Restylane

I would try a small amount of hyaluronidase to see if it helps. If you see improvement, you could repeat hyaluronidase again. I think that the swelling is likely related to the Restylane which was injected not very long ago. Make sure that you are going to an experienced injector.

Restylane and hyaluronidase

If your doctor is an experienced injector, you should consider his recommendation of hyaluronidase to dissolve the Restylane.

Swelling following Restylane treatment

Hello, and sorry to hear about the issues you are experiencing following your treatment with Restylane. It is possible the swelling can be a result of something else, as it is abnormal to have swelling appear randomly at 2 months. Were you swollen at all 1-2 weeks following the injections? When used properly by an experienced physician, hyaluronidase can have a fantastic outcome and successfully eliminate any filler that is present. And you are correct, filler can last longer than usual in... more

Restylane and removal

Based on your photo's I would highly recommend you give your provider the opportunity to remove the product and treat that area. You can read horror stories about virtually anything and everything on any website, however, the horror stories don't always provide all of the information and don't apply to everyone.

Sam Naficy, MD

80 reviews

Seattle Facial Plastic Surgeon

www.seattleface.com

Hyaluronidase and eye swelling

Based upon your photos, it sounds like a good idea to try some hyaluronidase. Yes, it will cause more swelling initially but that is usually temporary. Good luck.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Please do not let the so-called horror stories scare you off from having the right treatment.

The enzyme is highly effective at helping situations like yours. It is improbable that this represents and allergic reaction to the hylauronic acid filler. However, clearly you are holding too much water in association with the product. The enzyme can be very effectively used to help this. The reason why you hear horror stories about the enzyme it that using this product well requires significant experience.

Kenneth D. Steinsapir, MD

8 reviews

Los Angeles Oculoplastic Surgeon

Eye Festoons after Fillers or allergic reactions or hormonal changes?

Thank you for your answers. I agree it could be an allergic reaction: perhaps new creams, new soaps, etc. However, I have seen this with people who have festoons. Festoons are genetic swelling in the lower part of the lower lids into the cheek region that some people develop. Perhaps your mom or father have that too. It is thin skin with chronic swelling. A mild inflammatory process, made worse with fluid retention, spices, allergies, hormonal changes, etc... more

Marc DuPere, MD

11 reviews

Toronto Plastic Surgeon

Restylane under the eyes

Dear Sallify, Did you not have any swelling until 2 months out from your treatment? Your eyes look like they are having an allergic reaction, but I don't think it is from Restylane or else it would have presented much earlier You should see a specialist so that we can get a detailed history and exam to see exactly what is going on The other question is...are you sure that it was Restylane that was injected? Did you see it taken out of the box? Best... more

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Comments (7)

lucidity 17 May 2013

The doctor trying to pin it on the use of new soaps, etc is pretty shameless, IMO.

Sallify 16 Mar 2013

As it turns out, my swelling problem and lumpiness turned out to be a biofilm infection caused by the Restylane injections. I am being treated with a 6 week course of two antibiotics. After two days of antibiotics, the condition was much improved. Now, after a week, my eyes are back to normal. No hyaluronidase needed.

8969anon 19 Mar 2013

After reading your post I looked up biofilms/hyaluronic acid and came across this site. Good for your doctor for finding a solution to your problem. http://dermatologytimes.modernmedicine.com/news/biofilms-dermal-fillers-management-proper-course-action

Sallify 19 Mar 2013

Thank you so much for sending the link to this article. I think I spoke to soon in my comment above. While my condition is much improved, there is still some lumpiness and I can feel small nodules. After reading this article, I wonder if I should still try to have the Restylane dissolved with hyaluronidase to get rid of the biofilms. Have forwarded this link to my doctor.

8969anon 19 Mar 2013

You're welcome. I think there is something to the biofilms and restylane which are similar to capsular contacture in implants. I see so many pictures of people with lumps that look like tiny water balloons that don't go away. It's usually around the eye area where it can't be spread deep into tissue.

8969anon 19 Mar 2013

I truly hope that the antibiotics take care of the swelling and it dissolves on its own.

Sallify 28 Feb 2013

There are so many reports on RealSelf from other members who have experienced this exact same problem -- intermittent swelling that begins approximately two months after Restylane injections to tear troughs, with swelling recurring from 18 months to 3 years. This is not an isolated incident. I have not changed creams or skin care products, and even tried eliminating all make up and skin care product, but the swelling keeps recurring every two weeks. My doctor thinks it's an auto-immune response -- my body trying to attack and rid itself of the Restylane.