I’m a 26 year old female, I’ve had tear trough filler over a year ago and no matter how many times I massage them they have been lumpy, and honestly it looks worse than when I didn’t have filler. Should I have them dissolved and get fat transfer instead? I’m also worried fat transfer will have the same lumpy problem.
July 19, 2022
Answer: Filler-Related Under Eye Puffy Pillows Require Intensive Intralesional Anti-Inflammatory Treatments Unfortunately, it is difficult to tell from the photos provided, but there is a good chance that the problem is one that has come to be called infraorbital (i.e. under eye) "puffy pillows." These are due to lymphedema (obstruction of the lymph drainage channels) within the delicate under eye tissues due to an improper choice of HA filler for the infraorbital and/or too superficial placement of an appropriate filler choice. Whatever the cause, this problem is notoriously difficult to treat. I have fortunately had success with individuals who have come to me with this problem using varying concentrations and combinations of intralesional anti-inflammatory agents along with hyaluronidase. I personally believe it unwise to add fat injections to the mix for a number of reasons. Fat is a permanent filler and complications from it can therefore be permanent. Fat is a two step minimally invasive, relatively expensive process that requires large bore cannulas to remove the fat from the hips, belly or buttocks and to reinject with large bore cannulas to the under eye region (this also entails real downtime). Moreover, the process that all the fat will survive is seldom realized because much of the fat separated from its original blood supply does not survive, and that which does survive retains the characteristics of the location from which it is taken--meaning that if taken from the belly and belly fat develops a midriff bulge with time, so may the belly fat injected under the eyes. You would be wise to make sure that you consult an experienced, board certified cosmetic dermatologist. Hope this helps and best of luck.
Helpful
July 19, 2022
Answer: Filler-Related Under Eye Puffy Pillows Require Intensive Intralesional Anti-Inflammatory Treatments Unfortunately, it is difficult to tell from the photos provided, but there is a good chance that the problem is one that has come to be called infraorbital (i.e. under eye) "puffy pillows." These are due to lymphedema (obstruction of the lymph drainage channels) within the delicate under eye tissues due to an improper choice of HA filler for the infraorbital and/or too superficial placement of an appropriate filler choice. Whatever the cause, this problem is notoriously difficult to treat. I have fortunately had success with individuals who have come to me with this problem using varying concentrations and combinations of intralesional anti-inflammatory agents along with hyaluronidase. I personally believe it unwise to add fat injections to the mix for a number of reasons. Fat is a permanent filler and complications from it can therefore be permanent. Fat is a two step minimally invasive, relatively expensive process that requires large bore cannulas to remove the fat from the hips, belly or buttocks and to reinject with large bore cannulas to the under eye region (this also entails real downtime). Moreover, the process that all the fat will survive is seldom realized because much of the fat separated from its original blood supply does not survive, and that which does survive retains the characteristics of the location from which it is taken--meaning that if taken from the belly and belly fat develops a midriff bulge with time, so may the belly fat injected under the eyes. You would be wise to make sure that you consult an experienced, board certified cosmetic dermatologist. Hope this helps and best of luck.
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July 19, 2022
Answer: Lumpy tear trough filler Looks like you are harboring some extra fluid which may be due to the filler having been injected too superficially or even the choice of filler that was injected. When the skin adopts that bluish color, it is called a Tyndall effect and usually due to superficial injection. Would definitely be worth dissolving if it was a hyaluronic acid filler that was originally injected. Be careful with fat transfers as those can be more difficult to correct if not done correctly in the first place. Please see an experienced oculoplastic surgeon for best results with your eyelids.
Helpful
July 19, 2022
Answer: Lumpy tear trough filler Looks like you are harboring some extra fluid which may be due to the filler having been injected too superficially or even the choice of filler that was injected. When the skin adopts that bluish color, it is called a Tyndall effect and usually due to superficial injection. Would definitely be worth dissolving if it was a hyaluronic acid filler that was originally injected. Be careful with fat transfers as those can be more difficult to correct if not done correctly in the first place. Please see an experienced oculoplastic surgeon for best results with your eyelids.
Helpful
