What can be done to dissolve tear trough filler and address the eye bags, dry skin and wrinkles it caused? (photos)

Question

Hello, I got what I thought was a very tiny bit of filler in the year trough area. It has created the results you see here in the photo. I look like I’ve aged 20 years! I’ve gone in for both hyaluronidase and hylenex 6 times now. The last time a combo of hyaluronidase and steroid injection. This is the after result of that. The bags just keep coming back, and now the skin looks dry and wrinkled as well. Any advice on what to do next would be greatly appreciated, thank you.

Hung William Song, MD · Answer

When you use hyaluronidase to dissolve HA fillers, some of your own hyaluronic acid and collagen gets dissolved as well causing wrinkling of skin and volume loss. The best way to address this is to restore your own collagen and fat by getting a fat transfer or a PRP based treatment. The AutoCorre technique is the best way to restore your natural collagen without the risk of more lumps and swelling

Kenneth D. Steinsapir, MD · Answer

Hyaluronic acid fillers are beautifully sensitive to hyaluronidase, the enzyme that brakes down the hyaluronic acid filler. One challenge is that many injectors simply do not understand how much enzyme is needed to actual do the job. They rely on a "squirt" of enzyme which might be as little as a few units of enzyme. When one is attempting to entirely remove a filler service (or many services) a much large dose of enzyme is actually needed. Another issue in the lower eyelid is that some injectors inadvertently inject filler behind the orbital septum, and plane of connective tissue that separates the cheek from the actual orbit behind the eyelid. That causes the lower eyelid to bulge like a lower eyelid bag. To eliminate these situations, enzyme needs to be carefully injected behind the orbital septum. Knowing how to get behind the septum required a detailed surgical knowledge of the lower eyelid that, sadly, many injectors do not possess. Finally, the combination of steroid and enzyme is not an ideal one. The steroids kills eyelid fat in an uncontrolled way. Consequently, your current situation is consequence of a poorly performed filler service, a poorly performed enzyme service, and likely damage from corticosteroids intended to help you. To determine what the best solution is for your current situations, there is no substitute to a detailed, in person consultation to get to the bottom of what is going on. You should be skeptical of practitioners who insist on performing MRI or Ultrasound imaging to diagnose what is going on. While this seems reasonable, these imaging studies are really best for academic research purposes and practically do not make a difference in your treatment.

What can be done to dissolve tear trough filler and address the eye bags, dry skin and wrinkles it caused? (photos)

Answers (2)

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Everything you need to know about Hyaluronidase

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What can be done to dissolve tear trough filler and address the eye bags, dry skin and wrinkles it caused? (photos)

Answers (2)

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Recommended reading

Everything you need to know about Hyaluronidase

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