Can a lot of water retention impact effectiveness of Restylane? (Photo)

Question

Two years ago my plastic surgeon injected resta lyn and concealed malaria bags. He did exactly same a month ago but within a week they came back. Doc said I have a lot of water retention and I do wake up with shifting fluid in area? Do I have any other options? Diuretics improve it but not want to stay on them.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your experience with Restylane to conceal the festoons. Unfortunately, there is no clear choice for improving this problem. It often takes several different methods to improve the bags, but often they return. Have a comprehensive evaluation performed by an experienced Oculoplastic Surgeon.

Stephen Prendiville, MD · Answer

Restylane is, in my opinion, not the optimal treatment for malar bags.  Malar bags are areas between the cheeks and eyelids that have a tendency to swell with hydration or increase salt intake.  Hyaluronic acid fillers do not address this issue very well and can make the situation worse.  Although it is very hard to guide you without an examination, a surgical solution is usually the best way to proceed, I have included an example of a patient of mine who was treated with an extended lower lid Blepharoplasty for this problem.

Jason Emer, MD · Answer

If you have significant swelling oral diuretics and radiofrequency treatments with venus legacy can help decrease this.  If after 2-3 weeks you still have this, massage and/ hyaluronidase can be used to reverse the filler.  Best, Dr. Emer.

Kyle Coleman, MD · Answer

Swelling of the area of the malar cheek can develop after tear trough injection if the lympatic drainage of the area is impaired by the filler volume.  It is possible that this is related to the filler.  If it is unchanged since before the filler, the area may need additional filler and possibly some non-invasive tightening or surgical tightening of the lower lid.

Harry V. Wright, MD · Answer

In a word, yes. This part of the anatomy can be particularly unforgiving when it comes to fluid shifts. Certain fillers like Restylane & Belotero "behave" themselves better here, but can still give a displeasing result even when injected appropriately.My recommendation is to wait a few more weeks, and if there is no improvement know that the Restylane can be "dissolved" with hyaluronidase. You will then be back where you started. You may then consider a more definitive rejuvenation procedure, like a lower blepharoplasty. You can see some photos of lower eyelid/cheek rejuvenation with fillers and surgery on my profile page.Best wishes!  Harry V. Wright MD, Sarasota, Florida

William Marshall Guy, MD · Answer

Hello Clarieann,Restylane, and any filler, can only address the condition that is there on the day of treatment. If you tend to have swelling in that area from either salt, yeast, etc., that comes and goes, fillers won't treat that underlying problem.  And the fluctuation cannot be treated with Restylane.  The reason is if you tried to fill the area to the same degree as your maximum swelling, then when you didn't have the water retention the filler would look very bad.Treatment for the underlying water retention includes avoiding salt, products with yeast, diuretics, etc.  I would recommend you follow up with your injector and your primary care physician to help with the water fluctuations.  I hope this helps and good luck.

Melvin Elson, MD · Answer

Water retention will not exactly affect Restylane but f you are having enough fluid retention that there is actual shifting that you can detect, you should see your family doctor or internist to find out why and get some treatment

Michele S. Green, MD · Answer

I would consult your internist to make sure there is not a medical reason for your fluid retention to alleviate this problem.  I find that sometimes Belotero causes less fluid retention. Best, Dr. Green

Can a lot of water retention impact effectiveness of Restylane? (Photo)

Answers (8)

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