Eye Bags After Restylane

Question

I had Restylane under my eyes. I don't know if I had too much because it created bags in that area. Is this normal? Does that mean I shouldn't have this done again or was it the quantity of the filler?

Harold J. Kaplan, MD · Answer

Having noticeable bags under the eyes after the use of cosmetic dermal fillers usually indicates a problem with technique.  Although tear trough procedures are very popular and can be very satisfying - it is also very technique dependent.  The cosmetic dermal filler (should only be hyaluronic acid) should be placed under the muscle. 
When placed too superficially, the product creates the look of bags or can lead to discoloration known as a "Tyndall" effect.  Using a conservative amount of product also will contribute to a natural appearance.  We discourage massaging this area which usually will only result in swelling and more irritaiton to the tender skin.  Using hyaluronidase to dissolve the product is safe and a viable option for many.
Please see the below link for photos and more information.

Richard J. Bruneteau, MD · Answer

Restylane is a hyaluronic acid dermal filler that’s
associated with excellent clinical results and high levels of patient
satisfaction.Restylane is very
versatile and can be used in multiple anatomic locations.When the lower eyelids are treated, it’s
important to be cautious for several reasons.In this area the anatomy is very complex and the skin is very thin.It’s
important to place Restylane below the orbicularis muscles when treating lower
eyelids.Superficial injections can be
associated with several problems.These
include lumps, bumps and bluish discoloration of the eyelid skin. In some
cases, there may be a diffuse bulge in the area of the lower eyelid from
expansion of the loose lower eyelid skin.Although
swelling is always a possibility following Restylane injections, the problem
usually resolves within two weeks of the procedure.Under these circumstances, superficial
injection of Restylane is the most likely cause of lower eyelid bags.When this scenario arises, the excess
Restylane can be dissolved by the enzyme hyaluronidase.If
you’re concerned about lower eyelid bags following Restylane injections,
consultation with a board certified specialist is appropriate.This specialist should be able to evaluate
your lower eyelid bags and formulate an appropriate treatment plan.

Michael A. Persky, MD · Answer

Hi Linda,
Your injecting physician can best answer your questions.  It is not normal to create eye bags after Restylane.  Difficult to say whether it was too much or not placed correctly.  
Without knowing what your injector did, I am unable to tell you whether you should have the treatment again, but as long as you did not have an allergic reaction to the product, you should be able to have the product properly placed.
The lower eye lid area is unforgiving and very delicate.  You should choose a physician injector who is very experienced in this area, and trained in one of the cosmetic specialties.
Good luck and be well.
Dr. P

Monika Soni, MD · Answer

Thank you for your question. It is difficult to give you advice without examining you in person or a photo. There could be many possibilities for the cause of your eye bags this includes too much product, superficial placement and swelling. I recommend having a follow up with your injector. Best of Luck!

Kenneth R. Francis, MD, FACS · Answer

Linda Marie,
The "bags" could be a result of too much product, too superficial placement of product or inflammation/swelling caused by the product or its injection.  A discussion with your injector is in order to determine whether or not you should be treated in this area in the future.  Good luck!

Bryan K. Chen, MD · Answer

You may have received too much filler material under the eyes.  To address this problem, you could have small volumes of hyaluronidase injected to the under-eye areas to dissolve some of the material.  Otherwise, although the material will eventually resolve on its own, it may take several months.
Good luck.

Brooke R. Seckel, MD, FACS (retired) · Answer

Hopefully, you just have swelling which will go away. Massage the area 3-4 times a day to speed the removal by the body.
Do not have a Hyaluronidase injection to remove filler-it can dissolve tissue and leave a depression.
The eyelid skin is so thin and delicate that fillers often leave visible lumps and other problems such as discoloration.
I do not use them here and do not recommend their use--nor do the companies that make them.
I would not do it again.
If you have dark circles, a transconjunctival arcus marginalis release and fat grafting or repositioning can give a beautiful, permanent result.

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