What do I do if fillers made my malar bags looks even worse? What causes this?

Anytime fillers are placed in an area close to the malar mounds, they have a potential to swell.  Hyaluronic acid fillers work by absorbing water.  In doing so, they can draw water into the malar mounds, which fluctuate in size based on water retention.  If the swelling is still noticeable after 4 weeks, I would seek a physician who can help dissolve some filler in the area with hyaluronidase.  Sometimes, injecting a small amount of hyaluronidase in the malar mound can help reduce the swelling even though there is no filler in the malar mound.    

Hi @RSMember14740. I'm sorry you are dealing with this. Malar bags can be difficult to treat. I recommend Morpheus 8. Morpheus8 is a non-surgical treatment for full body skin resurfacing, skin tightening, and fat reduction of stubborn areas. It uses minimally invasive fractional radiofrequency energy (RF) to penetrate the skin deeper than other microneedling devices, triggering the skin’s natural healing response to promote skin tightening and lifting.

Best of luck,

Dr. Nima

Thank you for your question and the picture.  I have to say your picture does not look bad compared to what I normally see!  I would wait a couple of weeks to see if it improves.  If not, go back to the practitioner who put the filler in so it can be dissolved.  Then try a skin tightening approach instead that is safe for ethnic skin (example - Venus/Viva).  Hope this helps.

Unfortunately there is no cure for malar bags. Fillers can actually make it look worse dependent upon the case. I suggest reversing the filler if you are unhappy then starting energy based treatments like Fractora or laser to help. I recommend getting a formal consultation to see what is best for you and your goals.  Best, Dr. Emer.

We have seen clients come in with malar bags that have been treated elsewhere improperly with filler.  The idea behind this was that the filler would "stretch" the skin out, but unfortunately, malar bags are mostly due to skin that is already loose and stretched.The proper approach would have been to perform some form of skin tightening to reduce the bags.  The best results usually occur when the filler is dissolved and the bags are properly treated with laser or RF-based devices to tighten the skin.  Your skin type is darker so make sure that any practitioner you see is experienced with treating *all* skin types so you avoid complications.Hope that helps.

unfortunately not everyone is a good candidate for tear trough fillers - people who baseline fluid collection in this area often hold on to fluid after filler placement into the tear trough - it's not blocked ducts, its just the predisposition to hold onto fluid (you might note that these 'bags' get worse after eating salty meals?)
if things look worse, i would recommend reversing the filler. i dont like hyaluronic acid fillers in people who hold onto malar fluid. there are some people who say that radiesse in the cheeks can help to tamponade the fluid and may work better. there is some suggestion in the literature that injecting these fluid pockets with tetracycline or doxycycline can improve the fluid for some length of time (months to years). unfortunately even surgery doesn't reliably improve things... its a tough problem but i believe you can get back to baseline with reversal of the tear trough filler.
good luck

Great question thank you.  From the photo it is difficult to appreciate your malar bags, it would be great to see a before and after photo for comparison.  While there is no great cure for malar bags, filler can often help to mask this, yet if filler is not placed in the right position or if too little or too much filler is placed it can affect your end results.  Other things you may consider to help with the malar bags are microneelding with PRP or radio frequency treatments as these help to tighten the skin.  You could also consider different laser treatments.  I would return to the place that performed the filler.  If they continue to not respond to your calls then I would look for a second opinion.  An in-person consultation with an experience provider is best to determine which options will be best for you and help you achieve your goals.  Thanks again for the question.  Best wishes, Dr. Lindsay J Sturm.

Sometimes tear trough filler can block ducts and can make malar bags look worse.  If you hate the results, return to the provider who injected you and have them reverse it.  If it has been less than 2 weeks, you may want to wait a little while longer to see if the swelling from the filler resolves before reversing it.  Good luck.