Was Restalyne injected properly or too close to surface? (Photo)

Question

I received one cc of Restalyne to my tear trough area and I can see two big bulges and I thought it would be smooth. Was this injected too close to the surface? It is bothering me and I don't know how to fix this it's making me look more tired than before and my under eye circles look worse

Nima Shemirani, MD · Answer

Hi @Mdp2402. Most facial filler products that are injected into this area should ideally be placed in the tissue plane directly on top of the bone, or at least underneath the eyelid muscle layer. If a facial filler product is placed too superficial in the skin, or on top of the muscle layer, the product may settle in with an abnormal appearance and can look to be lumpy, swollen, or irregular. The filler products that are preferred to treat this area will have some degree of affinity for water molecules so all of these products will exhibit some degree of hydration and swell once injected into the body. Hyaluronic acid facial filler products that were previously injected into an improper tissue plane can be dissolved by hyaluronidase injections. Best of luck, Dr. Nima!

Nelson Lee Novick, MD · Answer

Although I do agree that the photos are not the best way to diagnose a problem and create a treatment plan, but if the bulges you are referring to are those diagonal seeming elevations to the sides of the nose, I do believe I see what you are referring to. In general terms, two common post-filler treatment problems under the eyes are the unwanted, bluish Tyndall Effect, which may result following too superficial placement of the material within the delicate tissues under the eyes, and bulges and sacs that typically occur when too much material is injected or the material used over attracts tissue fluid to it. Hyaluronidase, the enzyme that dissolves hyaluronic acid, can be used to dissolve the Restylane should either of the above be the cause of the problem. Return to the treating physician would be advisable to explore this further. Following dissolution of the Restylane, I would suggest appropriate retreatment with Belotero Balance (which I would use in my Upper East Side Manhattan office) and Teosyal Redensity II (which I would use in my Israel satellite facility where a far greater number of regulatory agency fillers and volumizers are available).

Jo Herzog, MD · Answer

The photos are taken at different angles so a little difficult to evaluate. However, I think that your under eye area has ben improved, unless I am reversing photos. Eyes look better in photo with striped shirt

Steven Wallach, MD · Answer

I am sorry, but the photos do not show what you are describing. It is best to be seen in person and better yet to be addressed by your injector.

Darryl J. Blinski, MD · Answer

Sorry but the posted photos do NOT demonstrate any issue as I can see. Best to return to see the injecting doctor for advise. I prefer Belotero-Balance in tear troughs - no Tyndall sign occurs.

Was Restalyne injected properly or too close to surface? (Photo)

Answers (5)

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