Is there a cure for thick raised horizontal lines after under eye filler? (photo)

Question

I recently got filler for my tear troughs and it seems to have made matters worse. There are thick raised lines going horizontally down my face. Any cure for these?

Nima Shemirani, MD · Answer

Hi @jennimohoney. Thank you for sharing your photo. 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. Hyaluronic acid facial filler products that were previously injected into an improper tissue plane can be dissolved by hyaluronidase injections.

Johnson C. Lee, MD · Answer

Thank you for your photo. It appears that the fillers are creating noticeable rolls under the skin. This can occur with the wrong type of filler or filler placed in the wrong location with the wrong volumes. This can be easily corrected with hyaluronidase injection which immediately dissolves the filler. There will be several days of swelling after dissolving the filler and final resolution may not be seen for up to 10 days. Hope this helps!

Johnson C. Lee, MD
Board-Certified Plastic Surgeon

Johnson C. Lee, MD 
Board-Certified Plastic Surgeon

Wayne Wertheim, MD · Answer

i would definitely return to the injector for evaluation. Hyaluronidase is an enzyme that can treat this issue. your injector should offer this to you at no charge. good luck

Amy Lewis, MD · Answer

The filler was not injected properly and it may also be the wrong filler for that area. Hopefully, it is an HA filler and can be dissolved quickly with any brand of hyluronidase. (Vitrase, Hydase, Wydase ,Hylenex etc) You will see the bulk of the filler “melt away” within the first few minutes. It is important to know that the various  brands of HA filler have different cross-linking properties which affects how much  hyluronidase will be required. Restylane family has the least crosslinking which lends to a fast response, Juvederm and Versa will require more but the Vycross fillers( voluma, volbella, and vollure will require many times the amount as the othes. As long as it is melting “before your eyes”, you are on the right track.
Find another injector with experience to redo this when ready. Belotero is a very thin HA filler that will not cause these lumps and is an excellent choice for under eye trophs.

Lamia Wassef, MD · Answer

Thanks too much for your question 
If the filler was done recently what I would recommend just hot wet towel to the area and massage it
It will settle down by time 
But it is persistent then you can go back to your injector and ask to dissolve it
I hope My answer to your question will help 
Good luck
Dr Lamia Wassef

Pradeep Mettu, MD · Answer

Hello. It appears the filler was not injected properly. Hopefully, a hyaluronic acid based filler was used in which case the product can be dissolved with hyaluronidase. Seek an in person consultation. If your injector is unable to help you, see an oculoplastic surgeon. There are many in your area who are members of the American Society of Ophthalmic Plastic and Reconstructive Surgery. Best of luck.

Steven F. Weiner, MD · Answer

The cure for this is to remove the filller. It was not done properly and no amount of additional filler will be able to hide this. I use Hylenex with cannulas for this and mix a slight amount of lidocaine. If you have hollows after removal, I would seek another injector. The medial cheek has to be filler whenutesr trough filler is used to blend in and to correct the deep medial fat pad descent and volume loss.

Is there a cure for thick raised horizontal lines after under eye filler? (photo)

Answers (7)

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