Is this hemosiderin staining from under eye filler? (Photos)

Question

I had fillers 4 days ago and as you may have noticed on the left eye, it has a dark ridge that looks consistent with hemosiderin. is my presumption correct? I don’t think it has changed color since day 1. And the color of the dark circles on the right eye is the normal color of my circles, it is not a bruise. Will the staining go away if the filler will get dissolved? Also, there is a lump right above the dark ridge. I’m not sure if it is a swell since it hasn’t gone down either since day 1.

Misbah Khan MD, FAAD, FACMS · Answer

fillers under lower eyelids can be tricky. my approach is that i never fully correct on lower eyelids on day 1. sometimes excessive amount of filler can bring the natural skin discoloration to the surface and can appear as hemosiderin. please be advised that hemosiderin is a by-product of blood. and it takes approx 7 days for the excavated blood to turn into hemosiderin. if you're seeing this in like 4 days or so, I'm not sure if this is hemosiderin you're looking at.

Shaun Patel, MD · Answer

Swelling and bruising are common after undereye filler treatment especially when done using a needle rather than a microcannula. That being said, it's a little too soon to judge your results. Give the undereyes 2 weeks to settle down. If at that point you remain unhappy with your results, I would followup with your injector. The filler can be reversed if need be using hyaluronidase.

Michael H. Gold, MD · Answer

Thanks for the question and sorry that you are having these concerns after your filler injection. It is hard to know exactly what is going on – one would need to know the kind of filler that was used, one would need to compare these pictures with photos before the injections, and then to examine the area closely in person. Four days after an injection seems very early for hemosiderin to develop and it appears that some of the filler may be too superficially injected which may be causing all of the concerns.  We would recommend that you use ice and gentle massage to the area for a few days and if not better, return to your provider and have them use hyaluronidase to the area to dissolve what was injected and then to start over again – again with skilled injectors.

Justin Harper, MD - Account Suspended · Answer

Hi pillowcase22, It would have been great to see your before pictures. But yes, it does look like hemosiderin rather than the Tyndall effect. Ask your doctor if lasers like the Cutera or Lumenis would help.Think twice about having fillers dissolve if the appearance improves after lasers.All the best,Justin Harper, M.D.

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