I got Juvederm 19 days ago for under eye hollow treatment. I feel the DR overfilled and my eyes are swollen like pillows

I would wait 2 weeks to see the results but if you are unhappy please reverse with the enzyme and find another doctor to use small amounts using cannulas.  Best, Dr. Emer.

If you feel there's too much, you might consider asking your MD to treat the area with hyaluronidase to destroy the filler. Sometimes several injections are needed if you want complete reversal.  Be sure to discuss with your own surgeon about how this applies to you, and whether they have any special concerns in your case.

Thank you for sharing your problems and posting your photos. Restylane is the best filler for the tear troughs. Juvederm can cause a blue hue and can swell too much. You appear bruised in the lower eyelid region. Your doctor can dissolve the filler with Hyaluronidase and you can be reinjected with Resylane. Make sure you see an expert injector with experience in the eyelid region. Good luck.

Hi James,Sorry to hear about your unsatisfactory results after lower eyelid injection of Juvederm.  First of all, Juvederm is a poor choice of filler for this area because it vigorously attracts water molecules and swells after injection.  The only filler that we use under the eyes is Restylane.  You may have residual bruising with your increased darkness.  Massage will not help.  The filler needs to be dissolved.  If you do not trust you injecting physician then consult with expert physician injectors to resolve your problem.  The under eye area is a delicate and unforgiving area, only expert injectors should treat patients under the eyes.  Good luck and be well.Dr. P

You might have some swelling still present at this point but that is fairly unlikely. There is likely some overfill especially in the outer undereye area. Assuming you had hyaluronic acid filler (most likely) those areas of fullness can be flattened with hyaluronidase injections. Consult with your physician injector or seek a second opinion for this. It should be fairly straight forward to address the issues that are troubling you. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Thank you for your question and for sharing your concerns.  Juvederm is not my first choice for filling in under the eyes.  It is the most common filler that I find is used when someone comes to my office after visiting another injector who tried filling the tear trough area.  It is combination of amount of Juvederm placed as well as technique.  The other challenge is that dissolving it is also an art.  I would recommend visiting with your injector or consider going to a board certified plastic surgeon or dermatologist who has a high volume injection practice.

You should go back to see your injector.  Make sure that you are seeing an experienced and reputable doctor with a busy injectables practice.  You could consider having a small amount of hyaluronidase injected to dissolve some of the filler.  I prefer to use Restylane under the eyes since it tends to cause less swelling than Juvederm.  It is also important to inject with proper technique in the tear trough, which should primarily be a deep injection under the muscle.  You could also consider using a bleaching cream for any skin pigmentation.  You should discuss in person with your physician injector.

Thank you for your question.  Tear trough treatment is typically a combo approach as filling alone does not give adequate results.  I think as far as volume replacement goes you may be slightly overfilled but it is not out of the range of normal.  Massage is unlikely to work 19 days later.  The pigmentation seems the same as previous to me maybe just more noticeable since there are less wrinkles under your eyes.  Nevertheless, I advocate a combo approach using both the fillers you had injected, and some other technique like clear and brilliant, infini, micro needling, etc. to further improve your tear troughs.  Please follow up with your Board Certified Dermatologist for proper evaluation and management and to discuss possible dissolution with hyaluronidase vs adding another therapy.  Regards, Dr. Matt Elias

Thank you for your question. From what I understand, you had Juvederm 19 days ago to address under eye hollows. However, you’re concerned about some issues with swelling and pigmentation after the treatment, and you’d like to get some additional opinions on your situation.A little about my background — I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon, practicing in Manhattan and Long Island for over 20 years. I specialize in eyelids and in helping people strategize the best way to address their cosmetic eyelid concerns.In your case, what I see first is some puffiness under the eyes, which I think your doctor was trying to soften with the hyaluronic acid filler. Such an approach will work on a person with mild puffy eye bags, however, more prominent eye bags will look even more puffy with the addition of filler. In cases wherein the puffiness is more severe, it is strategically better to address the puffiness directly.Another thing to keep in mind is that hyaluronic acid filler is hydrophilic, which means it absorbs water. That absorption of water can lead to some unsettling fluid accumulation in some cases, but with time and absorption, it usually improves.With regard to hyperpigmentation, this is unfortunately one of the challenges of darker skin, as this type of skin can be very sensitive to any type of treatment. What I do in my practice, especially when treating the eye areas, is I combine hyaluronic acid filler with platelet-rich plasma. Platelet-rich plasma is derived from your own blood and is made up of a concentration of the wound-healing and growth factors that stimulates collagen, improves blood supply, and seems to help pigmentation under the eyes in a way that may mitigate some of the issues with reactive hyperpigmentation. Regardless, hyperpigmentation in darker skin could last a while and might be something you will need to manage conservatively in the short-term. Another approach you can look at is augmenting the cheek area or eyelid-to-cheek junction to soften the transition between the puffiness and the adjacent areas. We do this in our practice with the Y Lift®, which is a procedure that placing filler into the deeper structural levels of the face, to create an elegant lift and balance to the cheeks.Bottom line is that if the patient has prominent under eye puffiness, I won’t recommend filler, as this could only make the puffiness worse. I would rather strategize addressing the eye bags directly by means of a transconjunctival blepharoplasty, and then deal with volume correction after the surgery.I suggest that you see your doctor again and discuss these options with them. As you can see, there are many ways to approach issues like yours, and many ways to correct it. If you still feel uncomfortable about the way your doctor is going about your case, then you should probably meet with other doctors and get additional opinions. I hope that was helpful and I wish you the best of luck!This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.