Can 10 year old filler be causing puffy, wrinkly under eye creases when I smile? (photos)

Question

Over the last year or so, I've noticed that I have these weird puffy spots under my eyes. They create a shadow and a crease when I smile. I never used to have these. I read somewhere that this could happen from fillers that still remain. I did have undereye fillers a few times in the tear trough area over 10 years ago. Could this be what is causing the puffy spots? If not, what else could this be and can anything be done about it?

Hung William Song, MD · Answer

We used to think that hyaluronic acid fillers dissolved away by themselves after about 6 months. This thought process was based on the observation that lip fillers often had to be repeated every 6 months. We now know that HA fillers do not dissolve away on their own. The lips deflating after 6 months was actually due to migration of the filler in this area where there is a lot of movement. The tears troughs are a tight closed space so fillers injected in this area tend to stay there and can remain there indefinitely. The good news is that HA fillers can be dissolved with an enzyme called hyaluronidase. So the short answer to your question is "yes" it is probably the filler you had 10 years ago that you are still seeing. Find someone who is experienced at dissolving under eye fillers and then consider having a more natural treatment like the AutoCorre procedure which is performed with a gel created from your own plasma and PRP to stimulate your own collagen.

Eric M. Joseph, MD · Answer

It is conceivable that the puffiness under your eyes is due to previous fillers. The best advice I could give you is to visit your plastic surgeon to evaluate your under eyes. If your surgeon agrees that you appear to be over corrected, the dissolving enzyme may be considered. I hope this helps, and I wish you well moving forward. Sincerely, Dr Joseph

Mehryar (Ray) Taban, MD, FACS · Answer

Although it appears you do have under eye fat bags, fillers can certainly last essentially permanently and cause more puffiness and other issues. See an expert for evaluation and treatment.

Anna Chacon, MD, FAAD · Answer

It's possible, though unlikely, that filler from 10 years ago is contributing to the puffiness and creases you're experiencing now. Most dermal fillers, particularly those based on hyaluronic acid, tend to dissolve and be absorbed by the body within 6 to 18 months. However, in some cases, small amounts of filler can remain or cause delayed effects, especially if there were multiple treatments or if a more permanent type of filler was used.

Other potential causes for the puffiness and creases could include natural aging, changes in skin elasticity, or fluid retention. As we age, the skin around the eyes becomes thinner and loses volume, which can lead to the appearance of puffiness and wrinkles.

To address these concerns, a consultation with a board-certified dermatologist or plastic surgeon would be beneficial. They can assess the area and determine the best course of action, which might include treatments like hyaluronidase to dissolve any remaining filler, laser therapy, or other cosmetic procedures to improve the appearance of the under-eye area. Additionally, they can recommend skincare products or lifestyle changes that may help reduce puffiness and improve skin texture.

Camille Cash, MD · Answer

If you still have filler present in the tear troughs and HA fillers were used you can have remaining filler dissolved with hyaluronidase.  If no filler is present you can consider a lower blepharoplasty to improve the contour.  Visit with a board certified plastic surgeon near you for an evaluation and to learn more.

Keera Kang, MD · Answer

Hi stixnstonz34.I am sorry to hear that you are experiencing those creases / puffy areas under your eyes. First of all, I cannot say with confidence it is due to filler. But what you have said can be true at times because when the filler gets stuck with the tissues in your undereye area, they may not fully dissolve. Also the type of filler you used is important as well. Another thing I do want to mention is from your picture the area where you got filler injection seems to be a bit too close to your lower eyelids and that is a very delicate area so normally you need to use a very soft filler and it is in some parts of the world technically not a common place to do the procedure. So what can be done about this matter would be you need to go to a experienced physician and get a thorough physical examination done on your undereye area. It would be helpful to the physician if you informed him/her about the type of filler and amount used. Also as you mentioned when you smile the crease and puffy area is more prominent so a small microbotox session for the area would be helpful as well (but also this should be done by a professional physician since undereye botox can sometimes make your facial expression unnatural. ). Additional treatment modalities may be used as well. Hope this helped! Good luck! :)

Darryl J. Blinski, MD · Answer

Based on your two posted photos without an in person consult which I recommend or a virtual consult. A non-invasive approach would be to use the end, lays laser under local anesthesia, probably two sessions one month apart per session $2000. Best of virtual consult with. But surgical option is a lower lid le plasty to see to remove the fat accumulation in the tear trough area maybe trans con tile of approach or external approach. Again best virtual consult with cost for lower lid left $3500 to $5000.

Can 10 year old filler be causing puffy, wrinkly under eye creases when I smile? (photos)

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