Bruising after 1.5 months from tear trough Restalyne? (Photo)

Thank you for your picture.  The area under the eyes is very vascular - combined with the thin skin/muscle of that area, it means that if there is significant bruising you can get a hemosiderin stain on the skin for some time (as the bruise breaks down and gets resorbed by your body, the break down leads to hemosiderin being deposited in the area).  The good news is that it always goes away.  Unfortunately knowing exactly how long it will take to go away certainly varies from person to person.  I would advise you not to add any more filler at this time, mostly because ti certainly doesn't look like you need it from the picture above.  I hope some of this helps! Best of luck.  

Thanks for this question. You have to consider whether this is a hemosiderin stain (which is left over after bruising) or product with a Tyndall effect. It might be worthwhile to see your injector and try a small dose of hyaluronidase.Otherwise, give it more time and it should get better.Best, Dr. ALDO

While bruises can linger and even cause hemosiderin staining, I think what have here is related to an uneven treatment.  Unfortunately, these are super fussy treatments.  Some injectors are genius with these products and others should not be doing them.  You need to get care from someone who is more in the genius category rather than the not knowing what they are doing category.  I think you have funky service and it needs to be adjusted.  

There are several possibilities for the persistence of the discoloration you describe. On is the persistence of hemosiderin (blood breakdown products) that can following bruising--a problem that typically will resolve spontaneously over time may take months to do so. The unwanted, bluish Tyndal Effect, which occurs when certain hyaluronic acid products are injected superficially within the delicate under eye skin, is a second possibility. This, too, tends to persist in this region for prolonged periods of time until all the hyaluronic acid filler is metabolized naturally by the skin. While at one time Restylane was routinely used in the is area (often diluted), these days most experienced practitioners prefer the use of agents, such as Belotero, Restylane Silk, Teosyal Redensity II, more suited to the region (and less likely or unlikely to give rise to this problem). Juvederm is also seldom used, since it attracts a good deal of tissue water that may give rise to swellings and bags under the eyes when used there. If the filler is believed to be at the root of your problem, hyaluronidase may be injected to speed the dissolution of the culprit discoloration. Finally, the photos shows some flattening of the volume in the cheekbone region. Very likely the use of a volumizing filler in that region, such as Voluma XC or Stylage XXL would not only improve the cheek contour and shape, but would secondarily improve the under eye area. Treating the under eye region is not a area for novice injectors trained to inject ordinary Juvederm or Restylane in simple smile lines. Going forward it would be prudent to make certain that you consult with a board certified aesthetic physician with experience and expertise in advanced techniques of facial shaping and recontouring, as well in directly treating the under eye region. Insist upon seeing his/her before and after photos of these regions before agreeing to proceed. Good luck to you.

The area around the eyes is very vascular and bruising from under eye injections is very common. In most patients the bruising is gone by 1-2 weeks after the procedure. In a small subset of patients (about 1% in my experience), bruising is severe and can lead to hemosiderin deposits in the skin, which looks like a prolonged bruise. This always goes away, but can take several months to clear completely. In rare cases, it can take six months or more to go away. In patients with very fair skin such as yours, even small amounts of discoloration can be very visible.It is hard to tell what is going on from a single photo. Adding some filler to your cheeks would probably help improve the overall look of your under eye area, but if there is still residual bruising I would wait until this resolves.

Thank you for your question. The area under the eyes is very vascular and having bruising after injection to this is area is common. This usually resolves in 1-2 weeks in most patients. In a small amount of patients bruising can be severe and can lead to hemosiderin staining. This can look like a prolonged bruise. This will go away, but may take several months. I recommend having this evaluated by your treating physician. Best of Luck! 

Hi There Thank you for your question and photograph. It seems to me that you have some swelling under the eye that may well be lymphatic in origin or possibly even the consequence of the bruising you have had.My first thought is that Restylane is a bad choice for under eye filler because of its tendency to cause discolouration. Really it should not bruise at all if done with a cannula.My patients tell me that Arnica 30C tablets can help speed recovery for bruising. How or why it works is anyones guess but it seems to.In my practice I would resist the temptation to do anything for at least 3 months.Reassess after this. Certainly do not start melting filler just yet.I wish you well.Kind Regards Dr Dinesh Maini Zenith Cosmetic Clinics 

the bruising in this area can persist and the chemicals left after the bruising dissipates also has color.  you can have this done again but keep in mind this is a very difficult area to treat and be sure you see a board certified dermatologist or plastic surgeon who is really skilled in treating this area

Thank you for your question.  Tear troughs are technically one of the most difficult areas to treat and the easiest to do wrong.  That being said, your pictures show nice results, but if you are unhappy you should follow up with your board certified Dermatologist/PS who treated you and discuss treatment options.  I would advise against adding more filler.  Regards, Dr. Matt Elias