Can there be damage to the lymphatic drainage system around the eyes from Restylane injections in the tear trough?

Question

I went to have injections to my tea trough area with a new doctor, when he saw me he said he thought some of my puffiness was due to a lack of drainage. We decided to dissolve the previous injected material with Vitrase. After 4 weeks, still fluid retention after the restylene dissolve. He believe that previous injections damaged my lymph. drainage. He believe this is permanent damage and can only be corrected by a lower bleph. Has anyone heard of this before?

Aldo Guerra, MD · Answer

Most often, the weak lymphatic drainage is there before the injection, just undiagnosed. You could still have filler in place and you may need more Vitrase. Best wishes, Dr. ALDO

Faiyaaz Kalimullah, MD, FAAD · Answer

Thank you for your question.  I'm sorry to hear that you're experiencing chronic swelling after your Restylane injections.  Chronic swelling under the eyes (also known as malar edema) is a known complication of under eye and tear trough filler injections.  This typically occurs because the superficial fat compartment under the eyes has relatively poor lymphatic drainage to begin with.  If an injector places too much filler superficially under the eyes, this can further block lymphatic drainage, resulting in chronic swelling.  Generally speaking, this is not permanent damage to the lymphatic system, and this swelling typically resolves once the filler has been dissolved.  Please keep in mind that it can often take multiple sessions of hyaluronidase injections to fully dissolve Restylane.The under eyes and tear troughs are among the most complex areas to treat with fillers.  I would recommend seeing a highly experienced cosmetic dermatologists, plastic surgeon, or oculoplastic surgeon for treatment.  Best of luck!

Melvin Elson, MD · Answer

This does not sound right. It would be helpful to know when you were injected with the filler.  any injection should not affect lymph drainage and Vitrase if indicated should have helped.  I suggest you seek a second opinion with a board certified oculoplastic surgeon

Katrinka L. Heher, MD · Answer

I've never heard of this theory so I would look at other causes.  Could you still have residual filler that still needs to be dissolved?  Have you had Botox to your crows feet over the last few months?  Botox in this area can definitely affect fluid drainage.  I don't believe you have permanent damage and I also don't think surgery would be the solution. Hope this helps and best of luck.

Can there be damage to the lymphatic drainage system around the eyes from Restylane injections in the tear trough?

Answers (4)

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