Juvederm under eyes for troughs but now looks worse - strange depressions and bumps. Is this normal?(photos)

Hi Calikimber,Sorry to hear about your problems following Juvederm injection under your eyes.  Most sophisticated physician injectors use only Restylane or Belotero to fill the delicate and unforgiving lower eye hollow area.  The problem with Juvederm is that it attracts too much water after injection, often causing excessive swelling.  At this point you should speak with your injecting physician about your concerns.  If things do not improve shortly, then I would recommend seeing an expert injecting physician to dissolve the misplaced Juvederm.  Choose your injecting physician most carefully.  Good luck and be well.Michael Persky, MDEncino, CA

1 week post under eye injections you will still have swelling to the areas. Wait approx 2 weeks for swelling to subside so you can obtain a clear assessment of your result. At that point you can schedule a follow up visit with the injector to discuss your results. If you have areas of depression you may add more filler to smooth that area, any areas of excessive filler you may want to have dissolved. Best of Luck. 

Based on your photos, it appears that the Juvederm was injected too superficial which is creating the bluish hue that you see under your eyes. This is actually making the "dark circles" more prominent. Also, too much filler was placed in this area which is why you have that "lumpy" appearance under your eyes. I would contact your injector for hyaluronidase treatment which will dissolve the Juvederm filler. I prefer Restylane in the tear trough area which may be a better option for you in the future. I do recommend consultation with a board certified physician who is experienced in filler injections. Bestwishes. 

The fullness is likely filler, in which case it can be dissolved.  Lumpiness can result from filler injection around the eyes if injected superficially and too much.

Thanks for your clarification. From your pictures it appears that the Juvederm was placed inaccurately and too superficially. This can cause bumps and lumps. An in-person evaluation would be best to accurately assess the situation and determine which course of action would be best moving forward. You may require hyaluronidase to dissolve the superficially placed Juvederm. If you are in the Los Angeles area and would like a second opinion, feel free to contact my office to set up a consultation.

Hi CK.  The appearance of the two eyes is very different as you have pointed out.  One looks puffy and the other still has the naso-jugal groove (the depression at the left eye).It appears that your injector did not equally distribute the product and more was needed at the left eye.  It's also important when performing this procedure to use a deep injection technique where the product goes "under the muscle".  When the product is placed too superficially it can lead to a bumpy appearance and it's harder to make the area look smooth and evenly contoured.You do have the option of dissolving the product with Vitrase (Hyaluronidase) to remove it and this would allow you to start over.  Without an in person evaluation, it's difficult to tell if this is necessary or not.To see examples of before and after photos for Los Angeles and Orange County patients that have undergone the tear trough under eye injections, click the link below.

I like Restylane better than Juvederm around the eyes as it's less apt to create a blueish Tyndall effect.  But I think your main problem is too much, too superficial.  Beyond 1 week I think you might get some improvement but not a lot.  The good news is that hyaluronidase is pretty effective in treating this.  Make sure you see someone experienced in treating complications of injectables.

Generally speaking both restylane and juvederm are nice options for the tear trough, but my preference is restylane or restylane fine lines. In you case, there is a bit of lumpiness and hyaluronidase should be injected by your physician to bring it down since fillers in the tear trough often last 1-2 years. Another option sometimes is to put more filler into the depressed areas so it blends in with the bumpy area. Best to have your dermatologist assess your skin to decide on the best option.