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Chronic Under Eye "Swell Bags" Due to Lymphatic Drainage Problem , Triggered by Restylane Injection

I am a 50 year old female and I had restylane...

I am a 50 year old female and I had restylane injections done in my tear troughs two years ago. They looked good but had these unusual bumps or ridges in the malar area underneath. I had the filler reduced with an enzyme a week later but still had a bump on the left side. Then last April I had a blepharoplasty and while the surgery looks good, the ridges came back full force under both eyes and it seems to have take on the shape of the swelling from the original restylane disaster.

Anyway, I went to an ocular plastic surgeon and he said that is was a lymphatic drainage problem and if it hasn't gone away by now then it never will. It's been 7 months since surgery and has improved somewhat but still there. He said the only thing to do to treat it was a steroid injection but has a low success rate and would look worse for a few weeks since it would initially add to the fullness.

Also,he said if I have other surgeries like a face lift (which I'll eventually want), that it could exacerbate the problem and I'd swell up there moreso again.

Restylane fills nasolabial folds really well but I don't recoommend putting it under your eyes !! I had deep dark tear troughs. Now I was told I have clogged lymphatics under my eyes which result in these swell pads under my eyes just below the eye hollows at the malar membrane.

Has anyone had this problem ? Should I do the steroid injection (not Kenalog but a short acting steroid)? What about lympatic drainage massage ?
Name not provided

I would recommend him for other things but not off label fillers

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Hi depressedgirl, I think the thing you should try is the enzyme that gets rid of filler - hyaleurondase. I know how awful those bumps and lumps can be. Best of luck ! It is always best to go to a noted, recommended person. I know Dr. Haideh Hirmand (E.86 and Park Ave NYC) is very good with the eye area - both surgically and with filler. I would trust her. Best of luck ! Annibal
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I have the same problem , it is terrible ,does it go away ?

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Has anyone tried having their filler surgically removed and some skin pinched to address the laxity? I am still dealing with the bumps under my eyes. I've given up on injections being able to reduce them, they have only traumatized the tissue and resulted in crepiness. Annabel, I would esp like to know where you are at...
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UGH! I am dying! I have horrible skin under my eye socket( above cheeck) that I believe is a residual effect from a filler that I had put in year and a half ago. I have skin that is sticking up... crapey but not filled with anything. Almost like a deflated ballon. I am in New Orleans now. I had the filler oringinally done in Toronto. When I had it done, it has been nothing but disasterous! I was bruised for 2 months and the swelling was unbelievable! Now that I am in New Orleans, I went to a reputable plastic surgeon but he was in a query as to what to do about it. He had suggested laser but at $4000.00 it is expensive and no guarantee of the result. Anyone have any luck lately?
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Annibal's recent post brings sense to the matter. Restalyne simply does not last for years. Juvederm does. Also, Hyaluronidase does not work on Juvederm. Juvederm takes a few years to diminish. Based on your timeline, it appears a few years passed and the condition diminished. I know this because I had Juvederm inhections under the eye and have the same bags and have reseacrh potential solutions. The only one I have found is masseg of the area under the eys and eye socket/checkbone. Juvederm can be felt crunching and moving etc.
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I mispoke. Hyaluronidase will work on Juvederm but not on Radiesse. I had Radiesse injected. Hyaluronidase should work if the product is in date and been kept refridgerated. If it does not be sure to have Dr. order fresh batch..
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Thank you!
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It was Dr. Schwarcz. Dr. Lisman was very hands off and didn't want to try anything but Dr. Schwarcz was much more proactive. I'm surprised he was perplexed. I think he would be more willing to try stuff. He is featured in W magazine this month (February) as one of the plastic surgeons who fixes other people's messes!

I'm not sure but I think it was around $200. He used a both the steroid and the hyalurondaise on one eye and just the hyalurondaise on the other.
Good luck !!

