Tear trough filler problems. Is this normal? (Photo)

Question

Is this normal - was injected by plastic surgeon on advanced training course with intraline filler Had intraline filler in tear troughs 12 days ago initially had severe bruising but now is lumpy and my eye bags have just been pushed further down my cheeks

Nima Shemirani, MD · Answer

Hi @sazzlesig1! The tear trough is a very sensitive and delicate area. Hyaluronic acid facial filler products that were previously injected into an improper tissue plane can be dissolved with hyaluronidase injections. Best of luck, Dr. Nima!

Jason Emer, MD · Answer

Some bruising can be normal after tear trough injections. I recommend injections with cannulas to limit bruising and/or swelling. In the mean time, VBeam treatments can give improvement. See an expert. Best, Dr. Emer

Stephen P. Bracci, MD · Answer

The photos show a condition that is likely caused by a hyaluronic acid based filler (HA). If this condition is the result of a hyaluronic acid based filler, the solution may be a simple Hyaluronidase injection. Hyaluronidase, an enzyme, is used to remedy the bump by reducing the amount of the (HA) filler in this area. HA fillers should always be used sparingly in this under eye area because they may cause puffiness, but the good news is that an overcorrection can be adjusted with an injection of hyaluronidase. 
Most patients can benefit from using other filler types in the area in conjunction with HA fillers, which attract less water and are firmer, to get the best results.  However, injecting other types of fillers in this area is technically difficult and should only be performed by a very experienced injector. Regardless of whether the fillers were applied using a cannula or needle, HA fillers have a propensity to retain water, resulting in a puffy appearance in the under-eye area.  Lasers may be beneficial in reducing the appearance of a bruise but are generally not effective in reducing injectable products such as Hyaluronic Acid fillers. As with all filler injections, it is best to select a dedicated full time cosmetic injector with a lot of experience.

Peterson Pierre, MD · Answer

I definitely understand your concern! The bruising at this point can be addressed with a laser to speed up its resolution but will go away on its own very soon. You may want to consider taking Arnica prior to future treatments to avoid such prolonged bruising. The lumps probably won't resolve on their own. You should return to your plastic surgeon and he should be able to address that.As with all cosmetic procedures, especially when it comes to fillers, the skill of the injector is paramount. Always seek an expert in facial aesthetics, such as a board-certified dermatologist, to maximize results while minimizing side effects.

Anna Avaliani, MD · Answer

Thank you for your question and pictures. You seem to have prolonged recovery period which was complicated due to bruising.  The swelling you have could be still due to the healing bruise.  I suggest you definitely contact your physician and come in for a follow up visit. If those bumps are form the filler, your doctor would be easily able to address them at the visit.  hope this helps. In the future, if you decide to  have your tear troughs injected again, I highly suggest having it done with a cannula technique as it almost guarantees no bruising and significantly decreases downtime. Best, Dr. Avaliani

Samer Muala, MD - Account Suspended · Answer

You definitely need to get examined.  If it is filler that is distorting the look then you have to get rid of it. The bruising will continue to go down though.

Tear trough filler problems. Is this normal? (Photo)

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