Treating Stubborn Juvederm and Fluid Bags in Lower Eyelids?

I had deeply injected Juvederm 10 months ago for lower lid hollowness. An overfill occurred, giving me bags and distorted lids. Several rounds of Hyaluronidase injections have reduced the bags by only 25%. Months later I am still left with bags. When I apply finger pressure it sometimes resembles fluid, with some firmer areas. There was no prior bagging or puffy lids before the filler. I'm 30 with no allergies. Eager to fix this & sad. Try more Hyaluronidase or maybe need the fluid cauterized?

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8 Doctor Answers | Asked by Raleigh4718 in US

Doctor Answers (8)
Community Comments (0)

Hyaluronidase works for Juvederm overfilling

I would ask how much hyaluronidase (Vitrase) has been used under the eye. I would be willing to bet that a conservative total amount was used. I would consider re-treatment--Vitrase will melt away excess filler and usually works within 24-48 hours. I would also be curious what your before photos looked like. Did you have any lower eyelid fullness prior to treatment. I often screen patients prior to tear trough/lower eyelid filling to screen for those that might... more

Melanie D. Palm, MD

10 reviews

San Diego Dermatologic Surgeon

LOWER EYELID BAGS AFTER JUVEDERM. WHY? HYALURONIDASE ALWAYS WORKS!

I firmly believe lower eyelid injections with Juvederm are excellent but must be done on a serial basis. I have inadvertantly become a local referral center for hyluronidase treatment after Juvederm or Restylane mishaps. I bought the kit for one of my patients so I was the local guy with the hyalronidase. The biggest problems are the patients that had large amounts injected at on setting. This is not ideal. Do 2 or 3 small treatments and this will... more

Lower Eyelid Swelling after Juvederm or Restylane Treatment

The loose skin under the eyes and above the bone that defines the lower edge of the eye socket can be problematic after the injection of fillers, such as Hyaluronic Acid, Collagen, Radiesse, or Artesense. The reason for this is that the filler takes longer to disintegrate in this area. The first time I saw this was in 1982, in a patient treated in another clinic, shortly after injectable Collagen was introduced. It took about 6-9 months for this to resolve on its own.... more

Fluid bags under eyelids after filler with Juvederm

Hyaluronidase does come in different forms and the number of units may vary from doctor to doctor as to what is injected. Patients who have such conditions may need a consultation with an oculoplastic or plastic surgeon to ensure that the bags are fluid and not fat that has herniated out from deeper tissue as that would require surgery to correct it, but your history is most consistent with fluid retention. Further hyaluronidase treatment may help.

Best Treatment for Stubborn Juviderm and Fluid Bags in Lower Eyelids

HI Raleigh, Hyaluronidase needs to be injected right where the Juviderm was injected. Unfortunately sometimes there is some residual swelling that is difficult to resolve. I have tried systemic steroid injections (Depomedrol intramuscularly) with some success in these cases. If still persistant, then treatment with Fraxel repair and/or Ulthera ultrasound may help. Best to discuss with an experienced physician. Good luck, be well, and I hope that your... more

Michael A. Persky, MD

21 reviews

Los Angeles Facial Plastic Surgeon

drpersky.com

Juvederm and Fluid Bags in Lower Lids

Hyaluronnidase placed in the Juvederm should dissolve it. I prefer to use Restylane rather than Juvederm in the lower lid orbital rim because the Juvederm tends to be hydrophilic (absorbs water). Hopefully your problem will be short-lived.

Richard W. Fleming, MD

9 reviews

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Juvederm and eye bags

It is always nice to see pre-treatment phots. Often these bags are present. Only the injector will know where the juvederm was placed. If it is due to juvederm, then hyaluronidase will dissolve it.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Juvederm

Whoever injected the Juvederm knows where and at what level the juvederm was injecte. The hyalorinidase should be ijected at the same level. Cauterization ???? what is that>|???? See a board certified plastic surgeon for proper examination and diagnosis. Once that is made then a plan of treatment can be presented to you with options, and potential risks.