Under eye filler 5 days ago- now I have a double bag. Will this subside or is it an issue with placement of the filler? (Photo)

Hello and thank you for your question.  It is normal to have swelling and bruising after any injections which can create bumps, unevenness, swelling or asymmetry for up to 2 weeks after your treatment. It is best to wait it out until the 2 week mark, however, if you are still noticing any unevenness, it is best to follow up with your injector to have it fixed. In the meantime, you can do a gentle massage over the area and take Arnica to help speed up the healing process. 

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

First, take a breath. It's only five days post-treatment and the delicate, thin skin under the eyes is one of the most edema (tissue swelling) prone regions of the face. So, for the moment, this could still be a matter of waiting a couple more weeks waiting to see how things settle. Although a photo is by no means a substitute for an in-person examination that allows for manipulation and palpation of the skin, there appears to be considrable flattening, i.e. volume loss, in the cheeks (which serve as a support for the under eye region). If this is indeed so, then volumizing fillers for the cheeks would be in order, and in fact should have been the first step in helping to improve the under eye bag problem. Frequently addressing the cheeks alone in this fashion is enough to secondarily improve the under eye region with the need for any direct injection of filler. In my NY practice, I would opt for Voluma XC for the cheeks. In my Israel satellite facility, where a far greater number of regulatory agency approved injectables are available, I would opt for Stylage XXL, Neauvia Intense Flux, and Aliaxin EV for the malar area. Should it still be necessary to directly treat the under eye bags area Belotero Balance (NY) (and Teosyal Redensity II in Israel) would also be my choice, since it possesses little to no tendency to give rise to the unwanted bluish/gray Tyndall Effect when injected into the delicate skin under the eyes. Again, for the time being relax. Make sure that you are consulting with an experienced board certified aesthetic physician. Best of luck.
 

Hello, a great question. Rest assured, your swelling and residual bruising are normal for 5 days out. The good news is, you may have far less bruising than a lot of people following filler at day 5, according to your photo. I would wait a full 2 weeks for filler to "settle". Then if it is still a problem to you, see your injector for manual manipulation, or Hylenex injections to dissolve filler. However, dissolving, as you can get a teeter-totter effect taking out, putting back in, etc. Just give yourself some time first before anything. Recover first, and make sure to use SPF30+ protection at your incisions to prevent hyperpigmentation.Best,Dr. Kristin Tarbet, MD, FACS