Is this swelling filler and why would this be happening nearly two years later? (Photo)

Question

Almost two years ago I received volbella in my tear troughs. Almost immediately i decided i didn't like the look and proceeded to have it dissolved on two occassions. Recently I have been have been getting swelling under the eyes accompanied by an eczema break out and it appears that perhaps there is still filler there? I don't know if the reaction is causing the filler to swell or if the filler is causing the eczema. Thoughts?

Nima Shemirani, MD · Answer

Hi @DreamCatcher19! There are a few reasons for this swelling. One being that the filler was not placed in the proper tissue plane. Most facial filler products that are injected into this area should ideally be placed in the tissue plane directly on top of the bone, or at least underneath the eyelid muscle layer. If a facial filler product is placed too superficial in the skin, or on top of the muscle layer, the product may settle in with an abnormal appearance and can look to be lumpy, swollen, or irregular. Another reason for the prolonged swelling can be due to the fact that too much facial filler product was used. The filler products that are preferred to treat this area will have some degree of affinity for water molecules so all of these products will exhibit some degree of hydration and swell once injected into the body. Hyaluronic acid facial filler products that were previously injected into an improper tissue plane can be dissolved by hyaluronidase injections. Best of luck, Dr. Nima!

Karan Lal, DO · Answer

Delayed swelling after filler is a well known side effect. Even small amounts of filler can migrate down and accumulate fluid. You should see your board certified dermatologist. The eczema should be evaluated as well.

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