Should I dissolve or surgically remove overfilled Restylane after 6 months? (photo)

Hi BlueBosch, If your right eyebag was larger than your left eyebag prior to injection of filler, then more dissolving will not work. If the eyebags were  even then most likely even with a couple of dissolving sessions there may still be a small pocket of filler that was missed. Why might the filler be missed during dissolving?  A lot of filler was used so, it makes sense that more dissolved and more sessions may be needed to get it all “washed out.”  5 syringes of filler, is a lot of filler for lower eyelid filling to either fill in hollowing or trying to camouflage the eyebags.  In general, most patients only require 1-2 syringes and the most I’ve used on one patient was 4 syringes. With all of those injections, there is a membrane around the eyebag which holds the lower eyelid fat, called the orbital septum. When filling the lower eyelid hollow under the eyebag, we fill under the muscle (orbicularis oculi) but do not want to get any filler under the orbital septum, because that would make the eyebag larger.  How do I guide the filler under the muscle but not under the orbital septum?  I prefer using a microcannula, which is a specialized needle used for injecting filler which has a blunt rounded tip, this helps me feel which layer the tip of the cannula is located.Before I used microcannulas (prior to 2012), I would use the needles provided with the syringe of filler.   The technique is to place the tip of the needle onto the surface of the bone and inject small amount on the surface of the bone like a mini implant.   Thinking back, this technique would definitely ensure that the filler is under the orbicularis muscle, and if the needle tip is below the eyebag that should keep the filler outside of the orbital septum.  With larger eyebags, filler on the bone doesn’t seem to hide the eyebags well enough, and you can still see the eyebag above the filler.   If they use the needle and move upwards to try to further fill the remaining groove, going down with the needle, they may actually be inside of the lower edge of the eyebag and under the orbital septum, and any filler inside the orbital septum would actually make th eyebag larger. For this particular reason and many others, I prefer using a microcannula for filling the lower eyelid hollowing and camouflaging eyebags.  In future responses I will give to other questions, I will try to go into more detail the benefits of using a microcannula  If your injector did use a microcannula, it is still possible to get a little bit of filler through the orbital septum, but less likely. Why? The blunt tip requires some additional pressure to pop through the orbital septum, and the injector should be able to feel that pop.  The dissolver (hyaluronidase) can be directed under the orbital septum to intentionally using this technique to make sure the dissolved is in the same compartment as the possible residual filler. If  not the orbital septum will actually act as a wall and protect the filler from dissolving. Hope that makes sense. Best,Dr. YangP.S. If you find my answers or other doctors answers to questions are helpful, please +1 those answers to push up the better answers to the top, which helps others who read the same post, get to the more helpful answers first.
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Hi @BlueBosch! The filler can be dissolved with Hyaluronidase. I recommend seeking treatments from expert injectors who have the skill and experience to precisely inject fillers into treatment areas and avoid risks and complications. Best of luck to you, Dr. Nima!

I'm sorry you aren't happy with your results. The good news is you can have the filler reversed with hyaluronidase. Hope this helps.