Removal of Belotero 3 Years Post Injection - Can this be dissolved or should I consider surgical removal?

Question

I had Belotero injected in my tear troughs in August 2019 at a reputable plastic surgeons office. Unfortunately, it immediately resulted in a festoon like appearance under both eyes. I have had two injections of Hylenex and one of Vitrase to both eyes. The right eye is close to normal now. The left eye continues to have a bubble under the eye which goes up and down but never quite disappears. Do I need surgery to remove at this point or can it still be dissolved at this late date?

Ali Ghafouri, MD · Answer

If you have not gotten full results after the Hylenex injections, I would recommend Morpheus8. Morpheus8 is very effective for resolving festoons and reducing unwanted filler in the tear trough. It is a good idea to treat both eyes even though you feel the issue is resolved in the right eye. On a positive note, you will get additional benefits from Morpheus8 besides correcting the unwanted filler.

Nelson Lee Novick, MD · Answer

The history and appearance of the up and down, difficult-to-treat infraorbital swelling described here is consistent with under-eye puffy pillow, or lymphedema (lymphatic obstruction) that may follow filler injections in the tear trough region.  In my experience, this complication, which may persist for year following treatment, is difficult to treat and is seldom responsive to hyaluronidase alone. I have had success treating this unhappy complication using an algorithm of varying combinations, concentrations and amounts of anti-inflammatory agents in combination with hyaluronidase. Unfortunately, surgery has not been reported to be satisfactorily successful in dealing with this issue. You would be wise to consult an experienced, board certified cosmetic dermatologist. Best of luck.

Removal of Belotero 3 Years Post Injection - Can this be dissolved or should I consider surgical removal?

Answers (2)