Annibal
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Also, do you remember what they charge for steroid injections?
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Annibal,

Was Dr. Robert Schwarcz the doctor that injected you with the steroid or Dr Lisman? I have met with the former a year and a half a go - he is a doll but I wasn't sure he had enough experience at that point and he was a bit perplexed by my case. I've tried Hyaluronidaise injections 5+ times and it hasn't done a darn thing (perhaps slight improvement). I suspect I have lymphatic stasis, like you do, because the swelling varies and I am susceptible to occasional edema. I had the juvaderm injections done 3+ years ago! Please let me know if you recommend steroid and if anything else has been helpful...

Debbie
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Dear skingurl,

I have had my swelling reduced by a steroid and hyaleruondase (the enzyme that gets rid of fillers). I wouldn't recommend certain kinds of intense fraxel under the eyes as I hear they can cause more problems as you well know . Also, my problems began with Juvederm. I'd heard that if one were going to inject under the eyes that Restylane is the better choice. I have used that now since I "reduced" my swelling with the steriod which worked all too well (cause a bit of sunken in look) But now it's alot better than it was. If you are in the New York City area I would recommend Dr. Robert Schwarcz on E. 79th street. 212-396-4400. He is an oculoplastic surgeon as well as regular plastic surgeon and has fixed alot of messes. He just mentioned to me that he fixed under eyes post fraxel damage. Try him if you're in NYC. If not, I would try and seek out an oculoplastic surgeon in your area. Good luck ! I know how disconcerting this can be.

Annibal
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I had Juvederm four months ago and still have an awful lot of swelling. It varies from day to day and depending on what I eat, and I definitely cannot drink any alcohol.

The Restalyne/Juvederm can cause permanent lymphatic drainage problems? Now I am more worried than before.......How are you doing now?
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I had Juvederm Ultra injected 8 months ago in my tear trough area. I have tried a few treatments of Fraxel and Alma Accent to remove the product because of the increased redness and severe swelling. I look like a freak. I would appreciate any additional information that you could share.
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Hi Down Under,

Thanks for your email about your situation. I had had some steroid injection which helped a little. It's still there but my doc feels it's too risky to do again right now as too much could make a dent. I have to check out FL3 serum. My condition isn't allergies but lymphatic stasis. But I do have some crepiness too. This other doc recommends Fraxel or Fractional CO2 laser for under eye area. It improves skin texture. My oculoplastic surgeon says it can't hurt though wouldn't reduce puffiness but would make the skin better.

Good luck !

Valerie
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hey A

not sure you got my email

maybe it went to spam?

