I had Juvederm Ultra Plus injected in tear troughs to fill hollowness 9 days ago and the results are alarming. Need help (Photo)

Juvederm is a hydrophilic material.  This means that it attacts water.  When it is injected in an area of thin skin (like under the eyes) it attracts water over time and causes a water balloon like appearance.  You can have injections of hyaluronidase to help dissolve the Juvederm.  I would recommend getting a second opinion to make sure that this is exactly what you need.  Good luck!

I suggest hyaluronidase injections to reverse the filler but if you want to wait and try conservative measures -- oral diuretics, finger tip massages and venus legacy treatments.  Best, Dr. Emer.

From the photographs, it appears that you have filler injected too superficially.   Luckily this can be dissolved easily with hyaluronidase.  If your doctor couldn't correctly identify the problem, it is probably a good idea to get a second opinion with an expert in facial injectables.  It is always a good idea to see an expert the first time, it will save you money and problems.

Thank you for your question and series of photographs.  I would recommend allowing your results to mature for at least two weeks. The under-eye area is prone to swelling and palpability of filler material as a result of its thin tissues. If your results show no improvement, best to see your injector about possible dissolution of product material to restore your prior appearance.

First, let me say how sorry I am that you are feeling this. Next, let me tell you that you can calm down.Juvederm Ultra, and even more so, the more robust, Juvederm Ultra Plus would not be a first choice of experienced injectors for use in the tear trough regions under the eyes. The under eye area is the thinnest skin area of the entire body and the relatively superficial placement of hyaluronic acid that is required in this thin tissue can give rise to the unwanted, bluish Tyndall Effect and/or the swelling effect that you are likely experiencing (from the particular water-attracting properties of the Juvederm injectable). The latter two problems are far less likely with Belotero Balance and Restylane Silk. If there is no diminution of the swelling over the next two weeks or so, it would probably be advisable to have hyaluronidase injected to dissolve the Juvederm Ultra Plus, after which it can be properly retreated.The under eye area is not a region for novice injectors accustomed to injecting simple smile lines with ordinary fillers. You would do well to seek consultation and treatment by a board certified aesthetic physician with experience and expertise in advanced injection techniques, and make sure to ask to see his/her before and after photos.

Dear Dnuzzo,Thank you for providing your photos. Juvederm can be an excellent product for tear troughs provided that the injector has mastered the techniques and nuances necessary for its successful injection in the under eye area. (This includes knowing how much or how little to inject, where to inject it and where not to inject it, knowing how different skin types will react, and adjusting the treatment to suit each patient's anatomy and tissue  constitution.) This only comes with extensive experience.  Along those lines, I would strongly recommend that the public seeks such injections from highly experienced Board Certified core specialists such as a Board Certified Facial Plastic Surgeon. Please rest assured that the issue you have, can be alleviated with a hyaluronidase injection by a specialist who is experienced with it. Best of luck in your quest, Dr. Anna PetropoulosBoston's North Shore

Give the Juvederm three weeks to settle in. If you are still unhappy with the way it looks, the product can be dissolved and the bubbles will go away. In my opinion Restylane is a much better product for the under eye area than Juvederm. Juvederm attracts water and can tend to expand over time. 

It is difficult to say without seeing the issue in person but appears like the filler was placed too superficially. It needs to be dissolved by someone with expertise in the anatomy of the area. I would recommend making sure you see a board certified dermatologist or plastic surgeon who specializes in this. Our office is located nearby you.

Juvederm ultra plus is not my preferred product for the tear troughs. What you see is the filler. You might need to dissolve it and start over with something else like restylane.

The tear trough area is a special case when it comes to dermal filler because the tissues swell so easily and are very thin. It is probably the most difficult area we treat. I do believe you can have one or two hyaluronidase treatments, and then fill the tear troughs with Beletero or Restylane. Both of these fillers have rheologic characteristics that make them ideal for the tear trough area. Juvederm Ultra Plus would likely last longer than either of the other two, and on a rare occasion for this reason I have injected tiny amounts of this product deeply with great and long-lasting results, but it is less "forgiving" than the other two. Beletero, in my experience, is the most successful because it spreads like honey into all the large and small spaces between the connective tissue components without forming balls or lumps (it has low 'cohesivity') and does not swell much after injection.All the best,Dr. Clark