Restylane under eyes made it worse, what do I do now? Doctor says he can either inject more or "melt" the Restylane (Photo)

Question

As you can see from the pictures, the restylane just made my problem a lot worse. I don't think the doctor was very experienced. It appears as if the product was placed ABOVE tear through, making bags even bigger. There is still discolouration at injection sites (don't know if bruising or product itself, it's gray/blue-ish). He injected 1/2 syringe, can inject 1/2 more. Or "melt" it. What are the risks of "melting" it? I don't trust this doctor anymore. Can I have surgery after "melting" it?

W. John Bullis, MD · Answer

Thank you for your questions and photos.  From what I can see on the photos, it does look like you have excessive water retention under your eyes, likely from too superficial placement of the hyaluronic acid (HA) filler.  Although I cannot see it in the photos, I will take your word for it that there is a bluish hue showing through the skin in this region too.  This is called hyalinization and usually results from HA fillers that are too superficially placed.  Since you are at least 3 weeks (20 days) out from the procedure and are still seeing hyalinization, I would recommend having the filler dissolved with one of the available hyaluronidase products, such as Hylenex or Vitrase.  Injecting the tear troughs is considered an advanced injection technique and must be performed by someone with experience doing it.  The filler should be placed just immediately above or on the bone of the eye socket (inferior orbital rim) and should be used sparingly.  I often couple this with deeper filler in the cheeks and that gives my patients a good result.  I did have one patient who developed the same problems you seem to be having, despite my following this technique - she had very petite, delicate facial features and there simply was no way to get the filler deep enough in that area.  I dissolved the little bit of filler in that part of the tear trough and it resolved within a couple days.  I have been injecting the tear troughs since 2008 and I love doing it, because the results are usually so dramatic, but no matter how much experience an injector has, he or she can still have the occasional case where things don't turn out as planned.  The best will recognize it early and know how to take steps to correct it.

Jason Emer, MD · Answer

If you are unhappy get the filler reversed.  you are the typical candidate that needs a combination of lasers, fillers and microneedling/PRP.  I find that fillers just into the tear troughs do not give great results in men, the cheek/mid face also needs to be addressed.  Best, Dr. Emer.

Harold J. Kaplan, MD · Answer

Hi URLM.  It's difficult to assess from the photos how the procedure was done or where the product was placed.  If you had before photos, this would be easier.But irrespective, if you do not like the outcome, it's easy to reverse the procedure with Vitrase or another Hyaluronidase.  The procedure is quick and simple and will get you back to baseline.  At that point, if you are still interested in cheek or tear trough correction, perhaps a better injector may be able to achieve your goals.  To see before and after photos for a recent tear trough injection reversal in Los Angeles, click on the link below.

Michael A. Zadeh, MD, FACS · Answer

I agree with you, the injections were made in the improper place and likely too superficially. How long ago is this? If you have waited 2 weeks with no improvement then it's best to have the filler dissolved and start over with an experienced injector. Best wishes.

Kyle Coleman, MD · Answer

Unfortunately, filling of the tear troughs or hollows under the eyes is a procedure that is often performed poorly or incorrectly leading to less than desirable results.  If injected in the wrong plan or location, it may actually accentuate the hollowness and make swelling worse.  If placed too superficially, it can create a bluish-gray appearance to the tissue and visible lumps or bumps.  Thankfully, hyaluronidase injections can reduce these effects in as little as a few hours.  Make sure to always see an expert injector as it will save you time, money, and potential complications.

Restylane under eyes made it worse, what do I do now? Doctor says he can either inject more or "melt" the Restylane (Photo)

Answers (10)

Answer: Injecting Under The Eyes With Filler

Answer: Injecting Under The Eyes With Filler

Answer: Filling tear trough hollows

Answer: Filling tear trough hollows

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Restylane under eyes made it worse, what do I do now? Doctor says he can either inject more or "melt" the Restylane (Photo)

Answers (10)

Answer: Injecting Under The Eyes With Filler

Answer: Injecting Under The Eyes With Filler

Answer: Filling tear trough hollows

Answer: Filling tear trough hollows

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Recommended reading

Everything you need to know about Restylane

Our mission is to create a world where every investment in modern beauty is Worth It.