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

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.

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. 

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.

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.

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