Dissolve Restylane Before Bleph?

Should I have TE restylane in my tear troughs dissolved before having a lower bleph? Thanks!

Doctor Answers 8

Dissolving Restylane in Tear Trough Prior to Eyelid Surgery

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   It may be reasonable to dissolve a temporary filler prior to eyelid surgery.  This would depend upon what surgical techniques are employed and surgeon preferences.

Lower bleph and existing Restylane in tear troughs.

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If the Restylane is placed in the tear troughs, it is probably not necessary to remove it prior to a blepharoplasty.  If the Restylane is present and directly over the fat pads, it is best to have it removed or wait until it has dissipated prior to having the lower blepharoplasty. The reason for this is so that the surgeon can identify the precise amount of fat that needs to be removed to get a nice cosmetic effect without the temporary augmentation in the way.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Blepharoplasty# #cosmeticsurgery #beauty

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Dear meI37


Thank you for your question!

The removal of a filler - will depend on your surgeon - and whether it will affect what they are going to do for you during surgery.  I replace the filler with micro fat grafting - so I remove the product if I think that there is excess or distortion of the tissue. If there is minimal product remaining I just massage it out of the area, then perform the micro fat grafting.


With Warm Regards,

Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 126 reviews

Restylane distortion when performing a lower eyelid blepharoplasty

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Any soft tissue filler, injected into the tear trough zone of the lower eyelids can distort and change a surgical plan.  To get your best result it would be best to wait until it resolves or you could consider injecting it with an enzyme to speed its resolution.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

It Depends on the Type of Lower Blepharoplasty

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Generally speaking, it is best to wait a couple of months after Restylane injections to perform a lower blepharoplasty.  With filler in the area, it distorts the what the natural lower lid/cheek appearance.  One of the best reason to have a lower blepharoplasty is that it is permanent and should reduce the use of fillers in the area.  If the face is full of fillers, then it is hard to determine the best surgical procedure.  You other option is to have the Restylane dissolved.  It is up to the surgeon if they feel they need to dissolve the Restylane before undergoing a lower blepharoplasty to create the best surgical plan.  

Dissolve Restylane before bleph?

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It would be important to know exactly what kind of lower blepharoplasty you would be having.  It would also be helpful to know how long ago you had the Restylane placed into your tear trough areas.  If you were only having surgery on the skin portion of your lower eyelid, the Restylane may not be an issue.  If you are having fat removed from your lower eyelid, then the Restylane could be a factor.  I would discuss this with your surgeon to see what he or she feels would be most appropriate. 

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Restylane and blepharoplasty

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Generally, when a hyaluronic acid filler is used, it is injected in the tear-trough which is located below the actual fat-pocket which will be reduced or repositioned during a blepharoplasty. That said, an easy option to dissolve out all the filler would be to have a small injection of hyaluronidase (which will dissolve the filler) three weeks before your surgery so the region can be visualized completely.

Best wishes,

-Dr. Jamil Asaria, 

FACE Toronto

Jamil Asaria, MD
Toronto Facial Plastic Surgeon
4.8 out of 5 stars 139 reviews

Timing Lower Blepharoplasty After Dermal Filler Therapy To The Tear Trough

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Unless the volume of remaining filler is thick and palpable, I don't think recent filler therapy will influence the performance of lower blepharoplasty by your plastic surgeon. Most of the tissue manipulation is mid-lid, between the lash line and the bony lower orbital rim. The tear trough is at the lowest part of the blepharoplasty field.

Good luck!


Dan Downey MD FACS

Downey Plastic Surgery

Seattle WA

Dan Downey, MD
Seattle Plastic Surgeon

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