How long before Restylane in tear troughs shows complete results? How long will results last? (Photo)

Question

Almost 2 weeks ago, I had restylane injected into my tear troughs One side shows some improvement, but the other side does not. Also, both sides have raised areas or bumps, but one side looks worse than the other. Should I give it more time or is this the way I'm going to look?

Nima Shemirani, MD · Answer

Hi @RSMember3868! Two weeks is enough time for swelling to subside.  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. Hyaluronic acid facial filler products that were previously injected into an improper tissue plane can be dissolved by hyaluronidase injections. Best of luck, Dr. Nima!

Nelson Lee Novick, MD · Answer

I am very sorry that you are experiencing this problem. I have been injecting tear troughs with fillers for over three decades, since the early days with the original Zyderm I collagen filler, and can say with good authority that the results of injecting fillers into the tear troughs tend to be immediate, typically engender a "Wow!" response immediately following treatment, and also may last for periods far longer than the usual 8-14 months. Since you are two weeks post-treatment already, it would be prudent therefore to return to your doctor to discuss dissolving the Restylane and retreatment or seeking a second opinion regarding these issues.Nowadays, we are fortunate to have a variety of excellent fillers available for treating under eye dark circles, hollows and tear troughs. In my Upper East Side Manhattan office, I prefer Belotero Balance for this region since the product possesses little to no tendency to give rise to the unwanted, bluish Tyndall Effect when injected superficially within the delicate skin under the eyes. Some use Restylane Silk. (In my Israel satellite facility where a far greater number of regulatory agency approved fillers are available, I prefer Teosyal Redensity II and Hyaluronica 1). If you choose to seek a second opinion, make sure to consult with a board certified aesthetic physician with extensive experience and expertise with using fillers for the under eye area and insist on seeing his/her before and after photos before proceeding.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your concerns and photograph. At 2 weeks you are probably going to continue to look the way things are for about 6-9 months. You should see your doctor if you are displeased with the results, because there are other options at this point. Good luck.

Melvin Elson, MD · Answer

Time is not going to change this for the better. Tear trough injections are very difficult and it appears that the injections may have been too superficial leaving bumps and not enough material so you did not get correction. I suggest you return to your doctor or see another and get injected with enzyme to remove this and get reinjected after a couple of weeks. Be sure the doctor injecting is experienced in this area

Bridgit Nolan, MD · Answer

Hi, Two weeks post injection is a good time to evaluate your results as most bruising/swelling should be resolved by this time.  If you have raised areas or bumps, you may return to your injector and these may be dissolved with hylauronidase.  He/she can also evaluate your results and determine if more filler is necessary.

How long before Restylane in tear troughs shows complete results? How long will results last? (Photo)

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