Why did I get a bag after tear trough filler with micro cannula? (Photo)

Question

I've injected my tear throughs once a year with Restylane with regular needles and I've had awesome results every time. The last 2 times I've used micro cannulas with different injectors since I've moved to NYC, and both times I've been left with a small bag under my right eye making the line of the hollowness look deeper. Is it the injector's skills? Should I go back to needles? Do I need a lower blepharoplasty? Are needles more precise ?

Mitesh Kapadia, MD, PhD · Answer

I dont see enough excess fat to warrant eyelid surgery. There is very little margin for error when injecting the under eye area. My personal opinion is that I get much better results when using needles compared to using a microcannula. A microcannula needs to be inserted under the skin through a single puncture wound and then guided to different positions in the eyelid. In my experience it is very difficult to get the cannula to the right place and right depth throughout the lower eyelid through this single entry site.I suspect other doctors will have different opinions on this topic. My recommendation is to find a doctor who has a lot of experience treating the under eye area and then go with whatever method he or she recommends.

Dennis Wolf, BScHons, MBBCh, MRCSEd · Answer

Difficult to say from the pictures.  The lighting is different and left and right look different.
Cannula is generally seen as safer as less likely to inject into a blood vessel.  But this does depend on the injector.
You seem a bit young to have eyelid surgery.  
I would suggest seeing your injector again and discus your concerns and come up with a plan.
Time is also a good predictor, don't rush to have more filler and other treatments.

Jason Emer, MD · Answer

This may be due to injector technique, but keep in mind a combination approach is needed to get improvement under the eyes. Fillers, lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer

Mehryar (Ray) Taban, MD, FACS · Answer

It appears you have fat bag under eye. You may fair better with transconjunctival lower blepharoplasty with fat redraping but I need to examine you to better help you.

Shaun Patel, MD · Answer

I suspect this is related to injector experience and technique. I use a blunt tip microcannula for most of my tear trough filler treatments. The correct filler needs to be used and it needs to be placed deep to prevent lumps and bumps. A microcannula is safer when it comes to the undereyes then a needle and it also leads to less bruising and swelling.

Why did I get a bag after tear trough filler with micro cannula? (Photo)

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Answer: Tear trough filler treating using microcannula

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Why did I get a bag after tear trough filler with micro cannula? (Photo)

Answers (7)

Answer: Under eye fat bag after filler ?

Answer: Under eye fat bag after filler ?

Answer: Tear trough filler treating using microcannula

Answer: Tear trough filler treating using microcannula

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Recommended reading

Everything you need to know about Dermal Fillers

Our mission is to create a world where every investment in modern beauty is Worth It.