Why do I have swelling one month after tear trough filler?

Hi @rlbeisenstadt! There are a few reasons for this swelling. One being that the filler was not placed in the proper tissue plane. Most facial filler products that are injected into this area should ideally be placed in the tissue plane directly on top of the bone, or at least underneath the eyelid muscle layer. If a facial filler product is placed too superficial in the skin, or on top of the muscle layer, the product may settle in with an abnormal appearance and can look to be lumpy, swollen, or irregular. Another reason for the prolonged swelling can be due to the fact that too much facial filler product was used. The filler products that are preferred to treat this area will have some degree of affinity for water molecules so all of these products will exhibit some degree of hydration and swell once injected into the body. Best of luck to you!

The good news is that the swelling of the tear trough area can be corrected if the fillers are reversible.  Juvederm ultra and ultra plus fillers can hold more water than others causing that sausage look, the chances of infection or Biofilm is rare but when in doubt please contact your physician, have them examine you, look at your before and after photos, let your physician decide if you need hyalurodinase/ antibiotics. Malar edema due to impaired lymphatics after the fillers could also be the case. Please have your physician examine you.

Hello and thank you for your question. It’s tough to answer this without pictures. I recommend following up with your injector as soon as possible for a consultation. The nice thing about dermal fillers is, if necessary, they can be reversed with a quick and easy injection of hyaluronidase. Best of luck.

I suggest reversing the filler if you are still swollen or unhappy. this can be replaced with a different technique or filler type .  Best, Dr. Emer.

Although swelling after these injections is universally seen for a few days, prolonged swelling is usually due to the wrong filler being used, or too much volume being added. The tear trough is a delicate area and should not be treated in the same way as deeper and less forgiving areas like the nasolabial folds.

Thanks for your question.This might depend on the filler used. Some fillers will draw water more readily and can have late swelling. I would suggest ice and rest and call your injector next available appointment for a check up. Best wishes. Dr. Aldo 

The filler used was hydrophyllic and is taking on water. It is generally not a god idea to use this type of filler in the tear trough. Chances are it will continue to get worse unless it is dissolved

As noted in the other answers, you should return to the physician who injected you.  Most fillers that are used in the tear trough are made from hyaluronic acid, which likes to bind with water.  If the filler is injected too close to the surface of the skin, it can appear lumpy and swollen.  The good news is that, if this is the case, it can easily be dissolved.

It is difficult to give you a direct answer without any photos. When receiving dermal fillers it is common to expect swelling 1-5 days post treatment. Due to the time frame now being one month post treatment I recommend scheduling a follow-up with the injector that performed the treatment. In the meantime, I suggest taking a Zyrtec daily to see if swelling will reduce. Best of luck.

Asymmetrical, one side vs other side, swelling or changes a month out are not normal. There are few benign explanations but you should see your provider or get a 2nd opinion ASAP. You want a facial aesthetics provider to reassure you that it is not infected or a granuloma.  Dont wait any longer.
Good luck and Let us know what they find.