Under eye filler resistant to dissolving - what will help? (Photos)

Question

I have attempted to have this occlusion or pocket of filler dissolved 5 separate times. Nothing has improved. The last time I attempted it resulted in making even more exaggerated puffiness and hallow effect. I am very focused on it as it shows up in very noticeable ways. What can I do? All dissolves have been made with hyloronic. I do not know what filler was originally used.

Nelson Lee Novick, MD · Answer

The history of filler treatment and the appearance in the photos suggests that this is likely to be what has become known as under-eye "puffy pillows," I.e. filler-related lymphedema or lymphatic obstruction. If so, the use of hyaluronidase alone is typically not effective. I have had gratifying results in treating this  issue in people who have come to me with this problem using an algorithm of varying combinations, concentrations and amounts of intralesional anti-inflammatory agents. You would be wise to consult with an experienced, board certified cosmetic dermatologist filler injection expert and best of luck.

Anna Chacon, MD, FAAD · Answer

It sounds like you're experiencing a challenging situation with under-eye filler that has been resistant to dissolving. Here are a few steps you might consider discussing with your healthcare provider:

Consultation with a Specialist: Seek a consultation with a board-certified dermatologist or plastic surgeon who specializes in facial fillers. They can assess the situation and provide expert advice.

Ultrasound Imaging: Consider asking about ultrasound imaging to better understand the location and amount of filler present. This can help in planning further treatment.

Alternative Dissolving Agents: While hyaluronidase is commonly used to dissolve hyaluronic acid fillers, if the original filler was not hyaluronic acid-based, it may not respond to this treatment. Identifying the type of filler used is crucial.

Time and Patience: Sometimes, the body will gradually metabolize the filler over time. Monitoring the area with your specialist might be recommended.

Surgical Options: In rare cases, surgical intervention might be necessary to remove the filler, especially if it is causing significant issues and is not responding to other treatments.

Addressing Aesthetic Concerns: Discuss options for addressing any aesthetic concerns, such as puffiness or hollowness, which might include additional treatments or corrective procedures.

It's important to work closely with a qualified professional to determine the best course of action for your specific situation.

Under eye filler resistant to dissolving - what will help? (Photos)

Answers (2)

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