Restylane Silk for under eye hollowness, now puffy eye bags, very worried. Overfilled? (Photo)

Question

Today I got my under eye hollowness filled for the second time. Had a great experience the first time 3 months ago - instant results, virtually no bruising or swelling. So I went to the same doctor for a touch up. The instant result was good. But half hour later, a massive bruise and swelling developed. Not too worried about the bruise since it will go away. But I can't decide if the puffiness which looks like a huge eye bag (I had none before) was just swelling or the area was overfilled.

Carlos Mata, MD, MBA, FACS · Answer

Good afternoon Jenny,Thank you for your question.  The under eye-area tends to swell a lot after treatment, especially Restylane Silk.  If you were happy with your initial result, then most likely, you'll be happy with your end result- just be patient with the swelling, as it can last up to 2 weeks.  Applying ice really helps as well as sleeping with your head slightly elevated the first few nights.  Hope this helps.All the best,Carlos Mata, MD, MBA, FACSBoard-Certified Plastic Surgeon

Jack G. Bertolino, MD · Answer

Under eye hollows are tough. It is sometimes over correction and has to be reversed, but swelling is common because HA fillers draw water. I like PRP under the eyes, but the look takes time. Hope this helps. JB

Aldo Guerra, MD · Answer

The bruise is significant in that you had some bleeding in the injection area. I suggest Arnica, Bromalein, but no massage for Silk. You can also try a steroid taper by prescription from your injector. If still present after 3 to 4 weeks then consider overcorrection as the leading diagnosis and possibly dissolving product would be appropriate. Best wishes, Dr. Aldo

Pedy Ganchi, MD · Answer

Hello,It is not uncommon to experience some swelling and bruising under the eyes after filler injections. This should resolve after 7-10 days and you can then assess the results. If there is excessive fullness after a few weeks, the excess filler can be dissolved with hyaluronidase.Warm regards,Dr. Pedy Ganchi                                                                                                                                               Village Plastic Surgery

Stephanie Beidler Teotia, MD · Answer

I would expect significant swelling the first week after injections under the eyes. I ask my patients to wait to judge the result at least 10 days. The bruising will go away before the swelling.

Mehryar (Ray) Taban, MD, FACS · Answer

Keep in touch with your physician. Bruising will go away but monitoring the eyelid is important.

Harold J. Kaplan, MD · Answer

Good morning,Being that your photo was taken shortly after the treatment, swelling is not unusual.  In addition, swelling and bruising goes hand in hand.  If the puffiness is swelling, it should improve gradually with each passing day.  If what you are observing is product misplacement, this will remain unimproved despite improvement with bruising.  The best advice is to follow up with your injector in two weeks for an evaluation.  In the meantime, avoid massaging or manipulation of the area.Please see the below link on how to correct over-filled tear trough treatments.

Jason Emer, MD · Answer

There can be some swelling and/or bruising after under eye injections which should resolve in 1-2 weeks. VBeam treatments can give improvement to the bruising. If you're unhappy with your final results, you can have it reversed with hyaluronidase and try a different technique next time. I recommend injections with cannulas to limit bruising. See an expert. Best, Dr. Emer

Faiyaaz Kalimullah, MD, FAAD · Answer

Thank you for your question and for submitting your photo.  The tear troughs and under eyes are an extremely sensitive area, and are particularly prone to swelling and bruising after filler injections.  In some cases, this swelling can last up to two weeks.  I also find that Restylane Silk in particular tends to swell more than other products, to the point where I have stopped using it under the eyes entirely.  If your immediate results were good, it's likely that your final results will be similar once your swelling has subsided.  For now, I would recommend that you gently apply ice or cool compresses to the area, as this may help the swelling subside sooner.  Please follow-up with your doctor if the swelling persists, or if you have any concerns.  I hope this helps!

Restylane Silk for under eye hollowness, now puffy eye bags, very worried. Overfilled? (Photo)

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