Should I be worried about puffy eyes and water retention 2 weeks after tear trough Juvederm Ultra? (Photo)

Thank you for your question and sharing your picture. This is not uncommon with Juvederm. It takes longer for swelling to be resolved . On average, it takes 10-17 days to see final results. I would wait for couple days and if you are still not happy, please go back to your injector and discuss your concerns. 

"This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

Thank you for your question and sharing your photographs. It is not uncommon to experience swelling after Juvederm injections. Juvederm is not the best filler for the tear trough area as it leads to constant swelling. The best filler for this area is Restylane as it is thinner filler and leads to less swelling. If this persists, I recommend having this dissolved with an enzyme known as hyaluronidase. Good Luck!

Thank you for your question and sharing your
photographs. It is not uncommon to experience swelling after Juvederm
injections. Juvederm is not the best filler for the tear trough area as it
leads to constant swelling. The best filler for this area is Restylane as it is
thinner filler and leads to less swelling. If this persists, I recommend having
this dissolved with an enzyme known as hyaluronidase. Good Luck!

Dear Tretini:
Many experts will use Restylane, Volbella or Belotero under the eyes before Juvederm, to minimize swelling and have the smoothest results, although there is nothin specifically wrong with using Juvederm under the eyes. Volbella and Belotero are the least likely to do this because they attract the least water after injection and have a low cohesivity, which means they spread like honey rather than like jello after injection. It also appears as though you may have a bit of a Tyndall effect, which means that at least some of the filler was placed rather close to the surface of the skin. It is not possible for either Belotero or Volbella to create this blueish tinge.
Unfortunately, I believe you will need to have some, but not all of the filler dissolved with hyaluronidase. In expert hands, you may be able to have this done without needing more filler injected.
All the best,   Dr. Clark

Tear trough deformity is commonly addressed with fillers. Placement of the filler is usually deep right over the bony structure. All hyaluronic acid fillers (Juvederm, Restylane etc) will attract water as the HA binds with water molecules. This may create more fullness that will take several weeks to dissolve. Under-correction of the deformity is the goal of the injection in order to account for the water absorption over time and avoid an over corrected swollen look. 

I prefer to use restylane under the eyes.  It might take a bit longer with Juvederm.  If it does not improve over the  next weeks or so, it may need to be dissolved.

I would not have recommended Juvederm for the under eye area.  Restylane or Belotero are much better choices. Unfortunately it looks like you may need to have this dissolved.  I would return to your treating physician if it doesn't resolve in the next week for Hyaluronidase to dissolve the filler.  Please consult an expert in under eye fillers for the best cosmetic results.  Best, Dr. Green

Juvederm is not the filler of choice for the under eye area for exactly this reason.  Juvederm has a higher tendancy towards water retention in this area and that swelling/puffiness can last longer than the usual 2 weeks swelling normally takes to resolve.  I would speak to your injector again if the swelling doesn't resolve to discuss your options for improving the appearance of the area.  Good luck with your recovery.