Thank you for posting your concerns and results. The tear troughs require careful attention for proper treatment to achieve optimal results. The skin is quite thin in this area and there are significant blood vessels that need to be avoided. Fillers that are injected too superficially can result in a bumpy appearance and sometimes create a bluish discoloration of the skin call the Tyndall effect. I prefer to use Restylane rather than Juvederm as it seems to attract less water and result in a less puffy or bumpy appearance. We typically combine a small amount of Restylane with a concentration of your platelets (PRP) and administer this through a small flexible blunt-tipped cannula. The combination of these treatment strategies results in a smoother appearance, requires less filler, and the PRP helps over the long term to improve your skin texture and stimulate natural collagen growth in this area. The cannula provides an additional measure of safety by minimizing trauma to blood vessels. You should be able to achieve a smoother more natural looking result than what is reflected in your pictures. There can be some initial swelling following treatment, but by three to four weeks out this should mostly be resolved. Dermal fillers, like Juvederm, can be fully dissolved and that is what I would consider in your case. I recommend you follow up with your provider to discuss your concerns. If needed, pursue a second opinion from another experienced provider.
