Tear trough worse after filler with Belotero - what are my options?

Question

I had my tear troughs filled with Boltero, I feel they're even worse now, how is that possible. It's like a shelf and my dark circles look worse.

C. Blake Perry, MD · Answer

Filler in the tear trough is a difficult location and should be done by someone who fills the area often. If you are unhappy with the filler, I would recommend having your injector dissolve it. Often surgery is a better option over filler for long lasting, natural, permanent results. Best to see an eyelid expert in your area.

Jason Emer, MD · Answer

At home peels like cosmelan, enlighten and aerify along with dermarolling (MTS roller with anteage MD ampules) should be started now. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as lower eyelid blepharoplasty with or without fat pad repositioning will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers (Belotero, Juvederm Volbella​), lasers (Moxi/Halo/Fraxel/CO2​), Renuvion (J-Plasma), microneedling/PRP, stem cells and microneedling RF like Fractora PiXel8 or Morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. A surgical option to remove skin and/or fat might be the best solution long-term. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

Nelson Lee Novick, MD · Answer

An inexperienced injector, improper evaluation and too superficial placement of the filler are very often the reasons for the development of these puffy pillows. Difficult to say at this point, but it is likely that had the upper outer cheeks been revolumized first, the amount and placement of the under eye filler (if even needed at that point) would have been less and different. For now, it would be wise to discuss dissolving the filler with hyaluronidase and seeking retreatment later by an experienced, board certrified cosmetic dermatologist. Make sure to ask to see his/her personal befores and afters of under eye filler treatments before agreeing to proceed. Best of luck.

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Hi there,

Its not the filler that made it worse its the placement.  See an expert injector and have more filler and use Restylane to minimize the swelling.

Best of luck!

Robert T. Buchanan, MD (retired) · Answer

It is hard to tell from the pictures, but you appear to be relatively classic for tear trough filling the way it is usually done with a light filler like Belotero. This is because the filler is placed superficial above the orbital ligament. This caused obstruction of the lymphatics and swelling where you don't want it. Next tike see an expert for a heavy filler like Juvederm Volume or Radiesse placed below the ligament deep on the bone or muscle..

Tear trough worse after filler with Belotero - what are my options?

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