Eyes are misshapen after surgery to remove Artefil from under eye area. What can be done to improve this? (Photos)

Question

I had surgury to remove Artefil that was placed under my eyes (yes, I know that that's awful but what is done is done) The problem now is that I have had the lower eye surgery and feel like my eyes are misshaped. I also have those track marks under one of my eyes and feel pain in the same eye. Do I need a graft? Do i need a repair? Please let me know what my next steps should be as I'm feeling very insecure about these results

Gary M. Horndeski, MD · Answer

You have a high vertical forehead and receding hairline. Your eyebrows are also too low, below the level of the orbital rim. You would benefit from an extended browlift done at the frontal hair level. This will decrease the vertical height of the forehead, lower the hairline and pull up the eyebrows. The incision can be extended down to the inferior area of your ear, which will pull up the mid-face to help with the crows feet and excess skin of the lower eyelids. You would also require a blepharoplasty. I would recommend doing the extended browlift first.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Kadir Berat Oyur, MD · Answer

Regarding the complications following your permanent filler removal, it is imperative to address both the aesthetic concerns and the localized pain you are currently experiencing. In cases involving post-surgical misshaping and visible track marks, a thorough clinical evaluation is required to differentiate between standard scar tissue maturation and structural eyelid malposition. While restorative techniques such as fat grafting or surgical revision are viable options to improve contour and symmetry, the presence of persistent pain necessitates immediate investigation to rule out nerve entrapment or localized inflammatory responses. I recommend a formal consultation to perform a physical assessment of the tissue integrity, which will allow us to establish a definitive reconstructive timeline and a targeted management plan to address your insecurities and physical discomfort.

Carl Truesdale, MD · Answer

Removing semi-permanent fillers like Artefil from the under-eye area is one of the more challenging things we do in facial plastic surgery. The fillers tend to integrate with surrounding tissue over years, so removal often takes some tissue with it. That's why the post-removal appearance is rarely back to baseline.
What you're seeing now is the result of three things happening at once: residual filler that wasn't fully removed, scar tissue at the dissection plane, and volume loss from the tissue that came out with the filler.
A few options worth considering.
Imaging first. An ultrasound or MRI can show how much filler material is still present and where. Some patients have more residual product than expected, and a second targeted removal may help.
If significant volume loss is the dominant problem, autologous fat grafting can rebuild the under-eye structure. It tends to integrate better than fresh filler in tissue that's been operated on, because we're working with your own tissue rather than introducing more foreign material.
For shape irregularities (asymmetry, lid retraction, ectropion), surgical correction with canthopexy or canthoplasty plus selective skin and muscle rebalancing is sometimes the only option. This is true revision surgery and needs an experienced oculoplastic or facial plastic revision specialist.
Timing matters. Most patients do better with at least 6 to 12 months between operations to let tissue settle, so plan for a sequence rather than expecting one operation to fix everything.
Find a surgeon with specific experience in post-filler revision work. This isn't standard bleph territory. Bring your operative reports if available.

Waylon Zeng, MD · Answer

Hi there thank you so much for your question and sharing your photos. I’m sorry you are experiencing all this from the initial filler injection. With contour deformities of the lower eyelids, my recommendation is typically fat transfer. This is soft and permanent, so it does not cause nodules or contour problems. It integrates with your body (it’s your own fat cells or you can also use off-the-shelf fat products) so it is a nice permanent solution to this issue. Hope that helps!

Eyes are misshapen after surgery to remove Artefil from under eye area. What can be done to improve this? (Photos)

Answers (4)

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