I had Juvederm injected on my tear troughs, with bad results 3 weeks out. Is this Tyndall or a hematoma? (Photos)

Question

My right eye is worse than the left, but they are both still swollen. The right eye is also discolored. My Dr is insisting that it is a hematoma, and refuses to dissolve the Juvaderm. She wants to wait two more weeks, then do a laser treatment for the 'hematoma' on the right eye. Should I find someone else to dissolve it for me? It seems unlikely that a hematoma would still be this large after 3 weeks.

Gregory A. Buford, MD, FACS · Answer

I would tend to agree with the other experts in that Juvederm alone is generally not my first line choice for the tear trough area.  Instead I would either use it in a diluted form (by adding Lidocaine) or by choosing another filler such as Belotero or Restylane.  However, that being said I actually would NOT have started with an injection to your tear trough area given how flattened your midface/cheeks are.  You would be a perfect candidate for Voluma to this area to help build up the mid face.  By starting with this area, we often see improvement in the tear trough area and don't have to actually inject it.  Start with dissolving this product and then move on from there.  I hope this helps and wish you the very best!Gregory A. Buford, MD FACSBoard Certified Plastic Surgeon/AuthorAllergan Facial Injectables Master Trainer

Jason Emer, MD · Answer

If you are unhappy, please have this reversed and see an expert for alternative injection technique and product.  Best, Dr. Emer.

John J. Martin, Jr., MD · Answer

Juvederm is not a recommended filler for the tear trough for exactly this reason.  It can create long term edema in the lids.  While you might have a little bruise still left,  after 3 weeks any residual bruise would not be causing this amount of swelling.  Get it dissolved and no more Juvederm in your tear troughs.

Steven F. Weiner, MD · Answer

This will not get better. Juvederm is not the right product for this area. It leads to a chronic swelling frequently. Also it has been filled incorrectly. I question the experience of this provider. I always use cannulas here and it is rare to get bruising with them and never hematoma. Seek out an experienced injector to correct the issue and fill the tear troughs appropriately.

Kimberly Finder, MD · Answer

I love Juvéderm, but not in the tear trough area. It can lead to a problem with excessive swelling, which is probably what your photos are showing. The only way to tell would be an in-person examination. If you're unsure about the physician (I hope it was a physician who injected you), then get another opinion from an experienced physician who regularly uses fillers, a "core" physician in one of the aesthetic specialties (dermatology, plastic or oculoplastic surgery) in your area. Juvéderm can be dissolved and after it settles down, Restylane or Restylane Silk are preferred options for that area of the face.

Adrienne E. Stewart, MD · Answer

I personally do not do this procedure.  I don't believe Juvederm is recommended for this procedure.  As far as the hematoma, I would definitely seek a second opinion from a board-certified dermatologist or plastic surgeon but I would probably dissolve it.  Thanks for your question. Dr. Adrienne E Stewart MD F AAD

Lenore Sikorski, MD · Answer

Thank you for your question. I do not use Juvederm in the tear trough area due to the fact that it can cause swelling in this area. Restylane is the better option for this area. I would recommend getting a second opinion and consider getting the filler dissolved.

Richard O. Gregory, MD · Answer

It seems that there are two problems, one being a deformity, and the second being the lack of trust in your injector. Although three weeks is too short a period of time for hematoma to recede, this could still be either hematoma or filler. I think that you should seek another opinion.

Marc Cohen, MD (retired) · Answer

Juvederm is a great filler.  However it is not a good choice for under the eyes.  The reason is that in many patients the filler tends to swell and cause a problem similar to the one you are experiencing.  A photo is not a good as a person examination, but it does not appear that you have a significant hematoma at this point.  You may want to get a second opinion.  Most likely you will need the filler dissolved, which is an easy procedure.  After a little time has passed you may want to consider another treatment with Restylane, which is much less likely to swell in that area.

Michael Elam, MD (retired) · Answer

Dear tishasheree, I personally do not use Juvederm in the tear troughs and I am not really a fan of tear trough injections due to the many patients who have passed through my doors being injected by other surgeons and and having similar results. I would suggest at this time that you see an expert physician injector and have the Juvederm dissolved. Best regards, Michael V. Elam, M.D.

I had Juvederm injected on my tear troughs, with bad results 3 weeks out. Is this Tyndall or a hematoma? (Photos)

Answers (11)