I had Restylane injected in mid October and I have this lump and horrible discoloration under my eye. What can I do?

Question

I try to cover it with concealer and makeup but it still shows. What is causing this and what can I do?

Jason D. Bloom, MD, FACS · Answer

It looks like you have some Restylane that was too superficially injected into your tear trough area.  When this happens, it can become "balled up" as you are describing and even bluish or dark in color.The good news is that this HA filler can easily be injected with hyaluronidase and quickly break up the filler that is causing the problem.  I would speak to your injector or another injector you trust and have them dissolve this area for you.

Deborah Kessler Hudak, MD, MHA · Answer

The hyaluronic acid product injected into you clumped up in the "lumpy" area, most likely.
From your photos, I believe you would have a far more desirable outcome with SculptraAesthetic, which, done properly typically lasts more than 7 years!!
See the Youtube channel videos for allaboutaestheticspc to see examples and learn more.
I am an oculoplastics surgeon, and this is my area of expertise.

Radiance Skin Therapy - Madison · Answer

Thank you for posting the photos! It appears that the filler was placed too superficially.  There is a solution to the problem you are having. There is a product called Hylenex that can dissolve hyaluronic acid based fillers. When administered by a provider that is familiar with the product, it works well. Dissolving some of the product should take care of the discoloration and the bump. It may take a couple of treatments to get the desired outcome! I would recommend informing the provider that injected the Restylane initially.

Center for Aesthetics and Plastic Surgery - Grand Rapids · Answer

Hello there! It appears that you either have a puddle of filler in that area, that the filler is causing fluid retention in that area, and/or it was injected too superficially. These problems can be remedied by reversing the filler in this area. I would recommend consulting with your injector about this. Good luck! Sarah RN BSN

Josie L. Tenore, MD · Answer

I can appreciate how distressing this is for you. Because the skin under the eyes is very thin, the under eye area can look dark before you place filler to conceal the shadows, so I recognize that it is frustrated when you go through a procedure, only to have the same issue only potentially worse. 
The cause is the filler being place or moving such that it is too superficial. I would recommend having very small amounts of hyaluronidase [an enzyme that dissolves filler] injected into the area. If done carefully it may dissolve just the layer of filler that is too superficial, without removing all of it thus eliminating the need to be re-injected. This is my first approach when I am presented with this issue. Sometimes, I am able to get this resolved with minimal intervention.
I hope this helps!

Neda Vanden Bosch, MD · Answer

I am happy to say there is a pretty easy fix. There is an enzyme available called Hylenex that can dissolve Hyaluronic Acid in just 1 or 2 treatments. It must be administered by someone who is familiar with the product but it works great. As for the discoloration that occurs when the Hyaluronic acid is place too superficial when injected. That should resolve once the filler is dissolved. I would call the provider who injected the filler for a resolution.

Nicholas S. Karter, MD · Answer

It is hard to tell exactly from the picture, but it looks like this may be due to the Restylane being injected to superficially into the tear trough.  The skin of the lower eyelid is very thin and if filler is injected to superficially it can often time show through both as a bump and as a blue discoloration.  The discoloration is caused from the reflection of light off the superficially placed product and is called the Tyndall effect.  If superficial injection is in fact the cause of this problem then you would likely benefit from dissolving the product in the troublesome area with hyaluronidase.  I would recommend contacting your injector in sharing you concerns with them.  Again, if this is from a superficial injection then there should be a quick and easy fix.  Hope this helps, good luck!!

Pradeep Mettu, MD · Answer

Hi there. An in person assessment is needed, however, this looks like poorly placed filler. Should that be the case, it can be dissolved with hyaluronidase. See a skilled injector. Best of luck.

Davin Lim, MBBS, FACD - Account Suspended · Answer

Lump with blue hue is called Tyndall. This can occur with any HA filler including Restylane, Bolletero and the Juvederm range. Lumps can be due to superficial placement, too much filler, or combination of the two. Easy fix with HYLASE enzyme. I do believe that injectors should take ownership of their mistakes and side effects. This happens to the MOST experienced injectors- the correct thing to do is to dissolve ones own work, then re-fill. Dr Davin Lim. Brisbane. Australia

I had Restylane injected in mid October and I have this lump and horrible discoloration under my eye. What can I do?

Answers (9)

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