I had restylane injected into my tear troughs. It is 6 days since my injections. Is this normal swelling or overfill? (Photo)

Question

I looked slightly uneven directly after procedure. 3 days after, when I was very swollen I looked smooth. Now, I am uneven and have even worse circles than before. Before injections I could cover up my dark circles with concealer. Now, post injections, I can no longer do that.

James M. Ridgway, MD, FACS · Answer

Dear Rya87,The question you ask is a good one. From what I can see in
the photos, you still have soft tissue swelling. This is common when placing
filler in this area, which is notorious for its swelling and unforgiving
nature. Such risks can be reduced with the use of a cannula (not certain if
this was used or not). The product that was used is tried and true, but there
are different options today that I would advocate for one reason or another
with regard to results and longevity. I would recommend following-up with your
provider as there may be some points that are better seen in person than in
photos. Hopefully this helps to answer your question.Be healthy and be well, James M. Ridgway, MD, FACS

Daniel Levy, MD · Answer

Rya,Thanks for sharing your photos and story.  Uneven tear trough contour after Restylane can happen.  This can be due to how the injection was performed, which plane of tissue it was placed, how much post-treatment massage you had, or the overall amount amount of filler injected.  Sometimes uneven swelling happens in this area even if the injection methods and amount are perfect.   I agree with the other experts who suggested following up with your physician within 2 weeks of the treatment in order to re-assess.In your specific case, I don't feel that Restylane is the optimal treatment. In the future, you should consider other options which have less risk for bruising and swelling.Good luck!

Jason Emer, MD · Answer

I suggest waiting 2 weeks before deciding on any treatments.  A lot of swelling can occur with needle injections into the tear trough.  I would speak to your physician if you are concerned, consider cannula injections in the future to limit complications.  Best, Dr. Emer.

Chad C. Zatezalo, MD · Answer

Looks to me as though you are still swollen from the injections.  This area is sensitive to trauma and manipulation.  Be patient. You may benefit from oral steroids, ask your injector.  If this continues after a few weeks, you know you are either over filled or are having a reaction to the material.  Be patient for now...

Benjamin Barankin, MD, FRCPC · Answer

The tear trough area is notorious for having unpredictable swelling. Some people swell a bit, others a lot; as well, there may be some deep bruising in some cases. I always advise waiting 2 weeks to let things settle down. At that point, if it was overfilled, your doctor can inject you with hyaluronidase to dissolve some or all of the filler. If you had no more than 1/2 syringe per side, then I doubt you are overfilled.

Jerome Potozkin, MD · Answer

I would suggest you return to whomever performed the injections for their recommendation.  It is very difficult to assess a 3 dimensional concern with a 2 dimensional photo.  Over fill can be addressed with injecting hyaluronidase to melt the Restylane.  Swelling can take a week or two to resolve in most circumstances.

I had restylane injected into my tear troughs. It is 6 days since my injections. Is this normal swelling or overfill? (Photo)

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