I had 1 syringe of Restylane in my tear trough area to treat my hollows. The area occasionally swells up and bags form (Photo)

Question

2.5 months ago I had 1 syringe of Restylane injected under my eyes. Since then, it has swollen up twice: once during my period, and now (not on period). The area looks bumpy, baggy, red, it's a little itchy, and wrinkled. Before the filler I had no visible undereye wrinkles except when smiling, now I do. :( I had no change in my diet, I haven't eaten more salty food, haven't rubbed my eyes, and I have not had a bug bite me. What is causing this swelling and should I be concerned? Thanks.

Nima Shemirani, MD · Answer

Hi @NDsaccount! Most likely, the filler was not placed in the proper tissue plane. Most facial filler products that are injected into this area should ideally be placed in the tissue plane directly on top of the bone, or at least underneath the eyelid muscle layer. If a facial filler product is placed too superficial in the skin, or on top of the muscle layer, the product may settle in with an abnormal appearance and can look to be lumpy, swollen, or irregular. Another reason for the prolonged swelling can be due to the fact that too much facial filler product was used. The filler products that are preferred to treat this area will have some degree of affinity for water molecules so all of these products will exhibit some degree of hydration and swell once injected into the body. Hyaluronic acid facial filler products that were previously injected into an improper tissue plane can be dissolved by hyaluronidase injections. Best of luck, Dr. Nima!

Jason Emer, MD · Answer

I see this often with patients who have had filler injections into the trough.  Soemtimes the filler causes asymmetrical swelling and radiofrequency treatments help resolve this.  If you are bothered by it, reverse the filler with hyaluronidase.  Best, Dr. Emer.

Mehryar (Ray) Taban, MD, FACS · Answer

It is difficult question to answer without examining you. It is best to discuss with the person who injected the filler and/or see an oculoplastic specialist. The good thing about Restylane is that it can be dissolved if necessary.

Robert S. Bader, MD, FAAD · Answer

This is very uncommon and might be due to other causes of swelling under they eyes and not the Restylane. For example, allergies can exacerbate this as can lying flat (when sleeping). This usually resolves within an hour or so. Immediately after treatment swelling is not uncommon, but this resolves within 1-2 weeks at the most.

Steven Hacker, MD · Answer

Restylane silk is a great new product indicated for the perioral rhytides and lip area only but swelling in this area should be expected because restylane is so hydrophilic. It is post op edema and will resolve over few days typically. Not indicated for the nasolablial folds. Would recommend you discuss your case with your board certified dermatologist.Restylane silk is not indicated for any area other than the lip and perioral rhytides.

Steven F. Weiner, MD · Answer

I think the Restylane is doing this and I would get it dissolved with hyaluronidase.  I might have been placed too superficial.  I like to place it deep using cannulas.

I had 1 syringe of Restylane in my tear trough area to treat my hollows. The area occasionally swells up and bags form (Photo)

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Answers (6)

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