Swelling and pronounced bags under eye/in eye socket area after Juvederm Voluma. (photos)

Question

I received 2 syringes of Juvederm Voluma 14 days ago from a Facial Plastic Surgeon. Unfortunately, he hit a blood vessel under my left eye which caused a huge ugly bruise (still slightly present) and swelling. I am now concerned with the bags/puffiness I have under my eyes. I don't know if this is "swelling" that will continue to go down or if it is "fat bags" that were pushed upwards when the filler was injected. I feel like my face looks distorted now and I am considering dissolving.

Nima Shemirani, MD · Answer

Hi @qtzie! I am sorry you are dealing with this complication. I recommend dissolving the filler with Hylenex. Best of luck to you, Dr. Nima!

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. Discoloration, tenderness, lumps, redness, bruising and swelling are side effects that may occur with Voluma, but these tend to subside within 2-4 weeks of the procedure. You should ask your board certified facial plastic surgeon for his recovery recommendation, and follow his and his team's instructions as closely as possible.
Best wishes,

Jason Emer, MD · Answer

You may still have some swelling, but it usually resolves in 1-2 weeks. If you're unhappy with your final results you can have it reversed with hyaluronidase and try a different technique next time. I recommend cannulas with tear trough injections. VBeam treatments can help improve the appearance of the bruising. See an expert. Best, Dr. Emer

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs and I am sorry to hear of your injection issues.  If you did not have the bags underneath your eyes prior to receiving your injections I would not anticipate them to stay once the filler softens and your results mature.  I would critically assess your before and after pictures with your facial plastic surgeon to determine whether to allow more time to pass or to place hyaluronidase to dissolve the Voluma.  Hope this helps.

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question qtzie. I am sorry to hear about your situation. Voluma is a
filler used to enhance the appearance of the face. I prefer Restylane and Volbella under the eyes as Voluma is a thicker filler and can lead to increased swelling. Bruising resolves on its own usually in 1-2 weeks. Typically swelling also lasts 1-2 weeks but when thick fillers such as Voluma are used in sensitive areas such as the tear troughs the swelling may last longer. I recommend that my patients apply cold compresses to reduce swelling. Please
consult with a doctor for specific recommendations.  Good luck!

Michele S. Green, MD · Answer

It appears that the bruise caused a great deal of swelling. I would wait a few more weeks for the swelling to resolve before you dissolve the product.  It will take a few more weeks to judge the full results.  Best, Dr. Green

Sean Doherty, MD, FACS · Answer

Thanks to your large bruise, it is going to take more time for the swelling to subside on that side of the face. Give it a few more weeks. Everything should settle with time. Best of luck.

Kouros Azar, MD · Answer

The bruising is unfortunate, but it will clear up with time. If you aren't taking arnica, you cold see if that helps. I doubt that the filler is pushing up your fat pads. Having said that, Voluma is a thick filler and not one that I would use under the eyes. Wait another week or two and if you are still unhappy with your results, see your surgeon.

Faiyaaz Kalimullah, MD, FAAD · Answer

Thank you for sharing your photos and your concerns.  I'm sorry to hear that you're experiencing so much bruising after your filler injections.  Generally speaking, the skin under the eyes is quite sensitive, and is prone to swelling and bruising after filler injections.  In most cases, this swelling resolves within about 2 weeks of treatment.  That said, looking at your photos, you have fairly extensive bruising, which may take a little longer to fully heal.  It would be rare to form new bags under your eyes from filler injections if you did not have them before.  I suspect most of what you are seeing is deep bruising/hematomas and swelling from your treatment.
I would recommend waiting for the swelling and bruising to fully subside to fully assess your results.  It may be worthwhile to follow-up with your plastic surgeon to discuss your concerns as well - he/she may be able to treat some of your remaining bruising with a laser to help it fade sooner.  If you are still unhappy with your results after the swelling has gone down, Voluma can be dissolved with hyaluronidase.

Kyle S. Choe, MD, FACS · Answer

I suspect that most of what you are seeing is swelling/bruising from Voluma injections. When needles are used for filler injections, blood vessels can be punctured and cause it to bleed. This will cause skin discoloration (bruise) and swelling/firmness (hematoma). It will take up to few weeks for all this to go away. I doubt that 'fat bags' have been pushed up with fillers. I would revisit your provider and discuss your options.

Swelling and pronounced bags under eye/in eye socket area after Juvederm Voluma. (photos)

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