Lymphatics being damaged after tear trough filler? (Photos)

Question

I have Belataro put into my tear troughs and was pleased with the results. A year later I returned and had Restylane L put in. My eyes were significantly swollen after 2 weeks and was put on a steroid. Nothing helped. I am now going for my 4th round of dissolving and nothing seems to help. I was told possibly my lymphatics were damaged. This has been an awful experience.

Kenneth D. Steinsapir, MD · Answer

There is nothing wrong with your lymphatics. The problem is runny filler and a lack of knowledge on the part of your injector. Belotero is a horribly runny filler that does not belong under the eye. Mix it with Restylane that is the right product for that area and you end up with a hybrid mix in the lower eyelid that is also runny. The fix is removal with a large dose of enzyme. Baby squirts of enzyme are not going to get the job done. There is no substitute for a personal assessment. Your eyes can be your best feature.

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Nelson Lee Novick, MD · Answer

It is absolutely true that filler can compress or obstruct the lymphatics under the eyes preventing adequate drainage and give  rise to the kind of "pale puffy lower eyelid pillows" seen in the photos. It can be a very difficult to problem to treat. I have personally had success, and this has been confirmed in a recent medical paper on the subject, that very high concentrations of hyaluronidase placed in boluses along the "pillow" can lead to shrinkage. Usually two to three treatment sessions are required to achieve optimal results. Make sure to consult with an experienced. board certified aesthetic dermatologist, and best of luck.

Shawna R. Kleban, MD · Answer

Facial lymphatics can be damaged by placing fillers. Hyaluronic acid fillers are typically dissolvable with hyaluronidase, but when the lymphatic channels have been damaged swelling may persist.

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Hi there,
I am sorry that has happened to you.  It isn't a matter of product but placement. It is possible your lymphatic drainage system has been compromised.  Be patient and see a Board Certified Physician and discuss your options.  It will likely resolve in time.
Best of luck...

Lymphatics being damaged after tear trough filler? (Photos)

Answers (5)

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