Bellafill under and around eyes, 48 hours later, swelling has gotten worse. Is this normal? (photos)

Question

This was done 44 hours ago. The under eye swelling has gotten worse not better since procedure. Bruising is worse. I feel botched. And was initially told swelling was minimal and would be gone by now. I start a new job in 4 days!

Raffy Karamanoukian, MD, FACS · Answer

Filler migration and granuloma formation can cause longterm problems with Bellafill and Artefill fillers. This is similar in patients who have Artecoll and PMMA fillers. Longterm filler complications include migration, edema, chronic swelling, and nodularity. If patients have filler migration or nodules, we recommend a combination approach of filler reversal with enzymes, corticosteroids, and scar tissue modulators. Our HIDEF approach can break down filler scarring and granulomas so that they are less apparent. If the filler material itself does not dissolve, it either means the filler is likely not HA material or is unresponsive to conservative therapy. This technique may be followed by surgical removal of the filler if there is a suitable target for removal and the chance of scarring is low.

Surgical removal of Bellafill is possible and we have a wide ranging experience with the treatment. Some areas of the face can be treated because the Bellafill removal scars are barely visible. We have found that Bellafill nodules, if palpated, can be removed from the tissue. Undereye Bellafill, nasolabial fold Bellafill, and lip filler can be treated successfully. Diffuse Bellafill is difficult to treat.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Surgical removal of Bellafill is possible and we have a wide ranging experience with the treatment. Some areas of the face can be treated because the Bellafill removal scars are barely visible. We have found that Bellafill nodules, if palpated, can be removed from the tissue. Undereye Bellafill, nasolabial fold Bellafill, and lip filler can be treated successfully. Diffuse Bellafill is difficult to treat.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Farah Naz Khan, MD · Answer

Yes, swelling tends to get worse post procedure day 2-3. In fact, my own nurse experienced swelling 2 weeks after bellafill injection to the undereye area. The swelling resolves with time (it took 2 weeks for my nurse's swelling to resolve). However, if you are really worried, you can see your doctor and ask about a steroid dose pack to quickly help reduce the swelling. Good luck!

Philip Solomon, MD, FRCS · Answer

Hello, thank you for your question and pictures. Bruising and swelling is normal after filler injections. The tear trough area is particularly worse for this. Can last up to 2 weeks. You can try applying cold packs, sleeping with your head elevated and take an anti-histamine. Always best to follow up with your injector for an in person assessment. Hope it resolves soon for you. Dr. Solomon

Elham Jafari, MD · Answer

Hi and thank you for your question! Swelling is very common following any filler injections, particularly in under the eyes area and it can take up to 2 weeks for the swelling to fully go away. On another note, while Bellafill is an excellent filler, for future treatments I highly recommend that you use hyaluronic acid fillers such as Belotero, Restylane or Volbella for around the eyes and leave Bellafill for other areas such as around the mouth. I hope it helps and good luck!

Jason Emer, MD · Answer

Yes, there can be swelling for 1-2 weeks after injections. Icing, arnica, venus legacy and thermage treatments can give improvement. See an expert. Best, Dr. Emer

Steven F. Weiner, MD · Answer

The swelling is fairly significant and is not normal in my experience. It is important to know what you looked like immediately after the injections. If things looked great afterwards, I would treat you with a short course ofsteroids, maybe even a shot. If your were "swollen" immediately, it is possible too much filler was placed. Also, did you get a skin test prior to treatment? Even if you had a negative test (after 3-4 weeks), it is still possible to be allergic to the collagen in the Bellafill. If this is the case, prolonged steroids - 4-6 weeks will be needed. To see if allergic, I would place a skin test on your forearm and see if you react to it. It should be rather immediate in your case, within a day or 2.

Raja Mohan, MD · Answer

Swelling and bruising is common after treatment with injectable fillers. I would recommend that you follow up with your injector to evaluate the area of concern. You can try ice packs or over the counter anti-histamines. Sometimes, prescriptions medicines are prescribed to help with swelling. Keep in mind that Bellafill is marketed as a semi-permanent filler, and it is not reversible. Hope you get better.

Roby F. Hayes, MD · Answer

Swelling and bruising are very common after injection of any fillers, especially in the tear trough and periorbital areas. It's usually most pronounced in the first 2-3 days, but may last for 2-3 weeks. Ice packs and head elevation may help reduce the swelling.

Annika Crosby, MD · Answer

Hello! Swelling and bruising around the eyes is very common after any filler injection. I would suggest trying cold packs and even some benadryl at bedtime to see if the swelling goes down, though it could take 2-3 weeks for symptoms to completely resolve. I would also suggest a follow up appointment with your injector to troubleshoot and discuss your treatment plan. Though Bellafill is one of my favorite products, I would recommend a different filler around the eyes going forward. The hyaluronic acid products are frequently used in this area with good success. I hope your symptoms are better soon!

Christine Gosch, MD · Answer

Thank you for you question.  It is very typical for there to be significant swelling and bruising after tear trough injection with fillers.  This is a very fragile area that responds with an inflammatory type reaction.  It is helpful to use ice packs, keep your head elevated and pepcid also can help with the swelling.  Arnica may help with the bruising.  The bruising and swelling may last up to 2 weeks.   Hope this helps.
Dr. Gosch

Bellafill under and around eyes, 48 hours later, swelling has gotten worse. Is this normal? (photos)

Answers (12)

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