I've had Restylane injected in my tear troughs and have since developed puffy bags. Any suggestions?

It's probably been over a year since the last injection, possibly longer. Is there anything that can be done to reverse this? I'd rather have dark circles then these horrible puffy bags!

Doctor Answers 6

Puffy bags following Restylane in Tear Troughs

Dear Pittsburgh1449:

Sorry for your troubles! 

It is hard to know what has caused your persistent puffiness following Restylane injection of the tear troughs from over a year ago. It is possible that the gel did not thicken and add resistance to the skin but separated the layer between the skin and the muscle. 

Please be re-evaluated by the injector or best by a Board Certified well experienced Plastic Surgeon or Facial ENT with surgical, non-surgical and minimally invasive skills for the lower eyelid and cheek region.

There are a few options to consider:
  1. A denser deep filler such as Voluma next to the bone in this area;
  2. Very judicious use of Sculptra;
  3. Skin tightening with peels or laser;
  4. A eyelid/cheek lift, also called a mid-face lift.

I hope this has been helpful. I wish you the best!

Baltimore Plastic Surgeon
4.8 out of 5 stars 82 reviews

Hyaluronidase Can Dissolve Unwanted Restylane (As Well As Other Hyaluronic Acid Fillers)

If previous treatment with Restylane under the eyes is at the root of the bags of the under the eyes, then hyaluronidase can fortunately be used to dissolve it. Hyaluronidase, which is an enzyme normally found in our tissues, is responsible for breaking down hyaluronic acid. Vitrase and Amphadase are two commercially available brands of hyaluronidase derived from animal sources that can be injected into unwanted bumps, lumps, bluish skin discolorations and bags under the eyes that have resulted from too superficial or improper placement of the material--generally by inexperienced  or inadequately trained injectors. Usually one treatment session enough to to the job, although a second session is sometimes necessary. 

Consultation with a board certified aesthetic physician with experience and expertise in filler injections and the use of hyaluronidase is a must. 

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.9 out of 5 stars 30 reviews

One year after #restylane

Restylane usually lasts about 9-12 months. The first step is to see a physician in your area so they can tell if there is any of the filler remaining. If there still is product there, it can be dissolved with an enzyme. If the restylane is gone, you can discuss with them other options for treating the puffiness under your eyes.

Best of luck

David Reinstadler, MD
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Restylane and puffy bags under eyes

Restylane is a great product to inject but if you are having problems for such a long time from your injections you should have it dissolved.  Please consult a board certified dermatologist to inject Hyaluronidase in that area which will dissolve the Restylane and then help with the dark circles under your eyes.

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 78 reviews

Yes, visit your injector and talk about a product to dissolve the Restylane.

Thank you for your question. Yes, visit your injector and talk about a product to dissolve the Restylane. This may help with the puffiness. At a year most of the product should be gone. Consider alternate reasons that may be the cause water retention.


Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 469 reviews

Bags under eyes after restylane injections

Restylane under the eyes can often last several years. If you think your eyes look worse with the filler, you should definitely have it dissolved.

Mitesh Kapadia, MD, PhD
Boston Oculoplastic Surgeon
5.0 out of 5 stars 167 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.