I damaged my under eye skin with Hyaluronidase. What can I do to regain elasticity and thickness? (photo)

Question

I'm 48. A year ago, I had under eye filler that created bags and ultimately needed to be removed with hyaluronidase. My under eye skin is now thin and lacks elasticity. I've had a phenol peel and dermapen treatments to try to fix this. I have had fillers around the orbital area but no fillers directly under eye due to doctor concerns with the thinness of the skin. What can I do to thicken skin and regain elasticity? (Note I'm wearing make-up in all pictures)

Harold J. Kaplan, MD · Answer

Hi Wish.  You have a couple options.  The first is to have fillers under the eye again -- but with a different technique.  In our opinion, dermal fillers should not be injected in the thin skin under the eye.  The filler is properly placed "under the muscle" that surrounds the eye.  This adds volume, but at the same time avoids the risk of having a "pouch" under the eye where you show the thin skin.The second option is using laser resurfacing to improve the texture and elasticity.  To see an example of before and after photos for fractional laser resurfacing under the eyes for another Los Angeles patient, click on the link below.

Anil R. Shah, MD · Answer

Skin can look differently after hyaluronidase.  There are a host of solutions to improving this issue.  To help restore vitality in skin, a combination of PRP and resurfacing can help improve overall skin texture and tone.  Seek advice from an expert.  Best Dr. Anil Shah

Brian S. Biesman, MD · Answer

Hyaluronidase is not likely to be responsible for changes in the appearance of your skin.I strongly recommend evaluation by surgeons who are also extremely knowledgeable in the use of technology-based as well as nonsurgical treatments as well as surgery of the eyelids.  Rest of luck.

Jason Emer, MD · Answer

Hyaluronidase does not damage normal skin.  The pH of the solution is not at the right pH to damage normal elastic or collagen fibers or any natural hyaluronic acid.  I suggest co2 laser in combination with PRP and radiofrequency laser treatments to improve the under eye.  The goal is improvement, there is no "cure" or reversal for aging of the under eye.  Fillers appropriately placed with cannulas can also help if done by an expert.  Best, Dr. Emer.

Alim R. Devani, MD, FRCPC · Answer

My feeling is that the sagging skin in due to the excess
volume created by the filler and hyaluronidase and this has caused the skin to
stretch. Thus is not from the hyaluronidase but rather the volume of fluid in
the area stretching the skin. This unfortunately may take months to tighten up
or you may need a procedure to tighten it.

There are a few options that I can suggest to improve your
condition. A retinol based eye cream is great option. Options include:

-ZO® Olluminate Eye Repair

-ZO® HydrafirmT

-SkinCeuticals® AOX Eye Gel

Other options include botox injection into the lower eyelid.
Filler is not likely going to fix the problem and might make it worse. Surgery
for excessive buldging might be an option as well. Skin resurfacing
procedures (laser resurfacing with CO2 laser, Er:YAG laser, Fraxel DUAL®,
PicoSure® FOCUS Lens Array or OBAGI® controlled depth chemical peel) might be
an option. This is an advanced technique so be sure to get an experienced
dermatologist or plastic surgeon consultation for recommendations and treatment
options.

Samir Shureih, MD · Answer

Multiple chemical peels have been proven to build up collagen and elastic fibers in the skin. Also The gold standard is Carbon Dioxide Laser resurfacing has been proven to build up collagen and elastic fibers in the skin and improve the quality of the skin. Extreme laxity may require surgical tightening of the skin as well. Also the use of medical grade skin care on the long run will improve skin quality. There are multiple non-invasive machines on the market, they do not work consistently, avoid spending your money on machine that do not work and be patient, it is a long process, to reverse long time skin problems.It is an art, science and honest advise.

I damaged my under eye skin with Hyaluronidase. What can I do to regain elasticity and thickness? (photo)

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