I had filler placed in my tear troughs 6 months ago. I still have palpable lumps. Should I remove it before adding anything?

Hi @JacksRN! Most facial filler products that are injected into the tear trough 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. Hyaluronic acid facial filler products that were previously injected into an improper tissue plane can be dissolved by hyaluronidase injections.

Hi,All fillers are gels and they can be palpable especially in an area like the under eye that does not have a lot of soft tissue covering. If it is not visible, it's best to just leave it alone. If you don't like the appearance, then you may need to dissolve and start over. Best,

An in person evaluation is really needed in order to give the best recommendation. If needed the remaining product can be dissolved with hyaluronidase. See an expert injector for an assessment.

It all depends on what the tear troughs look like on exam. Sometimes it is best to dissolve the filler if it has settled into an inappropriate area and other times it is better to add filler and blend around it. If the lumps are just palpable but not visible, and are not causing any deformity in the area at rest or when expressing I generally try to avoid dissolving and opt for blending with additional dermal filler. Best of luck on your aesthetic journey!

Thankyou for your question.  I would suggest your have the lumps removed before any more filler . The last thing you want is the lumps to become  visible with more filler . Also the lumps may be making the Tear troughs less attractive. If you wait it out it could take years. Good luck!

i would definitely recommend dissolving the previous fillers. I would also consider prp treatments first for three consecutive months to promote rejuvenation in all layers of the soft tissue of the tear trough, and only afterwards would I reconsider filler for this area, as sometimes prp alone can achieve an acceptable cosmetic outcomes without the potential lumps of fillers.

It's hard to comment without seeing a photo or evaluating you in person. In general, I would recommend reversing poor filler work before proceeding with additional filler. Hyaluronidase can be used to dissolve hyaluronic acid based fillers like Restylane and Juvederm. 

Thanks for your question
If you can feel lumps in the tear trough my recommendation to you don’t add more fillers
You can use warm wet towel on the area and then with oil you can light massage it
It will get better with time
Good luck,
Dr Lamia Wassef, Ottawa 

Without an exam it is impossible to give specific advice. However, since what you have is deep, adding filler should not cause a problem other than perhaps needing to add some more before whatever you now get dissipates. I would, however, make sure you see a real expert in treating the under eye area. Consult ExpertInjector.org.