Volbella filler under eyes - fold under eye? (photos)

Question

I had Volbella injected under my eyes yesterday. One syringe under each eye and Botox. Well now when I smile I look strange. It's almost like I have a fold under my eyes. I'm posting photos of before and after. Please advise.

Carlos Mata, MD, MBA, FACS · Answer

Hello there,Trust in your provider that the treatments he or she did will look great.  This will come with time, though, as swelling, redness or possible bruising play a part in how long each person takes to heal.  The fold is most likely due to the swelling and both botox as well as Volbella take 2 weeks to see final results.  I always recommend returning to your provider for an evaluation following 2 weeks just to make sure you are both happy with the work and if there are any concerns, they can be addressed early.All the best,Carlos Mata, MD, MBA, FACSBoard-Certified Plastic Surgeon

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  I would first recommend allowing your results time to mature over 2 weeks before assessing your long-term results. Though a soft filler Volbella needs time to incorporate into your tissues and smooth your overlying skin.  Hang in there!

Jason Emer, MD · Answer

It is too soon to tell what your final results will be. You most likely have swelling which will resolve in 1-2 weeks. If you're unhappy with your final results at that time, you can have it reversed with hyaluronidase and try a different technique next time. I recommend cannulas with injections to limit swelling. Best, Dr. Emer

Kouros Azar, MD · Answer

There is always some swelling after any injectable particularly in a sensitive area such as under the eyes. It may take a couple of weeks to fully resolve so, for now, be patient. Things will improve.

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question mara2001. Volbella
is a hyaluronic acid filler designed to enhance the lips. It can also be used in other areas off-label. Swelling is normal for 2 weeks after a treatment. At that point final results are seen. We have our patients return at that time to assess the results. More product can be added at that time if further enhancement is desired. Patience is important. Please
consult with a doctor for specific recommendations. Good luck!

S. Randolph Waldman, MD · Answer

The most common complaint that patients are distressed with... and physicians are bombarded with when dermal fillers are the issue... is the accompanying swelling, possibly bruising that sometimes occurs with the injection of  fillers. Especially those in the infraorbital (tear troughs) region of the face. Most patients are eager to experience their NEW look, one that will take a bit of time to reach the point of satisfaction. This is all normal and right now you just need some assurance that all will be well...and most likely it will. The beauty of Volbella and other hyaluronic acid based fillers is that correction can be obtained by injecting hyaluronidase, a safe and simple procedure that gives the patient assurance that permanence is not to be feared if satisfaction has not been achieved. Hopefully a little time and patience will prove your experience a worthy one! Best wishes on the new you!SR Waldman

Kevin Cavanaugh, MD · Answer

Hi,
Thanks for sharing your experience and photos. I would recommend you go back to the dermatologist who injected the Volbella and have them assess the filler. It is not uncommon for dermal fillers to sometimes form lumps that can be easily massaged out after injection. If there are no discrete lumps, what you are experiencing is likely swelling from the procedure itself. Swelling should typically dissipate after several days. If after several days you are not happy with the appearance of the filler your injector can dissolve it with hyaluronidase. I hope this helps!
Kevin Cavanaugh, MD

Faiyaaz Kalimullah, MD, FAAD · Answer

Thank you for your question, and for submitting photos.  The skin under our eyes is very thin and sensitive, and it's not uncommon to have swelling and bruising for up to two weeks after filler injections.  It appears that the lines you're seeing are most likely due to swelling.  I would recommend gently applying cool compresses to the area for the next few days to help the swelling go down sooner.  If you still notice swelling after two weeks, I would recommend following-up with your injector to discuss your concerns - Volbella can easily be dissolved using a medication called hyaluronidase, if needed.

F. Victor Rueckl, MD (in memoriam) · Answer

Any time you have injections done you need to wait a minimum of 2 weeks to really evaluate it. At one day, you have swelling and a bit of water retention there. Don't worry about it. Keep your hands away from the area and don't press on it. If you still don't like it in 2 weeks it can be removed with hyaluronidase. "This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

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