Bags Since Childhood. Someone Recommended Activ/deepfx. Would Surgery Be the Better Way? (photo)

I had restylene in my tear troughs, I feel like i had ok results on the right eye but the left side looks weird, you can see the filler really well when i smile. Is there anything that can fix this? Ive read horror story of people having it dissolved in this area. Do you have any suggestions for my eye area?

Doctor Answers 3

Under eye fillers

I agree with the other doctors - dissolving fillers with hyaluronidase is very safe. There are many horror stories about this on RealSelf, but I have not seen any significant problems with hyaluronidase in my own practice. 

I find that patients with under eye hollowing often also have hollowing in the upper cheeks. Sometimes additional filler injections in this area can help better optimize the eyelid-cheek junction and produce a more natural result when you smile.

Boston Oculoplastic Surgeon
5.0 out of 5 stars 165 reviews

Goofy Restylane service can be corrected.

The horror stories about enzyme are caused by injectors who do not know how to handle hyaluronidase, the enzyme that breaks down the filler product.  There are actually two options.  One option is to clear out all the old product.  This can sometimes be a bit of throwing out the baby with the bath water.  After all, you paid good money to have the filler.  In many cases, a better result can be achieved leaving the old product where it is and filling around it.  As I look at your photos, you would benefit from a substantially larger filler service.  The goal is to vastly improve the under eye circles.  So this is probably a very good option.  Occasionally, an old treatment is so wrong that getting rid of every bit of it is really the best thing.  Clear the deck and start over again.  The reason you will read about funky enzyme service is primarily from doctors who really don't get how to use the enzyme.  In fairness, no one is really teaching doctors how to do this.  The biggest issue I see with the enzyme treatment is lack of understand of how to use this agent to either shape an existing service or how much enzyme is needed to completely remove a prior treatment. 

Regarding active fx, it is likely that this treatment will improve the face overall but it lacks the power to really affect the dark circle.  Filler are really the correct treatment but how the service is done makes a huge difference.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Filler for Under Eye Area

Hi Mac.  Although you could consider surgery, you are not the best candidate because you do not have a lot of loose skin.  Restylane was probably the best choice but does not appear to have been done well.  

Dissolving Restylane with Vitrase is very easy and straightforward so we are not sure what horror stroies are associated with this process.  All that will happen is that you will go back to baseline before the Restylane was injected.  

Consider a revision with a new injector or getting Vitrase and then starting over with Restylane.  Good luck.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.3 out of 5 stars 6 reviews

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