Under Eye Bags After Restylane and Radiesse

I had Restylane under my eyes and some Radiesse on the cheeks. It looked great for the first few days, then I have these bags under the bags I had. I went to doctor, and he said it was normal, and believes it will go down. He also said that I will possibly need more filler in my cheeks. I am so depressed now, and I feel like I look worse then I did. Should I wait for 2 weeks to see what happens, or is there anything else I can do?

Doctor Answers 5

Fillers and swelling

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Swelling after a filler is normal.  Give it about a week is should get better if not go back to your doctor to be evaluated.

New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Filler ups and downs

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KelKel ,

Sorry to hear about your experience.  Restylane is a "forgiving" filler.  Radiesse is not.  Lumps and bumps can be massaged to resolution with Restylane, but not with Radiesse.  Additionally, Restylane can be removed if your are very unhappy with it.  Radiesse is very difficult to remove.  In your case, time is your friend.  Some swelling is normal.  If it does not resolve with time, then you can seek removal or further augmentation, depending on the outcome. 

Jason Hess, MD
San Diego Plastic Surgeon

Bags under the eyes after Restylane and Radiesse

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Restylane is a very popular and effective hyaluronic acid-base dermal filler. It has been used widely throughout the face for the correction of deep lines and wrinkles. The trickiest area to inject in the face is the area under the eyes, because this area has very thin skin, which can make lumps obvious, and a high concentration of blood vessels, which can create long-term bruising. If you continue to have bumps under the eyes after this injection, you may benefit from the injection of a small amount of enzyme to help melt some of the Restylane. Be sure that you're working with a board-certified plastic surgeon was a great deal of experience in facial rejuvenation, blepharoplasty, and using fillers as this is a powerful medication that can affect the surrounding tissue, if used inappropriately.

Factors of Under Eye Bags after Restylane

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Although residual swelling/bruising is not unusual with the procedure that you describe, it may be the technique that may be in question.  Using cosmetic dermal fillers to the under eye area (aka: tear troughs) requires meticulous technique and experience.  By placing the product too superficially, the end outcome may be worse than before treatment. 

If the product, such as Restylane, is not placed under the muscle, the area under the eyes may appear bulging or swollen.  Generally, if you are experiencing post-treatment swelling, the condition should gradually, progressively resolve over the next 7 to 10 days.  If it isn't resolving within a reasonable amount of time, it is most likely the technique.  Regardless, always address any questions or concerns with your practitioner.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Definitely more time to heal after Restylane and Radiesse

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Hi KelKel

Let me put my bias out immediately. I am not a fan of Radiesse. I think it can be safely used in the face and it has become very inexpensive relative to the hyaluronic fillers. Hopefully, doctors who use this product are passing along the savings to you as the end consumer.

However, I lost my interest in this product when Perlane was approved for the United States market. The reason for this is simple. Perlane very much does the same kind of filling that Radiesse is used for. It is much more expensive but it has an unbeatable advantage over Radiesse, which is that unlike Radiesse, Perlane® can be erased if necessary for any reason with the enzyme Hyaluronidase. Radiesse can not be adjusted if an issue (lump or bump) develops some time after treatment.

So lets talk about your situation. First, filling the under eye circle, especially when there is a lower eyelid bag, is much more art than science. Of course, one absolutely needs to know their eyelid anatomy inside and out, literally. However, where and how to fill and float material to fill the circle requires a physician who is artistic.

Now with regard to swelling, I tell my patients that they should think of this procedure as surgery in a syringe. The results, particularly when one or more syringe of filler is needed under the eyes, are not instantaneous. There is swelling. For small treatments, the swelling might be pretty acceptable in two days. For large treatments, it can easily take a couple of weeks for everything to sock in.

If you bruise and it is very easy to bruise someone with this type of treatment, swelling will not even begin to get better until the bruise clears. For reference, a bad black eye, aka shiner, can take three weeks or more to fully clear. Naturally, people will assume you were the victim of domestic violence (a real conversation starter when you go to pick up your child at preschool).

Yes, you need to give yourself a little more time. Your doctor should have a good sense of when you are ready to have your filler adjusted if this becomes necessary. If you don't settle down and the problem is from the Radiesse, then you will not be a happy camper. If the problem is from Restylane, as I indicated, this material can be erased as needed to reduce any overfill that is contributing to the unwanted fullness.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 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.