Juvederm Under Eyes on Darker Skin

I recently had juvederm to fill some of the...

I recently had juvederm to fill some of the hollowing underneath my eyes. This was two weeks ago. I now have a bluish-grey tinge underneath each eye, which seemed to have become more noticable about a week after the initial treatment (once the swelling went down, and it's down to my cheek over one. I have read many of the posts on here to try to self-diagnose and calm my anxieties. I have also been back to my initial injector who is uncertain if this is the tyndall effect of hemosiderin staining. I have another appointment to return.

To be honest, my actual treatment experience was not horrible. I think my doctor is very experienced and wants to provide me a solid experience. I have had several follow-ups. I just had some complications that need to be worked out and he seems willing to do that without charge.

My doctor was conservative during my first visit,...

My doctor was conservative during my first visit, and I liked the results. I wish I had stopped there. I went back, and he injected more. This time it was terrible. I had a horrible reaction. I have a huge bluish-brown pooling under one eye and a blue-green line down the other. I have been back to the doctor, and is unsure if it is the tyndell effect or if it is hemosiderin staining. He also said that the laser they normally use in their office to improve discoloration is not safe on my skin. I'm very upset, because none of this was discussed in our consultation. He was told up and down that there would be no permanent effects. It has been 3 weeks since my injections, and I have been reading about hemosiderin staining, and it seems like there is a possibility of permanent staining.

I am not sure that my doctor, while quite experienced and reputable in the area, has much experience on people of color. I also wish I had known that. If you are a person of color, and are considering juvederm or filler, please ask your doctor if he has worked specfically on ethnic skin. Apparently, we are at higher risk for hyperpigmentation. Again, these are all things I think HE should have mentioned to ME...Not the other way around. I found this out after the fact through my own research. I now feel that he is being so accommodating, because he aware that neither his consulation nor his informed consent truly discussed these risks. I look worse than I ever did before. I'm not even happy with the actual correction or be honest. I think it makes my cheeks drag down lower for some reason.

If there is anyone who has any ideas on how to correct this, I would truly appreciate it.

My questions: (1) I am brown-skinned, and my doctor said the laser treatment typically used is not safe for my skin to remove the discoloration. Are there any other ways to remove the discoloration? (2) Other thougths on what this is and if it's permanent? (3) Is it safer to remove the juvederm or let it just phase out?
Norfolk Dermatologist

My doctor is well-known and experienced. He teaches here locally. But I think I have had more complications. I do think this is a very delicate area of the skin and I wish there was more that could be done for tanner-skinned people.

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I had juve under my eyes over 4 years ago. The effects are still there. I don't think it dissolves under the eye. I still have the bulges.
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I don't know if this site will let me post links, but here is some info from Dr. Law (I don't work for him or anything!) {edited} If this link won't post, you can just google Dr. Michael Law, Raleigh, and Fat injection or grafting (ah... another mispelled word above!) to find the same article.

