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

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.

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.

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.