Festoons under eyes after filler have gotten worse after dissolving. RF hasn’t made any difference. What can I do? (photos)

Question

I’m 31 yo South Asian woman. I’ve got filler under eyes in December 2021 and developed festoons off late. I tried dissolving the fillers in order to get rid of the festoons but it has only became worse and more prominent. Even RF hasn’t made any difference. What should I do to resolve this?

Nelson Lee Novick, MD · Answer

It is quite possible that this is a case of a post-under eye filler treatment complication more recent called "puffy pillows"-- a quite difficult to treat form of lymphedema (lymphatic obstruction), which is quite resistent to therapy. It is usually a late complication of the use of an improper choice of under eye HA filler and/or too superficial placement of the filler in this region. It is typically quite resistent to therapy, as you have learned the hard way. I have had success using a combination of intralesional anti-inlammatory agents in an algorithm of varying concentrations and amounts. Make sure to consult with a board certified cosmetic dermatologist. Best of luck.

Festoons under eyes after filler have gotten worse after dissolving. RF hasn’t made any difference. What can I do? (photos)

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