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Will sagging improve after overfill and hyaluronidase? (Photos)

Randy3241Aug 25, 2018
Mid thirties. Was severely overfilled with 1 syringe under each eye and 2 syringes per cheek (6 total!!!). Was devastated. Had hydase injected 2 months ago (30 units each cheek bone, 30 units each lower cheek where no filler injected). Cheeks extremely saggy, very heavy around mouth. Used to have tight narrow face. Am I doomed or can I get my face back? Do I need facelift now due to damage?

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Raffy Karamanoukian, MD, FACS profile photo
Dr. Raffy Karamanoukian, MD, FACS
Board Certified Plastic Surgeon
4.6 | 124 Reviews
Answered on Oct 13, 2022
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Dr. Amy K Hsu, MD, FACS
Board Certified Facial Plastic Surgeon
4.8 | 78 Reviews
Answered on Sep 25, 2018
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Elham Jafari, MD

Hi and thank you for your question! You indicated that the hyaluronidase injection was to correct a probable Tyndall effect around marionette line (lines below the corners of mouth) but it seems that the concerns you have now are related to your under the eyes area. If the enzyme injection was ...

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Amy Miller, MD

Hyaluronidase usually works immediately--but I like to give it 48 hours for everything to settle before doing further treatments.  The problem is you may still be seeing swelling from the initial filler treatment and you might like the final results, so melting the filler out may be a...

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Vadim Pisarenko, MD, FACS

Thank you for your question. Hyaluronidase frequently causes more swelling than the HA itself due to an inflammatory response. Swelling should resolve in 7-10 days. You may need re-injection of Hyaluronidase for symmetry and more even dissolution of HA. Good luck.

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Raffy Karamanoukian, MD, FACS

Longterm filler problems include migration, edema, and nodularity. Filler migration and permanence is a very common problem because there are many different types of HA fillers on the market and each is specified for a specific part of the face. Use of highly cohesive fillers on thin skin may...

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Martin Jugenburg, MD

Hi. Thank you for your question. Cardio should not worsen the bruising. Apply arnica might help reduce it. Overall, will take no more than 2 weeks to resolve. 

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Amy Miller, MD

Let me just first say, you have gorgeous full lips, lucky girl!! So a nodule that is remaining over a year after filler injection and not responding to hyaluronidase probably is not just a simple blob of excess filler.  I suspect you may have something called a biofilm. ...

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