Do I have malar edema? (photo)

These pics are from day 3 after getting Belotero in my tear troughs (day 4 looks as bad). I bruised badly which I expected but there is a large lump (looks like a water sack not swelling) under one eye. Will this go down or do I need more Boletero under the lump? Or do I need to get it dissolved? Starting to get freaked out that it is not going to go away.

Doctor Answers 2

Lump after Beletero

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I would have liked to have given you advice earlier but just joined RealSelf and see that no one has responded as yet.

Genjenn, I am wondering if this protuberance was present when you left the office, or if it developed later.  

Beletero can be gently massaged after injection to spread it more laterally snd to allow it to distribute evenly under the eye, as Beletero is the only filler with multiple particle sizes, which means it spreads the most easily of all the fillers and is the least likely to cause lumps.

if this collection cannot easily be massaged into place by your physician, he or she may want to inject a little hyaluronidase to reduce it quickly back into a proper contour.

By now, I imagine, you have seen your dermstologist.  What was the outcome? Are you happy with the correction now?

Submalar Bumps

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It is hard to tell from the photos what is causing your swelling. Returning to your physician will be most helpful.

A for the bumps under your eyes, a little anatomy is helpful;
  1. Tear Trough is an anatomic groove that extend from the inner corner of your eye down and outward across your cheek at about a 45 degree angle. This is caused by genetics, a sagging of the cheek tissues, a bulging of the fat around the eyes and a separation of the muscle of facial expression.
  2. Malar Bulge or festoon - a a swelling of the lower, outer half of the orbicularis oculi muscle. It can worsen after injections and surgery, but chronic festoons are difficult to correct without direct excision.
  3. Eyelid Bulges - this is most commonly the result of fat, which bathes the eyeball, popping out to creat the tired , bags we all detest.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.