Tear trough edema still there after Hyaluronidase. What should I do now? (Photo)

Question

I received a shot of 12 U of Hyaluronidase to treat a 2 years old tear trough edema caused by a highly cross linked hyaluronic filler injected by mistake inside orbicularis and lip elevator muscles (ultrasound revealed that it was fragmented in tiny particles infiltrating muscular fibers). Even after 12 U of Hyaluronidase the permanent edema reduced very little, but the “lump” is still there. What could be done now?

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin. This is a great question. I highly recommend scheduling an in-person consultation in order to better assess your areas of concern and discuss an appropriate treatment plan to help achieve your aesthetic goals. Our office phone number is: (312) 944-0117. I hope this helps and best of luck!

Nelson Lee Novick, MD · Answer

At least from the photo and the history, the problem appears to be what has come to be called under-eye "puffy pillows," or more specifically lymphedema/lymphatic obstruction. This issue, which results from either an inappropriately selected HA filler for the area and/or too superficial injection of the filler is admittedly a difficult problem to treat. I have had gratifying results with individuals who have come to me with this issue using an algorithm of varying combinations, concentrations and amounts of intralesional anti-inflammatory agents. You would be wise to consult with an experienced, board certified cosmetic dermatologist. Hope this helps and best of luck.

Tear trough edema still there after Hyaluronidase. What should I do now? (Photo)

Answers (2)