How Can I Fix a Botched Under Eye Procedure?

I had very deep recesses under my eyes and so had Restylane injected to fill them out. BUT 4 years later I STILL have extreme swelling in pouches where the Restylane was injected. I was told by a Cosmetic Surgeons nurse 3 years ago that the filler has long gone and now I am left with oedema - which will resolve in time. But it seems they are not going anywhere! As it is fluid and not fat I have been told I can't have blepharoplasty. Does any one have any suggestions for me please?

Doctor Answers 6

You last had this evaluated by a "cosmetic surgeon's NURSE" 3 years ago.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

This sounds like a serious and complex situation that could have been caused by many factors. I highly recommend that you see a board-certified plastic surgeon or oculoplastic surgeon (MD's, not assistants) as soon as possible. The longer you wait, with an unresolved medical issue like this, the harder it may be to correct. Please go soon.

New York Dermatologic Surgeon
4.7 out of 5 stars 41 reviews

Swelling under eyes

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You will need an evaluation in person.  By three years I doubt that the product is still there.  Is it swelling or herniated fat?

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Erase Restylane with Vitrase

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

If the edema your experiencing is from Restylane or any hyaluronic acid product then I should be easily treated with an injection of Vitrase into the area.  Vitrase is an enzyme that litterally eats hyaluronic acid within 24 hours of injection.  If you do have the Vitrase but still have the edema, then look for another cause (fat herniation from under the eye, thyroid problems...) . Good Luck!

Julie E. Voss, MD
Kirkland Dermatologic Surgeon

Lower eyelid swelling

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

There are possible nonsurgical (injections) and surgical treatment options, but first need to find out exactly what the problem is.  I recommend a consultation with eyelid specialist (oculoplastic).

Dr Taban

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Swelling and Edema of Lower Eye Lids 3 Years After Restylane Injections

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi Bridgie,

We have had some success in patients such as yourself with fractionated CO2 laser treatment.  I have used Fraxel repair in a few patients who improved.  Make sure that you choose your physician carefully.  Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Persistent swelling after Restylane

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Without a personal evaluation with exam, it's really hard to tell you what's going on. Sometimes this area responds to almost any intervention by swelling in what is called the Malar Bag. We don't have a great treatment for the malar bags, but they may become less prominent with grafting of fat and stem cells (if this is indeed the problem).

It is likely that the Restylane is gone, though in certain protected areas (like the superficial dermis) it can persist for years. You might benefit from Hyaluronidase, to dissolve any possibly remaining Restylane. I don't think it will help much, but there is no downside to just being sure there isn't some left. 

Blepharoplasty may not be out of the question, but again you need to discuss that with a physically present surgeon. I would suggest speaking to one (not a nurse)

Verne Weisberg, MD
Portland Plastic Surgeon
4.6 out of 5 stars 18 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.