I got under-eye filler about 4 months ago and I feel it’s made my under-eye wrinkles worse. (Photo)

Question

The fillers aren’t an issue if I’m not smiling but I think the filler bunches the skin up and creates greater creases when I smile. Should I dissolve them? Is CO2 laser an option for me - I have Indian Skin. The rest of my skin is so young looking. I already use retinoic acid, vitamin C and copper peptides.

Tanya T. Khan, MD · Answer

Hello, you do have some lower eyelid wrinkling that accentuates in animation, from your above photograph. I think the filler may need to be injected at the bone level instead of the dermal layer within the skin to help elevate the skin away from the orbital rim. Alternatively, laser tightening will provide some smoothing of skin, however, some lasers can cause hyperpigmentation in pigmented skin. I would also consider a chemical peel to provide some smoothing of the skin surface.

Dana Goldberg, MD · Answer

Since your filler is most likely partially breaking down already, it may not be necessary to inject anything to break it down. It would be more helpful to see before and after photos with a straight face and smiling before recommending anything more specific about your filler. Based on the wrinkling you have on animation, micro Botox in the lower eyelid muscles (2-4 units spread out over the lower eyelid) could help smooth things out. I don’t think CO2 laser is a bad idea, but I recommend going to a practitioner who is experienced in treating patients with darker skin.

Jason Emer, MD · Answer

If you're unhappy with your final results, you can have it reversed with hyaluronidase and try a different technique next time. Keep in mind, a combination approach will give the most improvement. Fillers, lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer

Shaun Patel, MD · Answer

It would be nice to see a photo of your face at rest. It is possible that the filler was placed too superficially. I would recommend getting an in person consultation and second opinion from another injector. The filler can be reversed using hyaluronidase and the area can be reinjected using correct technique. A small amount of Botox/Dypsort under each eye may help with the dynamic undereye lines.

Kamran Khoobehi, MD · Answer

You have extra skin over the lower lids. You can try Botox and if not better use Wydaze to dissolve the fillers.

Ivan Vrcek, MD, FACS · Answer

Thank you for your question and photo.
I do see the skin bunching and wrinkles that you are noticing. These appear to mostly be dynamic lines, meaning they are predominantly present when you smile or squint. Dynamic lines are best treated in this area with a small amount of botox. If there are also some static lines, these can be effectively treated with a chemical peel. You are correct to be cautious about laser resurfacing with your skin tone--peels are safer for more pigmented skin like yours. That being said, I suspect that botox alone is likely to result in a substantial improvement. Consider seeing an ASOPRS oculoplastic surgeon in your area.
Best of luck!

Darryl J. Blinski, MD · Answer

Without in person detailed examination my over the RS internet guess is you were under treated with HA filler and you need a few sessions of low dose micro Botox injections..

Bradford A. Bader, MD · Answer

Filler in the under eye area can cause some edema of the lower lid skin in some patients. This should have resolved if it was 4 months ago. The skin bunching you see is due to muscle activity and is best treated with a small dose of Botox. I don't think skin resurfacing is the best option for you at this point.

Tom Jodlovich, MBBS, MPH (license suspended) · Answer

Thank you for your question.
I would advised that an appropriate dose of neuromodulator such as Botox to the Crows Feet area would be a better option to reduced that movement of the dermal filler that is contributing to the creases that you are noticing. I also concur with my colleagues whom have commented that laser resurfacing treatment would not be beneficial in this particular case.
I recommend that you consult with an experienced and highly trained practitioner to ensure your safety and for optimal results to be achieved.
Best wishes.

I got under-eye filler about 4 months ago and I feel it’s made my under-eye wrinkles worse. (Photo)

Answers (9)

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