Can Restylane or Juvederm Cause Edema when It Starts to Break Down?

Can fillers like Restylane and Juvederm cause unwanted fluid accumulation when they start to break down? I am reading posts online whereby people have experienced varying degrees of edema starting several months after the filler has been administered. In some circumstances the fluid retention has stayed for years, especially when around the eyes. Is this rare and what can be done if it occurs? I have found one paper that concluded Hyaluronidase does not fully resolve "doughy" edema.

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5 Doctor Answers | Asked by Raleigh4718 in US

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Edema after filler

Yes, fillers can cause fluid retention inthe area as they break down. This is part of the natural process of the product dissolving.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Fillers in the Lower Eyelid

The lower eyelid skin is very thin, has no fatty tissue to speak of, is filled with blood vessels and has valve less veins...all of which can lead to swelling that can be prolonged and unexplained. I know that injecting fillers in the lower eyelid area has become commonplace but I think one has to expect these types of reactions when injecting anything into this tissue. I'm not sure injecting hyaluronidase into the area will make things better, in fact I'd expect it to... more

I would disagree with the conclusion of that paper.

These filler work by holding water. We are not accustom to assessing negative volume which is what is seen as helpful volume created by filler begins to disappear. For quite a while with these fillers, what can be left is not our original face, but what you are describing as doughy ridges. The solution is to have these adjusted with hyauronidase enzyme. Generally, this is very effective for modify these ridges when they occur. The challenge is not getting rid of... more

Kenneth D. Steinsapir, MD

8 reviews

Los Angeles Oculoplastic Surgeon

Long term swelling after Restylane or Juvederm in the lower eyelid

I have had one patient who remembered having some filler injected into her lower eyelids about three years prior to coming to see me after she was referred by a physician to work up her swelling. I had noticed a sheen and consistency consistent with a hyaluronic acid rather than mere lower eyelid puffiness. After one injection of hyaluronidase her right lower eyelid which had the largest swelling resolved completely within a week and the other eyelid needed an additional treatment... more

Filler Related Swelling Resolves with Hyaluronidase

Dear Raleigh, I have seen swelling after the injection of hyaluronic acid fillers (Restylane, Juvederm, etc) up to a year and a half after the injection. This edema quickly resolves after the injection of Hyaluronidase.