Dissolve previous eye filler before lower eye surgery?

Question

I have filler (Restylane) still under my eyes from 9 months ago and am having a upper/lower eye surgery. Do I need to have the filler dissolved before the surgery is preformed or can it dissolve naturally? My surgery is in one month. Thanks!

George Volpe, MD · Answer

In most cases it is unnecessary to dissolve fillers prior to undergoing lower eyelid surgery. It is in most cases unusual to pose a problem. If you have a significant bump or other issue from previous fillers you may wish to treat that ahead of time. Remember, after lower eyelid surgery you may require fillers to touch up certain areas including the tear trough line on the inside part of the lower eyelid to finesse your final results.

Stephen Bresnick, MD · Answer

Cosmetic eyelid surgery requires contouring and fat reduction or repositioning, especially in the lower eyelids.  Any fillers in the eyelid area should be dissolved or should be allowed to dissipate prior to surgery in my opinion.  In this way, your doctor will be better able to verify eyelid shape and improvement at your procedure.  Hyaluronidase is an enzyme which dissolves Restylane quite nicely and your surgeon can assist you with this.  I would also recommend discussing this issue with your surgeon asap so that the trauma of eyelid injection does not create bruising and swelling prior to your procedure.    Good luck!

Kenneth D. Steinsapir, MD · Answer

It very much depends on your precise situation and your surgeon.  Each week I see several new consults of individual seeking eyelid surgery who have had fillers in the past.  Approximately 20% of these individual only need the old filler removed with enzyme and when this is done, the issue that they thought they needed surgery for is fixed and one in seconds.  Your surgeon might not be too happy with this but it needs to be explored.  Why have surgery if you don't need it!

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your question. If you still have obvious Restylane present in your lower eyelids/tear troughs, it would be prudent to dissolve the remaining filler with Hyaluronidase prior to having blepharoplasty. Discuss your concerns with your surgeon. Good luck.

Dan Landmann, MD · Answer

It really depends on what you are having done, so make sure to talk to your doctor about it. I've had patients come to me saying that they needed eyelid surgery, when all they had was swelling from previous Juvederm injections. But if you have hollow tear troughs, filler might be keeping them looking full, which will lessen the amount of work that needs to be done. Talk to your doctor about this as soon as possible, because if you two decide to dissolve the filler first, you will want to see how your eyelids look before proceeding with surgery.

Curtis Wong, MD · Answer

before having your lid procedure.  It would make a difference in some instances and your surgeon will have to determine if what you have should dissolve before surgery or not.

Elbert T. Cheng, MD · Answer

Hello Blondie!Thank you for your question.  As you know, filler under the eyes is more and more common with our presurgery patients.  In my experience, it is not necessary to dissolve the filler artificially or wait for it all to dissolve before embarking on eyelid surgery.  I do tell my patients there is an unknown variable now, and when I am in surgery, I will try to correct the issues the filler is compensating for.  Patients do well.  Best of luck!

William Portuese, MD · Answer

When placing fillers in the lower lids, they have become artificially inflated, so it's very important to have It dissolved several weeks before any elective cosmetic surgery on the lower lids to make sure that your surgeon can accurately determine the anatomical issues to address at the time of the surgery.

Donald Nunn, MD (retired) · Answer

I would discuss this with the surgeon doing your surgery.  In some cases it may make a difference and in others it would not. It depends on the amount and type of filler, where it is located and the type of eyelid surgery being done. Good luck.  Donald R. Nunn MD  Atlanta Plastic Surgeon

Dissolve previous eye filler before lower eye surgery?

Answers (9)

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