Is this the start of hemosiderin staining 2 years later? (Photos)

Question

Hello I had tear trough filler done almost 2 tears ago. Are these dark spots under my eyes hemosederin staining or just eye bags caused by age?

Jonathan Kulbersh, MD · Answer

This is unlikely hemosiderin staining after 2 years. Under eye bags and dark circles can be permanently corrected with surgery or temporarily camouflaged with fillers (Restylane, Belotero, Volbella).There are great non-surgical options to fill in under eye depressions and hollowness. Using dermal fillers, a liquid eye-lift can be performed. A dermal filler such as Restylane would be placed in the cheek and tear trough to hide the depression or bag underneath your eye. 
Surgery would require a fat-repositioning lower lid blepharoplasty. In this surgical procedure, fat from the eye area is moved into the tear trough depression filling the actual depression. 
I hope this helps!

Nima Shemirani, MD · Answer

Hi @melissa809,  After 2 years, hemosiderin staining is unlikely. The darkening is likely from the swelling of the fat in your lower eyelid. I recommend an in-person consultation with a facial plastic surgeon. Best of luck to you, Dr. Nima!

Jason Emer, MD · Answer

After 2 years, this is unlikely hemosiderin staining. Keep in mind, a combination approach will give the most improvement for under the eyes. Fillers, lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer

Mitesh Kapadia, MD, PhD · Answer

Hemosiderin staining is prolonged darkening of the skin after severe bruising. This would occur immediately after treatment. You either have some excess fat under your eyes or are having swelling as the under eye filler breaks down. If you didnt have the bags 2 years ago, I would recommend dissolving the existing filler and then reassessing the situation. You may need to repeat the filler or have under eye surgery. There is no way to tell if this is from the old filler without dissolving it.

Monika Soni, MD · Answer

After 2 years, this is unlikely hemosiderin staining. Keep in mind, a combination approach will give the most improvement for under the eyes. Fillers, lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals.

Mariela Lopez, MD · Answer

It is highly unlikely that the darkening in color is from filler injected two years ago. The darkening is likely from the swelling of the fat in your lower eyelid. I would suggest getting an evaluation for filler or lower blepharoplasty, a procedure that can improve under eye circles and tighten the skin under your eyes.

Melvin Elson, MD · Answer

It is very unlikely that this is hemosiderin after 2 years and apparently no bruising before. probably you need a blepharoplasty so see a board certified oculoplastic surgeon for a consultation

Samuel Baharestani, MD, FACS · Answer

Thank you for sharing your case and photos.  It is unlikely to be hemosiderin staining so far from your treatments, but I would recommend a consultation with a board certified injector who has experience treating this area.  You may have some filler that needs to be dissolved before considering any further treatments.  Good luck!

Is this the start of hemosiderin staining 2 years later? (Photos)

Answers (8)

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