Should I have my under eye filler dissolved? Would it be best to dissolve the ‘too high’ eye & re-do it lower? (photo)

Question

I had under eye filler (<0.5ml under each eye) to help with making the area under my eye look less hollow & slight eye bags look less obvious. One eye looks like the filler is too high. So on the bottom of the eye bag not just below it. Both look like too much filler so the area above and below the filler looks flatter. Would it be best to dissolve the ‘too high’ eye & re-do it lower, then see if both settle, or have I been overfilled so beat dissolve both?

John Tang, MD · Answer

I am sorry that the filler was done incorrectly and it turned out the way it did.  I would myself be very unhappy with the results as seen by your submitted photos.  I would recommend that you dissolve your filler and start over.  However, the method to dissolve the filler is the question.  If the product can be easily felt and identified then hylaronidase can be used to break down.  If it cannot be localized, then hylaronidase can also harm your natural tissue and possibly cause an indent.  In addition, injected too much hylaronidase or injecting hylaronidase in the wrong area can also cause the same harm.  In order to do this correctly and well, you would have to seek an expert, someone who has a lot of experience in correcting botched fillers in the eyes.  The other option to dissolve filler is to use an RF device to heat the filler to break it down over time.  If you can't find anyone you can trust, then just wait for the filler to resolve on its own because you don't want to create any more headache.

Michael P. Morrissette, DDS, FACS · Answer

It is probably a good idea to dissolve the filler and reassess the tear trough area. I think it is important to determine the extent of prolapse fat of your lower eyes. In some cases, it is better to remove the bulging fat with a blepharoplasty and simultaneously have fat injected in the tear trough to provide a smooth, youthful appearance. Good luck

Jason Emer, MD · Answer

Fillers ALWAYS respond to hyaluronidase.  IF there is still swelling after that then RF treatments are needed to improve the lymphatic flow of that area and antibiotics are needed to decrease internal inflammation.  You can give it 2 weeks and if not better then reverse but in general if there is this mcuh swelling it needs to be reversed.  And its often not a consequence of the technique used of the physician or its just an internal reaction to the filler from that individual person and can't be predicted who this will happen to.   Best, Dr. Emer.

Nelson Lee Novick, MD · Answer

Injectable natural fillers, such as hyaluronic acid-based fillers, are generally broken down by two major processes: ordinary metabolism and mechanical pressure and motion on the area into which it is injected. Metabolic breakdown is a rather sluggish process, while mechanical breakdown may occur quite rapidly. It is the reason that fillers placed in mobile areas, such as smile lines and particularly around the mouth have relatively short durations of effect. One of the side benefits of filler treatment under the eyes is typically a prolonged duration of results, since mechanical pressure on the injected filler figures very little in this region. So, it is not uncommon for filler results to remain for two or more years. For this reason, I would be inclined towards dissolving the unwanted filler results with hyaluronidase, rather than waiting for them to resolve on their own, and then re-treating properly. I would strongly urge that you consult with a board certified aesthetic physician with experience and expertise not only in the proper use of hyaluronidase, but in the injection of the under eye region, since this is not an area to be left to novice, cut-rate or medspa-type injectors. I would caution against the use of fillers, such as ordinary Juvederm for this region, since this fillers holds on to tissue fluid and can cause the kinds of swellings seen in the photos. I would also caution against the use of plain Restylane, as this filler may give rise to lumps and bumps. In my NY practice, I typically opt for Belotero Balance, since this smooth, cohesive filler possesses little to no tendency to engender the unwanted bluish/gray Tyndall Effect when injected superficially into the delicate under eye tissues. (In my Israel satellite facility, where a far greater number of regulatory agency approved fillers are available, I would choose Teosyal Redensity II for this area). Do your "due diligence and going forward, seek consultation and treatment by a board certified aesthetic physician, and make sure to ask to see his/her personal befores and afters before agreeing to proceed. Best of luck.

Michael A. Persky, MD · Answer

Hi Bobella,Sorry to see that your lower eye hollow injections are unsatisfactory.  I would advise you to consult with an expert physician filler injector for evaluation and correction.  After examination, I would either dissolve the excess filler with hyaluronidase and/or use Restylane to smooth out the area.  The most important aspect of any facial aesthetic treatment to choose your treating physician most carefully based on their skill, knowledge, experience, and natural artistic vision.  Good luck and be well.Dr. PEncino, CA

Mehryar (Ray) Taban, MD, FACS · Answer

Timing of the filler injection is important. It may take 1 month for the filler to settle. If longer than that, then one can consider dissolving the filler and re-evaluating again.

Michael A. Zadeh, MD, FACS · Answer

When did you have your injections done? If it has been at least 2 weeks since your injection then this is unlikely to resolve and I would recommend dissolving the filler with Hyaluronidase and starting over. Make sure you are under the care of an experienced physician injector. Best wishes.

Sach Mohan, MBBS · Answer

Hello BoBecca, 
Thank you for your questions and sorry that you feel unhappy with the results. I would really recommend that you go back to your treating practitioner and have a face to face consultation. Its unclear when you had the procedure done. If it was very recently this could be a degree of inflammation and swelling. Unfortunately if its longer than two weeks this may not settle.  Hyaluronic acid fillers can be dissolved with an enzyme called hyaluronidase. 
I hope this helps.

Lana Long, MD · Answer

This can happen when placing filler under the eyes.  It should be dissolved under both eyes.  It is a tricky area for filler and not everyone is a good candidate.  Lana Long MD

Should I have my under eye filler dissolved? Would it be best to dissolve the ‘too high’ eye & re-do it lower? (photo)

Answers (9)

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