Bags under eyes 2 weeks after Dysport, 3-4 units directly under each eye. What is the remedy aside from waiting? (Photo)

Question

My MD friend recently injected 3-4 units Dysport directly under each eye for reduction of crow's feet, plus a few units at the outer crow's feet. I stay hydrated, work out, eat well and I look years older now vs. before the Dysport. I would like to find a remedy to take the puffiness away and get movement back into the muscles under the eyes BEFORE the drug's effectiveness wears off naturally. I cannot squint or use the muscles under the eyes, therefore fluids accumulate.

Aldo Guerra, MD · Answer

Thanks for the opportunity to answer this question. You can consider taking a non-sedating antihistamine like Allegra if you're not allergic. Another consideration is Bromelain and/or Arnica. Always discuss your concerns with your injector.Best wishes, Dr. ALDO :)

Donn R. Chatham, MD · Answer

Botox and Dysport are powerful drugs and carefully administered. The fine muscles around the eye need to still function after treatment. We like to be very conservative with the lower eyelid muscles since they are so important for many reasons.  Once these drugs take effect they ‘work’ and cannot be reversed.  The muscles will gradually recover by about 90-100 days.

Vaishali B. Doolabh, MD, FACS · Answer

Hi JoieDeVivre2us.  If you deliberately continue to attempt squinting, you will strengthen the un-injected muscle sections and overcome the relaxation of the injected muscle section.  Manual massage from the inner corner to the outside with a Q tip or your fingertip and some eyecream will help drive fluid towards the outer lymphatics & reduce swelling.  Your dose was reasonable-I routinely use 1 unit of Botox (equal to 3 units of Dysport) under the eye for patients with small eyes (measured as a short distances between the lids) with favorable results, so hang in there!  Best wishes,

Kristine Romine, MD · Answer

Thank you for your question. For patients with a history of hay fever /
allergies, there may be some fluid build-up under the eyes after treatment with
neuromodulators (muscle relaxers) like Botox, Dysport or Xeomin.  Prior to
having treatment with neuromodulators, your muscles work to prevent and clear
out the normal (lymphatic) fluid which builds up at night (when we are not
using those muscles) however, once these muscles have been relaxed, the fluid
can build up overnight. Normally upon waking up with puffiness and bags, our
muscles work to clear out the fluid however when the muscles are not working to
clear it out, it remains. Taking antihistamines (if you are not allergic) can
help reduce this local fluid build-up. Please also consider use of a resilient
hyaluronic acid eye cream (I use Teoxane) which draws in fluid to the tissues surrounding
the bags and can help the hollow areas look better.  I would also
recommend consulting with a board certified dermatologist or plastic surgeon
who has extensive training and experience in injectables.  They fully
understand the facial anatomy and the artful placement of injectables which
leads to optimal results. They can also help you resolve your current issues.
Thankfully there are ways to improve this temporary situation and I wish you
the best.

Steven F. Weiner, MD · Answer

Unfortunately there is nothing to make the muscle come back faster after Dysport injection. As you stated, the pumping mechanism of the lower lid is not functioning and thus lymphatic drainage is impaired. Filler might be helpful to restore volume loss, but I'd be conservative - maybe 1/2 a syringe per side of Restylane using blunt cannula placement. Typically I inject about 3 units for a roll under the eye from orbicularis hypertrophy/wrinkles and don't have similar problems.

Shaun Patel, MD · Answer

Sorry to hear about your experience. The dose used was appropriate. I usually injection 1 unit Botox or 3 units of Dysport in this area in the appropriate patient. However, you may need additional Dysport at the inferolateral corner of the eye although care should be taken to avoid the zygomaticus muscle. I recommend that you followup with your injector to discuss your concerns.

Dinesh Maini, MBChB · Answer

Hi There
Sorry to see you have had trouble with this. It is an occasional issue.
One of the things that we have found helps is vibration - very much like a power plate in the gym.
The back of an electric toothbrush is quite helpful but only held on for a short period - less]

Bags under eyes 2 weeks after Dysport, 3-4 units directly under each eye. What is the remedy aside from waiting? (Photo)

Answers (7)

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Answers (7)

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