Juvederm Migrated to my Eyelids and Caused Intense Swelling and Wrinkling. Can Hyaluronidase Be Used to Dissolve? (photo)

Juvederm was injected in an area under both of my eyes that shouldn't have been. I'm thin and the skin in this area was very tight to the bone. The Juvederm migrated and caused wrinkles up to all over my cheeks and under my eyes and in my eyelids. My eyelids have been covered with deep, wavy, crisscrossing wrinkles for a month. None of which I ever had before Juvederm. I want to know if Hyaluronidase can be used safely in the eyelids, and corners of the eye, to dissolve the Juvederm?

Doctor Answers 8

Treating inappropriate placement of facial fillers

The answer is yes!

Juvederm should not be injected in the lower eyelid region since it retains water and causes sever swelling in that area.

seek a board certified plastic surgeon that has significant experience with injecting the fillers as well as dissolving the HA.

Good luck!!

Vitrace can help

I agree.  We do not use Juvederm under the eyes as results are not as predicable as other options.  The good news is YES, you can use Vitrace to help dissolve the product.  Be patience though.  You may have to return for a couple treatments to achieve desires results but less is more.  Make sure you are being treated by a board certified facial plastic surgeon/facility.  After this resolves, we have since nice results with Restylane and Prevelle Silk under the eyes for hollowing or tear troughs.  Good luck.

Richard W. Maack, MD
Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 46 reviews

Problems after Juvederm injection to lower eyelids

Hyaluronidase can be used to dissolve inadvertent injection of hyaluronic acid such as Juvederm. In general, I avoid injecting Juvederm to the lower eyelid area for exactly the same reason that you currently face. The good news is Juvederm will dissipate over time and Hyaluronidase can be used to make it go away faster. Find an experienced plastic surgeon to help you.

Best Wishes,

Stewart Wang, MD FACS, Wang Plastic Surgery

Stewart Wang, MD, FACS
Los Angeles Plastic Surgeon
4.6 out of 5 stars 28 reviews

Hyaluronidase to Remove Eyelid Filler

    Hyaluronidase can be used to remove HA filler that has migrated.  Restylane could be injected into the tear trough area in the future.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Will more Hyaluronidase help?

It is my understanding from your previous posts, is that you have had hyaluronidase already. So now your skin may just need time to heal. It would be helpful to have updsated photos but you appear to have delicate,  dry skin. It may have been stretched and irritated by the whole process. A good eye cream or emollient face cream may help for now.  At some point you could consider a surgical proedure such as fat grafting or CO2 laser or even a blepharoplasty

(an eyelid surgery to remove excess skin)  You would need to be evaluated in person to determine the best course of action.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Juvederm under eyes

We prefer fat Grafting under the eyes to avoid the many complications described on this site. Having said that, be patient and our concerns will likely improve.
A number of 'soft tissue fillers' are available for temporarily improving facial areas that have lost volume, are naturally thin or hollow, or have developed noticeable and bothersome lines and creases. The most popular fillers currently are hyaluronic acid products like Juvederm® and Restylane® which can be used to, among other things, plump up thin lips and to fill out nasolabial folds (lines that run from beside the nostrils to the area beside the corners of the mouth) and marionette lines (lines that run from the corners of the mouth towards the jawline). In this practice we have performed thousands of injections with these safe and reliable hyaluronic acid fillers. They are well-tolerated by almost all patients and they produce very few post-injection problems. The improvement generally lasts from four to eight months, the average being about five to six months. Of the available hyaluronic acid soft tissue fillers, I have been most pleased with the performance of Juvederm®.
Other injectable fillers are currently available which attempt to produce a longer-lasting soft tissue augmentation by incorporating substances that are more slowly metabolized or that cannot be metabolized by the body. These are sometimes referred to as 'semi-permanent' fillers. Some incorporate non-degradable biologic materials (e.g. Radiesse®, which contains calcium hydroxyapatite, the mineral component of bone) or non-biologic (synthetic) materials (e.g. ArteFill®, which contains polymethyl methacrylate, also known as Lucite) that are designed to persist in the body permanently. Another is Sculptra®, which consists of a synthetic polymer called poly-L-lactic acid, which is also used as an absorbable suture material.
Unfortunately, the body treats these materials as foreign objects, and as a result the placement of non-degradable and synthetic materials may lead to inflammation, infection, migration and granuloma (an inflammatory cyst) formation - none of which are problems that you want to experience near the skin surface in your face. In general, the 'semi-permanent' injectables containing these materials are less likely to produce a result that looks and feels natural, and because of the potential complications I feel that they should never ever be injected anywhere close to the skin surface. We do not use any of these injectables in my practice.
If you are looking for a longer-lasting result than you are getting with Juvederm® or Restylane®, we have a much better solution for you: you own fat, currently residing somewhere that you don't need it. The improvement is designed to be permanent, and your body will not treat it as a foreign object. Your immune system won't attack it. The cost is about the same as several syringes of a 'semi-permanent' filler. And the quality of your facial skin may, in fact, actually improve in the areas where fat is grafted.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 118 reviews

Hyaluronidase can remove the Juvederm

Injecting fillers under the eyes is a very delicate procedure and challenging in people with thin skin and little tissues. Hyaluronidase can remove it immediately. Best of luck.

Daniel Yamini, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 20 reviews

Fillers around the eyes require expertise

Doing fillers around the eyes requires expertise in facial anatomy and an understanding of the filler material. You want to seek out a physician that has had formal training in this which could include a dermatologist, an ENT facial plastic surgeon, an oculoplastic surgeon, or plastic surgeon (in alphabetical order) that can help you with this. In this scenario you are indeed correct that the Juvederm can be dissolved as it is a hyaluronic acid type of filler. It should be able to address this issue for you.

Omar Ibrahimi, MD, PhD
Stamford Dermatologic Surgeon
4.8 out of 5 stars 26 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.