What is wrong with my eyes? Are these little blobs actually the filler? (Photos)

Hello T,
Sorry for your bad filler experience. I perform all injections in my patients, yes, there still are facial plastic surgeons who perform filler injections without relegating injection patients to non-MD injectors. In your case, it appears that your have been undertreated, I would recommend additional strategic filling by an expert injector to correct your concerns. I would personally use Sculptra with a bit of Restylane in your under eye hollows. Feel free to contact us for a FaceTime virtual consult to answer any further questions or concerns. Choose your injecting physician most carefully. Good luck and be well.
Michael Persky, MD
Encino, CA

Longterm filler problems include migration, edema, and nodularity. Filler migration and permanence is a very common problem because there are many different types of HA fillers on the market and each is specified for a specific part of the face. Use of highly cohesive fillers on thin skin may cause swelling and nodularity. If patients have filler migration or nodules, we recommend a combination approach of filler reversal with enzymes Hylenex and Hyaluronidase in different strengths to dissolve the filler. We may also need to add Kenalog to the mix in order to reduce fibrous tissue. If the filler does not dissolve, it either means the filler is not HA material or we need more enzyme. The HA reversal can be combined with other lasers and skin treatments at the same time, and it usually (usually) does not affect adjacent tissue.

Best,
Dr. Karamanoukian
Realself100 Surgeon

There does appear to be age related under eye fat prolapse in addition to deflation and filler. You may benefit from lower blepharoplasty. Need more detailed evaluation to determine. See an expert.

First, as to your question of whether there are any true doctors that inject fillers anymore, there certainly are, and I am one of them. So, you would be wise going forward to make certain that you are consulting a board certified, cosmetic dermatologist and to make sure that the doctor him/herself does the injecting, and not a physician extender or aesthetician, etc. Second, plain Juvederm, has a well-known tendency to attract and hold onto tissue fluid, and thus makes a poor choice, among experienced injectors for use in the delicate and thin under eye region where such water retention can give rise to the kinds of puffyness seen in the photos. Fortunately, hyaluronidase, a natural HA dissolving enzyme, can be used to dissolve the unwanted filler and resolve the problem quickly in most cases. Hyaluronidase is a watery substance that does not add volume to an area and also cannot clog blood vessels, so its use even under the eyes when needed has a very long track record for safety and efficacy. Once the unwanted filler is dissolved and the puffyness gone, you may wish to consult with an experienced physician injector regarding the use of a more appropriate filler for treating the under eyes. Hope this helps.

Hello, I can honestly say that I can disolve your fillers cause Juvederm is a resolvable filler. For this process, we would like to invite you to Istanbul. I’m the only triple board-certified facial plastic surgeon all around Europe. I’m just focused on this issue. I am a doctor who goes to almost every country in the world and explains my techniques to important doctors with the congress invitations I receive, so I am definitely the only doctor who can perform your operation very comfortably and successfully. You can get more detailed information about me, ask all questions about your case and sending your photos to my assistants at the number on my profile (+90 539 204 40 90). You can also book an online consultation and discuss your problems with me.
With all respect.

Thank you for your question. It is difficult to say what the cause of your eye "blobs" may be as there are no pictures of before the filler injection or description of where the injection was administered under the eyes. Depending on the HA filler used, you can generally expect dissolution in 6-9 months. You may see improvement with daily massaging. I always recommend seeking experienced dermatologist, plastic, facial or occuloplastic surgeons for any injections around the eyes as the treating physician is usually the best person to advise you as to how any complication should be managed. Also, no "aesthetician" should ever perform injections on any patients. At a minimum, it should be a very experienced nurse under the direct supervision of an experienced physician. The success of most procedures depends on the experience and expertise of the surgeon performing the initial procedure.

Hi there,

I am sorry about your results. I do not know how much product you had and where. I hope you went to a board certified plastic or dermatologist. However you need to see an expert injector or plastic surgeon for an evaluation.
Best of luck!

You did not say which Juvederm filler you had placed where. From your question, I will assume it was the same filler for all 3 areas and that it was probably Juvederm Ultra. This would be a reasonable choice for your lips. I almost never inject the nasolabial folds as that is not where the problem is. It is higher with loss of volume in the molar area. This area and the tear troughs (which you still have) are best treated with Juvederm Voluma injected deep on the bone or muscle below the orbital ligament. It appears that you had Ultra injected above the ligament superficially. If this is so, you have 2 consequences. First the Ultra absorbs water and, secondly, injecting superficially disrupts the normal eyelid lymphatics and results in swelling, what your pictures convey. The best option is to dissolve what is there if possible and reinfect properly with the correct product. Unfortunately, a majority of physicians as well as nurse and aesthetician injectors inject this area incorrectly. To answer your other question, there are physicians who do the injections themselves. your best bet is a plastic surgeon who also operates in the area and understands the anatomy intimately and is an expert in this area.