Possible Complications of Having Restylane Injected to Get Rid of Under Eye Hollows?

Doctor Answers 6

Fillers can effectively treat the tear trough, but need experienced injector

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Certain fillers, like hyaluronic acid (Restylane, Juvederm),  can be used very effectively to correct under eye hollowness--or the tear trough. I would caution you to find a physician who is experienced with injecting fillers in this region. There is little room for error in this location because the thin eyelid skin won't hide any lumpiness and the bruising can be much more obvious than in other parts of the face. Also, if the product is too close to the surface, a bluish tint can be seen occasionally. If this complication occurs or if there is just too much lumpiness, there is a product that can be injected into the area which will dissolve the filler and essentially wipe the slate clean. One way to minimize these risks is to inject a little more deeply (under the eyelid muscle). This does sometimes require slightly more product, however. I also believe that it is best to start conservatively and add more product as needed to achieve the desired result.


Hope this helps!

Dr. Yalamanchili

Houston Facial Plastic Surgeon
4.9 out of 5 stars 31 reviews

Tear trough injection needs great expertise

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Treatment of the tear trough is usually done by injecting hyaluronic acid. It requires great expertise and cannot be injected by anyone. Injecting the wrong filler might cause bumps and lumps and injecting it superficially might cause a bluish tinge, the Tyndall effect. Thankfully, if HAs are injected, any correction can be performed with Hylase, which simply dissolves the filler.

Hassan Galadari, MD
Dubai Dermatologist

Generally a very safe treatment in the right hands.

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Dear Boston

Under eye filling to address the undereye hollows is considered an advanced technique.  This means that the nurse down the street is probably not a good choice for having this procedure.  Similarly if your dermatologist tells you that they are not comfortable injecting this area, you need to respect this.  You might look for an oculoplastic surgeon in your area with a reputation for doing this treatment.

Regarding complications, the biggest complication is the risk of bruising.  Approximately 30% of individuals will have some degree of bruising.  Two out of one hundred will have a big black eye that can last up to 3 weeks.  Naturally everyone will think your significant other slugged you.  Having a good story is helpful.  Bar fight usually works for guys.  HIding these with makeup is not so significant.  Avoiding things that can thin the blood is very helpful to reduce the risk of these.  It is important to remember that you are basically getting surgery, it just happens to be delivered by a syringe.

The next most common complication is not getting enough volume.  This is often the fault of the injector worried about your pocketbook.  Hey, this is expensive service, it is much better to spend a little more and get the volume you actually need.  This avoids the disappointment that will be caused if you are still hollow after treatment.

Lumps, bumps, and swelling are also to be expected after treatment.  Generally, I like to see my patients back within a week to seen if anything needs adjusting.  The genius of this treatment is that it is straight forward adjusting this material manually or with enzyme when needed.

Regarding the risk of some horrible event like blindness or being poked in the eye with a needle, it is critical that you seek treatment from injectors who are comfortable treating around the eye and know their anatomy forward and back.  I do midface surgery and know the surgical anatomy of the midface and lower eyelid like the back of my hand.  This is very important.  There are large blood vessel that must be avoided so that filler is not injected into a vein which might affect the circulation.  The choice of injector makes all the difference.  

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Tear trough filler

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Any filler has side effecvts of swelling, bruising and lumpiness. The tear trough has more of this if fillers are injected under the skin and above the muscle. There is less of these effects when the filler is injected under the muscle. This takes experience to fill this area so make sure you see a doctor who does a lot of this.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Treating the tear trough

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Treating the tear trough region is a very delicate area. It is best treated by one of the smaller particle hyaluronic acid fillers and gently placed at the right level and evenly distributed or else you may see lumps.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Possible Complications of Having Restylane Injected to Get Rid of Under Eye Hollows

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As the other expert posters have stated the risks are noted. You should have very little injected in a weekly series so to achieve a sloww effect. From MIAMI Dr. Darryl J. Blinski, 305 598 0091

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.