What is causing this lump while smiling after tear trough Belotero filler? (photos)

Question

3 years ago i had a filler in tearthrough and since then i have a lump while smiling under eye. When i dont smile it looks quite smooth. My dr says it is due to my LLSAN muscle which causes the lump when i smile however i am not confident in this and think it is due to too much product as i did not have this problem before the filler. I am looking for 2nd opinion.

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Paul Charlson, MBBS · Answer

I think this is likely to be filler which can hang around for ages.Best dissolve it with hyaluronidase and see

SLK - Nashville · Answer

Thank you for posting your photos and question to the forum! Do you know what type of Belotero filler you received? If it is Belotero Balance (the filler used for tear troughs 99% of the time) this cannot be from filler as too much time has passed and Balance only lasts about 6-9 months.

Amy Y. Paul, DO, FAAD · Answer

Thanks for your question and photos.  It is very unlikely the Belotero is still present in the tear trough area, and it is a fairly light hyaluronic acid filler, meaning it is not very firm and robust, so is usually a pretty good choice for superficial injection.  I would recommend consultation with an experienced dermatologist or plastic surgeon that is very skilled and experienced in injections to see if they have any further recommendations.  You could possibly try an injection of some hyaluronidase, which can dissolve the hyaluronic acid fillers, but if there is no actual filler there, you might risk dissolving some native collagen.  Please see an expert in person and best of luck!

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Hi there-  Belotero is Hyaluronic Acid.  The longevity would be approximately 6 to 8 months.  So the filler is likely not your issue.  Perhaps another filler has been used there in the past or you should have an evaluation by your Physician.Best of Luck....

Kristine Brecht, MD (license suspended) · Answer

Dear GB,Some fillers last years, and some like belotero last 6months at best.The belotero filler would be long gone by now.A physical exam of the area, and history of all types of fillers, treatments and topicals you’ve used may be helpful.Best. Dr Brecht

What is causing this lump while smiling after tear trough Belotero filler? (photos)

Answers (6)