Edited by Sharon: You're right, we don't allow links to third-party websites. :) Please share links privately, or you can also find Dr. Law's site through his profile on RealSelf.
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Oh, cool.. thanks, Sharon!
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There are a lot of negative reports even about fat injections and sometimes the effects can be permanent, so just be careful. I so wish I would have left my eyes alone.
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Well... I spelled steroids wrong, and that should have been "all OVER the web" :)
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Hi, I stumbed across these stories by accident... They have made me appreciate the depressions under my eyes! I was wondering if any of you have had more progress? I had once thought about doing "fat injections" under my eyes. I never liked the idea of injecting any filler that was not natural. Fat graphs are done from a person's own fat. I had always thought that the loss of fat under my eyes was due to steriod eye drops. Steriods are a de-fatter and thin skin tissue. If I ever do get fat injections, I will go to Dr. Michael Law in Raleigh. He has so much information all of the web... perhaps too much, but I like what he has to say.
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Hello, Just an update, because I know that when I was on here before, I often wondered what happened, how were things going and the time frame of improvement...I am now 2 months post-terrible juvederm experience. There is still some discoloration, mostly a yellowish greyish, but it looks so much better...and I've decided to let the Juvederm dissapate on its own, and it is. I wish everyone the best! And thanks much. I'm really grateful that this forum exists.
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That's great! Any further improvement since then? K
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How long did it take for it to completely dissolve? I'm 10 weeks out and I'm trying to wait it out. Had injections under my eyes and I hate everything about it. I even have stretch marks on my cheeks where I was overfilled. I am very apprehensive how they will look when the juvaderm dissolves. Were you back to normal after it dissolved?
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Also, does anyone know if warm compresses make it dissolve faster?
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Juvaderm will last 6 months to a year to completely dissolve. But during that time, it will be lessening. You can try to *gently* massage the area to speed up the progress. Just be patient and don't let anyone inject anything to help minimize the juvaderm. I've read so many reports of regret when someone does that. You can also try to apply a slightly darker makeup over the poofy area. Dark colors recede, so if it seems to poof out too much, that may help. It may also make it look worse, but it's a cheap fix if it works.
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I totally agree. I decided not to mess with the mess anymore and just put a darker blush over the bulges. It makes it appear to recede.
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Krystal - I have been reading your reviews and posts. Wish I had found you earlier! I say again that any advice from you would be greatly appreciated. I wish I didn't live so far away or I would pop around for a coffee and you could look at my poor face and tell me what to do! Cheers
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Do you still have the discoloration under your eyes? Have you tried Fraxel. I am going the exact same situation as you? It has been over a year and i still have a dark discoloration under my eyes.
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Hi MSwift - My discolourations have not improved 10 months later. Please read my post above regarding laser. I would never do Fraxel because in my view there is too much risk of a very bad outcome. Read some of the 'not worth it' review about Fraxel on this website. Fraxel is attracted to water in the skin, not colour. I need a laser that is attracted to colour (brown & red as described in my earlier post). While there are dangers with these lasers also and I am frightened of having any laser so close to my eyes, I am particularly afraid of Fraxel. I am considering pulsed dye or Nd:YAG laser but have not yet made up my mind. What are you considering doing for your discolouration?
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Hello* Tried but failed.... I am considering the pulsed dye laser or the yag laser. I have not done enough research yet. Currently my dermatologist has me using K-derm cream, which is vitamin K cream and eye lightening serum. This has helped a bit. Everyone says that my eyes are not as dark as they were a year ago but I am still obsessed with getting them fixed. Could we maybe talk through email instead? If so my email is melissaswft@verizon.net. I can send you pictures of my under eyes and you can tell me if you are having the exact same problem. I am having botox done in about a week. Hopefully it will not cause any problems.
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Hi Melissa - I will send you an email. I have not yet had laser (too scared) and I am still in the research stage too. Where are you considering having the botox? K
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Hello. I am having botox done for my crows feet... my derm said that she could put a small amount under my eyes to. I have had botox a couple times before in the past but i was not completely satisfied so I had the filler down. As soon as you send me an email I will send you a picture. Oh, i forgot to tell you under my left eye i recently had basil cell carcinoma removed which has made my eye even worse.
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Oh my god! Please do *not* have botox directly under the eye. It is the WORST place to put it. Please, please, please do not do it. It made my situation 1000 time worse and I am not the only one. It weakens the eye muscle and allows the fat pad to pseudohernitate and bulge forward. I have waited 38 weeks and it still hasn't properly resolved. I am emailing you the photos of what happened to me from botox directly under the lash line and in the crows feet area right now. Please don't do anything until you have seen my pictures. You might want to forget about botox altogether. K
