Restylane/Juvederm migration to eyelid.

Question

I had juvederm and restylane on several occasions in tear trough and crows feet area. It migrated to my upper eyelids (proven on ultrasound) and is causing serious issues. It is the lower part of my upper eyelid, near the lash line. Any recommendations of doctors to remove this? Cannot use hyaluronidase.

John J. Martin, Jr., MD · Answer

I think it is pretty much impossible that Juvederm could migrate from the tear trough into the upper eyelid.  An ultrasound can not identify a product.  If it is actually juvederm you can use hyaluronidase to remove it.  There should be no contraindication to this and there are multiple types that can be used if you have an allergy to one type.  Juvederm remains as a gel under the skin, so if it truly juvederm, you can make a small incision in the skin and actually squeeze it out.  But I have serious doubts that this is juvederm.

Jason Emer, MD · Answer

Why cant you use hyaluronidase?  Saline injections will work to decrease it as well or fractional devices such as non-ablative laser or radiofrequency.  Upper eyelid migration from the tear trough is very unusual, I suggest getting a true biopsy to prove this.  Best, Dr. Emer.

Harold J. Kaplan, MD · Answer

Hi CE.  There are three ways to get rid of Juvederm and Restylane.1.  Wait until it goes away on it's own.2.  Inject Hyaluronidase.3.  Surgically remove it.Of these we think that injectiong Hyaluronidase is the best option.  Why can't you use this product?  We would rarely if ever suggest option 3 to surgically remove it, so if you do not want to surgically remove it or use Hyaluronidase, you are left with letting it dissolve on it's own over time.  This usually takes about 12 months time in the eye area.As an aside, Juvederm and Restylane are rarely injected into the crow's feet.  It just doesn't work well in this are.

Jo Herzog, MD · Answer

I too think that this sounds unlikely. If there is product in eyelid it can often  be removed by pricking with a small blade or large needle and extracting if you can not use hyaluronidase. Are you allergic to bees? Have you had a skin test for Hyaluronidase?

Michele S. Green, MD · Answer

The migration of Restylane from the lower eyelids to the upper eyelids sounds physiologically impossible.  Please consult a board certified dermatologist for examination and possible biopsy of the area.  Please let us know what happens.

Steven Wallach, MD · Answer

Not sure how you got filler in the upper eyelid from injection into the lower.   Why not hyaluronidase?  It is the best product to dissolve the filler. If not you'll have to wait 6-9 months for it to absorb.

Restylane/Juvederm migration to eyelid.

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