Is the filler in the tear trough area injected into the muscle of orbicularis oculi itself?

Question

I went for tear trough area filler injection last tuesday when I'm back I discovered that the injection was in the muscle of orbicularis oculi itself and it start swelling day after day resulting in a groof beneath my eye Is it normal to inject in the muscle itself or it's a fault injection?Thx alot

Thuy Doan, MD · Answer

Tear trough filler is suppose to be injected below the muscle and above the bone. The filler is likely injected in the subcutaneous or dermis layer. You can always get this dissolve by hylenex. Hope this helps, best Dr. Thuy Doan.

Spa 35 - Boise · Answer

Filler isn't injected into the muscle. If this happens, product can ball up and may need to be treated with hyaluronidase. That being said, most of the time, even when filler is placed correctly, you will see swelling after injections. This is totally normal. I usually say give it 2 weeks for normal swelling to go down. Then if you have any problems or balled up product, follow up with your injector. I hope this helps!

Luke Swistun, MD · Answer

Thank you for your question. Usually, the appropriate way to inject filler to correct the tear trough area is deep to all the soft tissue structures, right on top of the bone (medial and lower portion of the orbital rim). That would place it deep to the orbicularis oculi muscle. That said, swelling at this stage is absolutely expected, the soft tissue layers in that area are all very thin, and it is near-impossible to tell by swelling alone where the filler was actually placed. You should always contact your injector ASAP with any concerns, but I suspect they will recommend to give it a full 7-14 days to allow for the swelling to resolve further, before they consider your result final.   Hope this helps!

Michael J. Denk, MD, FACS · Answer

The filler should actually be injected below the muscle. Generally, an injector will feel the bone of your orbital rim with the needle, and then simply back out just a tiny bit so that the filler is sub musculature and just lying on the bone. Hope this helps. Your injector’s experience and training matters!

Ian Lonergan, DO - Account Suspended · Answer

There are actually several different injection techniques when it comes to using dermal fillers in the tear trough area.  Although I can't tell you what technique your injector used, I can tell you that filler is often placed below the level of the muscle in the tear troughs.  This is due to the fact that the lower eyelid skin is very thin and filler placed too close to the skin (eg, above the muscle) may be visible.  My personal technique that I have been using over the last several years involves placing the filler below the muscle to help camouflage the injections while still providing volume to the trough itself.  While I have no way of knowing if this was the technique that your injector used, I would advise you to go back to them with your concerns as irregularities in the tear trough region may be correctable either with additional dermal filler injections or with hyaluronidase injections (to dissolve some of the filler that has already been placed).  Best of Luck!

Is the filler in the tear trough area injected into the muscle of orbicularis oculi itself?

Answers (5)

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