Malar edema from undereye filler injections seemingly caused by inflammation rather than lymphatic obstruction? (Photo)

Question

My doctor injected in my left tear trough (~0.2 mL Restylane-L) and left zygomatic ligament (~0.15-0.2 mL Restylane-L) 5 wks ago. I already had very mild swelling in the malar area from rosacea. The area immediately swelled up. I’ve had 2 rounds of hyaluronidase so far (15 units Hylenex then 30 units) which have yielded no improvement. I only got filler on the left side so my right side is a useful comparison. I believe I may have extreme inflammation as the area is on/off red. Really need help

Leonard Grossman, MD · Answer

It is unfortunate that you had hyaluronic acid fillers placed into your lower eyelid area/tear troughs. Those should only be filled out using fat. Give yourself a little time to heal and then follow up with fat grafting. Since fat contains a rich supply of stem cells, this procedure will correct the swelling that you currently observe. I hope this helps and good luck from New York City plastic surgery.

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