Chronic edema around eye after HA fillers?

Question

I had .5cc under each eye of Resty., maintained for 3 years. 1 or 2 sessions a year. Primarily mid to lateral cheek area, not tear-trough. Placed right along the top of, and on the rim, giving higher cheeks. Under 1 eye, I had minor persistent swelling. Also had upper eyelids done on 3rd year. On same eye I got an eyelid infection. After it resolved, the swelling was much worse, chronically. It is like a festoon, & eyelid bag, but is all fluid, no fat. Despite years since last treatment. Help?

Kenneth D. Steinsapir, MD · Answer

These products have a life cycle.  Eventually the old product that persists for years needs to be cleared out.  Enzyme treatment will remove the old filler product.  About a week later, you can be retreated without the chronic bogginess.  You don't need antihistamines, prednisone, or unnecessary laser treatment.

Matthew Richardson, MD · Answer

While there are several possibilities, biofilm formation (like a chronic infection) could definitely be going on in a scenario where chronic swelling is occurring in the location of filler injections and previous infection. An in-person exam is definitely warranted, but the fillers may need to be dissolved with hyaluronidase, and oral antibiotics may also be needed. A visit with a board-certified physician injector specializing in facial aesthetics is always recommended.

Mehryar (Ray) Taban, MD, FACS · Answer

Need photos or examination to tell you. It could be edema, residual filler, your own eye fat, or combination. Treatment depends on the cause. See an oculoplastic specialist.

Jason Emer, MD · Answer

This is difficult to answer without pictures and needs an in-person evaluation. I recommend getting a formal evaluation with a cosmetic dermatologist. Antibiotics, antihistamines, prednisone, venus legacy treatments may help give improvement. Best, Dr. Emer

Hardik Soni, MD · Answer

Thank you for your question. It is difficult to give you an answer without photographs. I recommend having this evaluated in-person to determine the cause and treatment plan. Please be sure to see expert. Best of Luck!

Michael H. Gold, MD · Answer

Thanks for your question and we recommend that you have a consultation with a board certified dermatologist or plastic surgeon to evaluate what is going on now, why you have what you have, and what is the most appropriate thing for you now moving forward.

Anthony J. Wilson, MD · Answer

Thank you for your question. Chronic edema following fillers and an infection is highly suggestive of a biofilm. It is impossible to give you a complete recommendation without an exam in person, but this problem can occur following HA filler. I would recommend seeing a plastic surgeon with experience in fillers and eye surgery. Typically this can be remedied or improved with several treatments of hyaluronidase and suppressive antibiotics. Best of luck!

Melvin Elson, MD · Answer

The swelling is most likely fluid that comes in because hyaluronic acid attracts water. without photos it is difficult to determine exactly what is going on but you do not need antibiotics, steroids or certainly any laser treatment. see a board certified dermatologist or plastic surgeon (hopefully one who injected you) to see if hyaluronidase will help

F. Victor Rueckl, MD (in memoriam) · Answer

This is a bit tough to answer but sounds just based on your description like it might be cellulitis. Find an expert cosmetic dermatologist in your area with a lot of filler experience. If that is what it is, he or she will be able to properly diagnosis it. I've found this is often misdiagnosed unfortunately. "This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

Chronic edema around eye after HA fillers?

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