Puffiness under Eyes after Belotero. Will it go away? (Photo)

I just had belotero for under eye bags and wrinkles yesterday. One side is bruised but the other side is Puffy in a half moon shape. Does this look normal? Will the puffy go away?

Doctor Answers 4

Undereye swelling after Beletero should not be a problem

This is "normal" in that it can happen, and it does improve. You might massage the area gently and slowly in a and continuous outward motion from the skin next to your right side of your nose to the right side of your face, making sure to apply something slippery first like Aquaphor, to push some of the accumulated fluid out of the area. You should try to drink lots of water and reduce salt in your diet. Elevate your head with pillows and lie on your left side or back when sleeping. Applying cold compresses and a properly formulated green tea cream such as Replenix (a substitute is a moistened tea bag that has been frozen) can help a lot.  If you squint your eyes tightly shut repeatedly, the periorbital sling of muscle around the eye will squeeze away some of the accumulated fluid.

I have good success in avoiding this problem by performing a "snap test" before injecting under the eyes, and being cautious about injecting anyone with a history of puffy eyes in the morning that improves during the day, or a history of lower eyelid surgery. These patients can have compromised lymphatic drainage from their lower eyelids, making it difficult to eliminate the fluid that is attracted to some types of fillers. I also limit the amount of filler I inject in this area in one session, very rarely exceeding one syringe.  Beletero is the least likely to attract water of all the hyaluronic fillers used in this area.

New York Dermatologist
5.0 out of 5 stars 8 reviews

Cautious waiting

Swelling to the under high areas after any type of filler is a common issue to have. The swelling will always be more pronounced in the first week following the injection. However, the swelling will sometimes remain based on the location the filler was placed, or the individual to receive the injection. Cold compresses, gentle massage, and patience, are all part of managing this complication when it occurs. If the swelling persists however, dissolving the filler with hyaluronidase may be the best option. After one week to two weeks of observation, it is a good time to have a discussion with your provider.

Jeffrey M. Joseph, MD
Newport Beach Oculoplastic Surgeon
5.0 out of 5 stars 14 reviews



Luis H. Macias, MD, FACS
Los Angeles Plastic Surgeon
4.9 out of 5 stars 58 reviews

Side Effects from Belotero

Belotero or any under eye injection with filler can give you bruising or swelling.  Since it has only been five days I would wait up to two weeks.  If after two weeks you are still swollen I would return to your treating physician for evaluation.  It is always important to find a board certified dermatologist with a great deal of experience with cosmetic dermatology and injections for the best results.

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 76 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.