Ridge under eye after Restylane in tear troughs. Is this normal? Is it due to the technique? (Photo)

Question

I received restylane injections under the eyes to the tear troughs. I bruised immediately. And under one eye, it was apparent that I had a swollen ridge right away. However, a week later, it is still as apparent as the first day (only in one eye). I would like to know if this is normal, or if this is due to the technique. Only half a syringe was split between both eyes, so I doubt too much product was used. Please advise. Thank you.

Martin Jugenburg, MD · Answer

Swelling and bruising is a common side effect of under eye injections. Swelling can last approx. 2 weeks. If you can feel the product when touching your under eye, return to the injector and have them massage the area. If at 2 weeks your problem persists, you may want to return and have it dissolved. All the Best.

Nima Shemirani, MD · Answer

Hi @Allymac4! The tear trough area is very delicate. It appears that the filler was placed too superficially. I recommend dissolving the filler with Hyaluronidase. Best of luck, Dr. Nima!

Jason Emer, MD · Answer

It looks like you have swelling from the filler and some is too superficially placed.  I would suggest getting a second opinion and having hyaluronidase injected to remove the filler and swelling.  Afterwards, another injector with more experience would be best.  Dr. Emer.

Parker A. Velargo, MD, FACS · Answer

Injecting in the tear trough area with ANY product is difficult and 
requires much skill. Most of what you are experiencing is swelling from 
the procedure itself; however, it does appear that the Restylane may have been placed too superficially.   It's always best to evaluate the results of 
fillers in the tear trough about 3-4 weeks after the treatment.   If, at that time, you still have the "ridges", you can 
ask your doctor to dissolve the Restylane with hyaluronidase, which will 
start working within hours.   After the product is dissolved, I would wait another 3-4 weeks prior to seeking additional injections.  I feel only "core" injectors should perform cosmetic injectables (facial 
plastic surgeons, plastic surgeons, dermatologists, or occuloplastic 
surgeons).  This is because we all have a keen understanding of facial 
anatomy and the effects of injecting fillers in different
 regions of the face.  Be sure you see an experienced "core" injector before getting more filler in the future.  Patience is difficult when your face is 
involved, but give it another couple weeks.  I wish you well!

F. Victor Rueckl, MD (in memoriam) · Answer

That appears to be superficial product, which has to do with technique and product placement. I would wait a full 2 weeks for all the swelling to settle, and then assess. If it is superficial product it can be removed with hyaluronidase. "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."

Ridge under eye after Restylane in tear troughs. Is this normal? Is it due to the technique? (Photo)

Answers (5)