Lumps and hollows after Juvederm. Any suggestions? (photos)
Doctor Answers 16
Lumps and Hollows After Juvederm Injected Under Eyes
This is not what you want to hear right now, but you need to give it 2-3 weeks before assessing the final outcome. Hopefully your injector recommended a follow up appointment to evaluate your results. If not, I would schedule a follow up and give your injector an opportunity to follow up with your care.
Juvederm is not a filler I like to place in the eye-trough because it is the most hydrophilic or "water-loving" of all of the dermal fillers and commonly yields this type of result when injected peri-orbitally. Should your ultimate outcome continue to be less than desirable, the good news is that you have a solution in the form of an antidote: Hyalronidase.
In the future, I would recommend you try a product like Restylane for a much smoother result in the eye area, and consider seeking treatment from a board-certified plastic surgeon.
Fillers do take time to settle, and addressing you eyelid-cheek area will improve the look of your eyes and cheeks as well
I can certainly help you with your concerns. Just a bit about my background — I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic surgeon, practicing in Manhattan and Long Island for over 20 years. I was first trained in eye surgery, before specializing in cosmetic and reconstructive surgery of the eye area, with the goal of helping improve the appearance of people’s eyes.
Based on your photos, it seems that you are dealing with several concurrent issues, of which the under eye hollows seems to be what bothers you most. In my practice, it is important to spend enough time to hear people’s concerns, understand where they’re coming from, and also understand their treatment priorities in order to effectively pinpoint what about their appearance bothers them most. Sometimes, people tend to zone in and magnify certain parts of themselves that they don’t like, so it’s also important to look at the big picture.
When it comes to under eye hollowing, it is important to define the cause — is it genetic or is it due to facial aging? With facial aging, keep in mind that you’re dealing with global loss of volume, bone, muscle and fat throughout the face.
In cases such as yours, most of the time, we can approach this in two different ways. The first is similar to what your doctor did, and that is to use a filler, which I prefer Restylane for under the eyes, which I combine with platelet-rich plasma (PRP) for under eye hollowing. Platelet-rich plasma is a concentration derived from your own blood that contains healing and growth factors that improve collagen and blood supply in the skin. Since your skin does look somewhat thin, you can benefit from this synergy of volume correction and skin quality improvement.
Another approach we do is by means of a procedure called the Y Lift™. In this procedure, we use a filler, such as Juvederm Ultra Plus or Voluma, and we place it deep in the cheekbone area in order to provide a type of cheek lift. A cheek lift with the under eye hollow being corrected is a very nice combination, and helps with your issue of your cheeks looking deflated to you.
I think your doctor was correct in advising you to wait, since it isn’t unusual for people with thin skin to have these types of lumps. In our practice, we usually follow-up with our patients after two weeks, as this is how long it takes for the material to settle within the body and the muscles, and also to massage the material into its contour. This is also the time to see if additional filler is needed for further enhancement.
I suggest you meet with your doctor and discuss this type of approach, as well as a way to get the whole area to look good instead of just the isolated area of the tear trough. It’s important that we look at the whole picture and not just the little areas.
I hope that was helpful and I wish you the best of luck!
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I am so sorry for your trouble. I would definitely wait at least 10 days to see the effect of the injection before I would attempt to dissolve it or put more product in. Please keep us posted. Best, Dr. Green
You need to give it time
you should relax and give it several weeks. It is not uncommon at all, after Restylane or Juvaderm is injected into the tear trough, to go through a period, where it looks worse before it looks better. Remember you can massage any lumpiness. The most important thing is just to be patient and not drive yourself crazy.
david berman md
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