Orbital bone area injection of Restylane, what went wrong? What can be done? (Photo)

Question

Restylane injected on orbital bone rim area 7 months ago. It actually magnified the fat bulge. The filler laid directly on the bulge. Ten weeks later, left eye injection grew x2. Remained this size until use of Hyaluronidase. Two mths later the bulge reduced 2/3rd. Now smile shaped “noodle” lay on rim of my orbital bone. Some natural skin thickness seems gone too. At 6 months, the same started in the other injection. At 7 months now; photos show current condition. What could be happening?

Mehryar (Ray) Taban, MD, FACS · Answer

The problem you are having is likely combination of filler + scar + eye fat. I have recently published my results on performing lower blepharoplasty on patients exactly like you. See attached website link where you will find more details and a link to the publication. Personal consultation is necessary for me to better help you. Skype consult okay too.

Robert H. Cohen, MD · Answer

Vickiemj, Injecting the tear troughs of the eyes is a nice procedure but initial injections should be "under corrected" to allow for the filler to absorb water from the surrounding tissue and swell. I recommend returning to your doctor for another round of Hyaluronidase. Although it has been months, it can be reduced as I have removed Juvederm after eight months with the enzyme. You may also consider having some Voluma injected in the Malar pad areas, which appear a bit flat in your pictures. Often combining the injection of tear troughs with Malar pad injections works best to provide a fuller more youthful mid face area. I hope this helps. Have a wonderful day.

Kenneth D. Steinsapir, MD · Answer

You may or may not ultimately benefit from lower eyelid surgery for herniated orbital fat.  However, it is ridiculous to treat lower eyelid filler issues with surgery.  You had filler from an inexperienced injector who exaggerated the fullness of the lower eyelid bags.  Properly done lower eyelid filler is supposed to do the exact opposite of this.  You had some fix but not enough.  Most injectors simply do not understand the dose of enzyme that is needed.  Don't commit yourself to lower eyelid surgery unless this is what you desire.  Have an appropriate enzyme treatment.  I think both lower eyelids require more enzyme.  I would use another 150 units of Hylenex in the right lower eyelid and up to 300 units on the left side.  That product needs to be injected into the correct spaces including the the anterior orbital fat space.

Melvin Elson, MD · Answer

It appears you were overcorrected and the hyaluronidase did some good but not all and the trauma has apparently led to swelling.  Another round of hyaluronidase may help but it may not at this point,.  See a board certified dermatologist and in the interim use warm compresses to the area

Orbital bone area injection of Restylane, what went wrong? What can be done? (Photo)

Answers (4)

Answer: Tear trough injection problems

Answer: Tear trough injection problems

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Everything you need to know about Restylane

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Orbital bone area injection of Restylane, what went wrong? What can be done? (Photo)

Answers (4)

Answer: Tear trough injection problems

Answer: Tear trough injection problems

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Recommended reading

Everything you need to know about Restylane

Our mission is to create a world where every investment in modern beauty is Worth It.