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Hi Krystal - thanks for your advice. I agree that my face has gone through hell and I am being very cautious in my approach to removing the discolouration. What happened with your fraxel experience? I have been looking at the reviews of laser on here and can see that lots of people are initially happy with fraxel then they encounter long term problems like fat loss from the burns - for example the late Angie Walker (Awalk on RealSelf). Is this what happened to you when you say you got indentations in your cheeks? Was it from the burns? Are these areas discoloured also? From what I can gather there are two types of laser - ABLATIVE (Erbium, CO2, Fraxel, TotalFX etc) and NON-ABLATIVE (KTP, Gemini, Medlite, Pulsed Dye, V-beam, Ruby, Nd:YAG etc). The whole laser caper is massively confusing, for example YAG can be ablative (Erbium YAG) as well as non-ablative (Nd:YAG). Lots of people refer just to 'YAG laser' in the reviews and I always wonder which one they are talking about. Add to this the various manufacturers' names for the lasers and it just about does your head in trying to work it all out. At least I am doing my research in advance for once! I am planning to go to the Victorian Cosmetic Institute and they have a very good summary of all the lasers at: http://www.thevictoriancosmeticinstitute.com.au/laser-general-information/ The Victorian Cosmetic Institute is not in my home town but I am prepared to travel for a consultation because they have ALL the lasers and their website looks like they know what they are doing. From my reading of the reviews on RealSelf about ablative lasers, it would appear that lots of problems occur because they are designed to resurface the skin and they are therefore attracted to the water in the skin. From the reviews, I can see huge down time, burns, fat loss, more discolouration, results that just don't last and permanent damage. I would be way, way too afraid to ever try any ablative laser. I am looking at non-ablative lasers only and I have a variety of issues that I think would need to be treated by a variety of lasers. I can see from the information on the Victorian Cosmetic Institute website that some non-ablative lasers are attracted to melanin (brown pigment) and some are attracted to oxyhaemoglobin (blood) and some are attracted to both. I think I need a combination of lasers to treat my post-juvederm, post-hyaluronidase, post-botox skin issues because some of my problems are blood-related and some are pigment-related. Further, I think some of my pigmentation problems are dermal and some are epidermal. In respect of the new wrinkles and crepey skin, I would rather live with it than try an ablative laser. Treating the discolouration will be enough for me. I would like to have a Woods lamp assessment and get some proper advice about which combination of non-ablative lasers might actually work. I have also considered a chemical peel, but I think the hemosiderin and melanin staining is too deep to be touched by a peel. Lots of disaster stories about peels too! I have a very demanding job and it is going to be a real effort in co-ordination to fly back and forth from where I live to Melbourne for this treatment and it will be expensive too. But I have been hiding at home for more than 7 months and I desperately need to feel positive about something, so I am looking at 2010 as the year to get my face back. I have also resigned myself to a lower blepharoplasty in July this year to fix the botox damage under my eyes. I have deliberately not sought out a surgeon yet because I don’t want to rush into anything. I know from the feel of my face and the weakness of my facial muscles that it is still way too soon. My dilemma is should I address the discolouration before the surgery or have the surgery and then address the discolouration? I am really not sure what to do. Do you have any experience with non-ablative lasers, Krystal? Any thoughts about whether it should be laser then surgery or surgery then laser? Or do you think I should avoid laser altogether, even the non-ablative kind? I have had non-ablative laser before to treat a broken vein under my nose and it was successful. It scabbed up for a couple of days but then went away. Unfortunately, it also came back a couple of months later! There is so much trial and error with these procedures, but I am tired of being the error... Thanks again for your advice Krystal. I will certainly consider everything you have said and I would appreciate any further advice you have. Cheers, K
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Hi TBF! :) yes i wish you did live nearby and we could have coffee or something. For my own opinion about what you should do... well i am not medical professional (and from what I and others have experienced, i would be cautious even from medical professional opinions), it would be great to look at you first, but from what you describe, I would go for the bleph first. But finding a good dr is imperative. You are right not to rush into anything. Look at before and after pics. Do not let anybody push you into anything. (I once visited a PS who wanted to carve up my face in my 30's. He wanted to do upper and lower bleph and also cut into my hairline to do a brow lift! It was crazy! i refused, of course.) Yes I do have experience with non-ablative Fraxl, which I would not recommend. It is extremely expensive, and from my own experience, damaging. I have what you describe, where I guess the girl went over my dark spots too many times, or maybe the laser is just attracted to melanin like you state, but I have indentations where the dark spots are... and the dark spots are still there! There are more things I would like to do, but like you, I am waiting. A lot of these horror stories on here are from people who rushed into a procedure trusting a practitioner. So lately I have been doing chemical peels and using tretinoin and Avon products and staying away from doctors. :)
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Thanks for your help, Krystal. I am 37 and if it wasn't for the botox disaster, I would also consider myself too young for a lower blepharoplasty. Actually, if it wasn't for the botox, I wouldn't need a blepharoplasty! I am just doing some preliminary investigation into blepharoplasty at the moment and would not consider actually doing it until July this year or later. As to laser (ablative and non-ablative) there are lots of reports of indents from fat loss as well as no longevity in the treatment because the treated marks come back sometimes worse than before. I have no desire to pay more money for someone to make my face even worse!! I am thinking chemical peel might be the way to go too but it won't fix the broken capillaries, so I am in a bit of a dilemma there. I don't think anything fixes broken capillaries except laser. I will post again if I decide to try anything for the hyperpigmentation and hemosiderin staining but at the moment I am just waiting, waiting, waiting! Will it never end??! Thanks again for your reply and advice. Cheers, K
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Hi Tried But Failed did you end up going to the Victorian Cosmetic Institute because although everything they market and advertise sounds good this clinic has ruined my skin. I am a year and a half post laser treatment with them and I am still suffering. When things go wrong and they can't fix it they act like there's no problem. Not good enough!
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Hi tried but failed just to let you know I had laser at the above clinic you are mentioning and they have ruined my skin. I am now approximately a year and a half post laser and suffer every day and it continues to worsen.
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Krystal - I could not agree with you more.
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