okay

hope all is well

best
j
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Hi from Down Under
I am 63 year old female and 4 weeks ago had a double blephoraplasty. Had hooded eyelids and big bags under my eyes too which made me look tired and older than my years. And I'm a performer (singer) so it's important to look good. Had been using FL3 (serum) to smooth out under eye bags, which worked, but wanted a more permanent solution. Well, four weeks later the upper eyes are great, and directly under eyes is great too. But the "allergy" crinkles are there, and look more pronounced now that the rest of the skin is taut. Surgeon says nothing he can do, it's about allergies. Same as your discussions. So I'm back to using FL3 again, but at least just in a very small area. Thank God it works..... Will only use it when doing gigs, otherwise will wear glasses (need them anyway) since the frames conceal the swelling. But I'm NOT HAPPY. Thought the double bleph would do the job, and it didn't. Surgeon didn't bother to spell it out prior to expensive surgery either. Not that I'm sorry I had the surgery, because I look better, but I like knowing what I'm in for. He tells me now this is the way it's going to be permanently...............
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Also, did you have crepiness under your eyes, as well? And if so, did the bleph make your undereye area any worse or better?
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Hi Annibal, Thanks SOOO much for your response. It sounds like Dr Lisman is on to something and I am going to most certainly reach out to him. Some questions for you: Did you get the bleph simply to treat the bumps caused by the Restylane? In other words, you had surgery to undo the complications caused by "temporary" filler? You said you had fat removed but if you had chronic fat bags under your eyes, why did you get fillers in the first place? Also, if residual Restylane is causing lympahtic stasis, why wouldn't Dr. Lisman recommend hyaluronidase injections to eliminate the remaining Restylane, as opposed to steroids? Also, does Dr. Lisman have experience with hyaluronidase and fillers?
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Hi Debbie, I had the bleph for upper lid hooding and lower lid wrinkling and had fatty bumps removed that were close to the lash line. The residual bump I had was lower and I thought maybe by taking out a pinch of skin on the lower lids, it would smooth out that bump but it just kind of swelled in that area. I think it's more uniform - no real bump anymore but there was like a crest under my eyes that has dissipated some but not entirely. When I had the restylane bumps, I pushed them out which caused some crepiness on the right side by the nose but that was taken up by the surgery. I did the resylane for tear trough hollowness and darkness by my nose. The fatty tissue was at the lateral ends of my eyes and directly underneath. I think Dr. Lisman felt at this point there was no restylane there but that it clogged my lymphatic drainage vessels so I have some chronic lymphatic swelling. The steriod injection would help dissolve that if it works. He said it worked 25% of the time. I had heard of people having real issues with it - that especially with Kenalog, it can cause dents as the substance can eat away at healthy tissue and cause a crater. That's overkill. Dr. Lisman said he'd use a short acting steroid and just a bit of it . He didn't feel all that confident that it'd solve the problem but he did not feel it would make it worse as long as I cleared myself of sinus and allergy possibilities. So I'm going to wait it out, do some lymphatic drainage and drink lots of water. I'll revisit Dr. Lisman in maybe a year. Then it'd be 2 years post surgery. Hope this helps. Let me know what you find out. I hope your issue heals swiftly ! I know how disheartening this is. Truly Valerie
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Thanks for your reply. I live in Australia but I am willing to travel to get this sorted out correctly. I am looking for conservative, not aggressive surgery. Lower lids only. Could you please post some of the surgeons' names? Or send me a private email with their names? The last thing I could stand would be another disaster. Thanks so much.
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Dear tried but failed, I could recommend one doctor that I think would be conservative and really great. His name is Dr. Richard Lisman. He is an oculoplastic surgeon so he does only eyes. I didn't use him but I certainly would trust him knowing what I know now. Even though I hadn't used him, he is the only one I feel comfortable recommending. I'm sure you'd be fine with any number of surgeons. And there has to be alot of really good surgeons in Australia. Shop around locally. It would be good to have someone near you do the surgery for followup. Ask around and see if there's someone whose surgery you think is great and get their doctors name. Best of luck. I do understand traveling for the best care. Hope it turns out really great for you. Truly Annibal

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Thanks Annibal!
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Is the swelling actually in your lower lids (ie looks like puffy eye bags) or is it in the part below your lower eye lids at the top of your cheek? I am thinking of having a blepharoplasty. I also had restylane dissolved with hyaluronidase (disaster) and I don't want to have the same issues. Any advice would be greatly appreciated. Cheers
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Yes, the swelling is the area below the lids on the upper cheek known as the junction, or malar membrane. If your restylane was dissolved completely and not lumpy or leaving shriveled up skin then I'd say you are okay. Also, I had an aggressive surgery - I had the fat removed from inside the conjunctiva and also a pinch of skin removed (the stitches were between my lower lid lashes) Also had upper lid skin removed. I wonder if I would have had the swelling if I only did the upper lids and just fat removed on lowers. Talk to your surgeon about your concerns. Are you in the NYC area ? I know a good occuloplastic surgeon that is conservative and has tons of eyelid experience. Good luck.
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Hi Annibal, I had the exact same problem as you after restylane injections- I had the injections 2 years ago and i still suffer from bags, which seem to be aggravated by edema. Yours is the first posting I've read which also talks of swelling which varies from one day to the next. It makes addressing the problem that much more difficult. Have you tried Hyaluronidase? - I have had it injected 6 times with little success. I have been thinking of a bleph - mainly to address the swelling - but your experience scares me. My doctor is suggesting I see an allergist, and discuss trying prentsezone for a week (though I have never had allergies before) Can you PLEASE tell me which occuloplastic surgeon you recommend? Also, feel free to contact me directly via email if you want to talk. I am located in NY as well. Debbie
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