Best way to fix overfilled my tear troughs? Adding a little more to round the raised portion out? Dissolving it? (Photos)

Question

I had my tear troughs filled for the first time and had an approximate total of 2 CC of Restylane injected almost 2 weeks ago. Is this overfilled or am I just being paranoid and perhaps it needs more time to settle if there is any residual swelling at all anymore?? I have been taking bromelain and arnica orally as well as topical arnica since before the injection to prep. A week after the procedure the physician said it looked great and it needs more time. I disagree.

Nima Shemirani, MD · Answer

Hi @LindaLane2017! There are a few reasons for this swelling. One being that the filler was not placed in the proper tissue plane. Most facial filler products that are injected into this area should ideally be placed in the tissue plane directly on top of the bone, or at least underneath the eyelid muscle layer. If a facial filler product is placed too superficial in the skin, or on top of the muscle layer, the product may settle in with an abnormal appearance and can look to be lumpy, swollen, or irregular. Another reason for the prolonged swelling can be due to the fact that too much facial filler product was used. The filler products that are preferred to treat this area will have some degree of affinity for water molecules so all of these products will exhibit some degree of hydration and swell once injected into the body. Hyaluronic acid facial filler products that were previously injected into an improper tissue plane can be dissolved by hyaluronidase injections. Best of luck, Dr. Nima!

David Yew, MD · Answer

If it's been 2 weeks and it's still visible then it's most likely from the Restylane being placed too superficially.  Your options would be time (but it could take several months or even longer) or go back to the injector and request hyaluronidase (vitrase) for dissolving the filler.   Make sure they are skilled in dissolving the filler as well and explaining the process.  It's very effective but they need to know how much to use and where to place it.

Jeanine B. Downie, MD · Answer

Hi Linda, it looks like you need to get some of the filler dissolved with Hyelenex.  Wait two weeks and then unfortunately you may need a little more filler injected to smooth out the area.  This happens from time to time and you are not being paranoid. Good luck, Dr. Downie

Chase Lay, MD · Answer

Thank you for your question.  I understand your concern and sorry about you are worry about your tear trough been overfilled.  It is best for you to get evaluated by your injector and some of the excessed volume can be reduced with Hyaluronidase.  Best luck to you.

Melvin Elson, MD · Answer

2 cc is a lot for the tear trough and i think you are overfilled.  It will eventually wear off but it will take time. To address this hyaluronidase injection can remove the material and then it can be reinjected at about 2 weeks. Be sure you are seeing a board certified dermatologist

Best way to fix overfilled my tear troughs? Adding a little more to round the raised portion out? Dissolving it? (Photos)

Answers (6)