Help! Made the mistake of getting dermal filler in 2017 and have been trying to dissolve ever since (Photo)

Question

Hoping for some answers! Looking back, my eyes looked FINE before I had this procedure. Medspas were pushing it, so I fell into the trap.. Wish I had NEVER done it. I would rather have some under eye hollowness than this lumpy uneven mess I have been stuck with since… To try and treat it, I have done the following procedures: -Dissolver (maybe 3-5 rounds?) -Morpheus around eyes (dissolves filler) -PRP/PRF What do I need to do here to get it ALL out?! PLEASE HELP!!!!

Anna Chacon, MD, FAAD · Answer

It seems like you've been through a lot trying to dissolve the dermal filler. I can certainly provide some general suggestions:

1. Consult a Board-Certified Dermatologist or Plastic Surgeon: It's crucial to get an expert opinion. A professional can assess your situation, consider your history, and provide the best course of action.

2. Hyaluronidase Injections: If the filler is hyaluronic acid-based (like Juvederm or Restylane), it can be dissolved with an enzyme called hyaluronidase. It sounds like you've already had several rounds of this, but sometimes it can take multiple treatments to fully dissolve the filler, especially if it was deeply injected or if a large amount was used.

3. Patience and Time: Unlike other treatments, fillers naturally dissolve over time. The body gradually metabolizes them, with most lasting between 6 to 18 months depending on the type of filler used and the individual's metabolism.

4. Ultrasound: Some doctors use ultrasound to locate areas of filler that need to be dissolved.

5. Consider Second Opinions: If you're not making progress with your current provider, it may be helpful to seek a second opinion from another qualified professional.

Remember, it's important to communicate openly with your healthcare provider about your concerns and expectations. They can guide you through the process and help manage any discomfort or side effects you may be experiencing.

Michael A. Persky, MD · Answer

Hi TMC,
I often treat  patients  from medspas who have  your problem with selective micro-focused ultrasound heat in the area of concern.  I also use hyaluronidase.  It may take more that one treatment, but patients do respond very well.  Once all the exess volume is removed, then we can consider natural replacement with EZ Gel.  Consult with an expert injecting physician for your treatment.  Feel free to contact my office with any further questions.  Good luck and be well.
Michael Persky, MD
Encino, CA

Nelson Lee Novick, MD · Answer

At least from the photos provided and from the history of persistent post-treatment under-eye swelling, the problem here is likely to be what has come to be called under-eye "puffy pillows," which is actually lymphedema or lymphatic obstruction that resulted from either  the use of an inappropriate choice of filler for the area and/or too Superficial injection of the filler in the delicate tissues of the infraorbital region. Unfortunately it is generally a difficult, persistent, and resistant problem to treat. Fortunately, have had success treating it in patients who were injected elsewhere employing an algorithm of varying combinations, concentrations, and amounts of Intralesional anti-inflammatory agents. You would be wise to consult an experienced, board certified cosmetic dermatologist filler expert and best of luck. .
For other readers of this response, this story raises some important issues that my regular followers are well aware of.  For one, Groupon and medspa shoppers looking for free consultations and cut-rate treatments are likely to get exactly what they pay for; i.e. consultations that last for about five minutes and simply push whatever treatments or devices the venue is hawking--no matter what the problems really are--as well as treatments administered by non-professionals. And finally, I am also not surprised by the lack of success here with the energy-based devices, as well as PRP/PRF used here, since the hard science to support these gizmos and expensive treatments lags well behind the heavy marketing and social media hype to promote them. A healthy dose of "buyer beware" should be exercised whenever considering these.

Help! Made the mistake of getting dermal filler in 2017 and have been trying to dissolve ever since (Photo)

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