How to Fix Severely Creased Lower Eyelids Due to Allergy to Fillers?

I had an extreme allergic reaction to a filler injected into my cheeks. (My practitioner didn't tell me he was using a counterfeit product). I ended up with a painfully swollen face for well over a year.

Thank goodness that it is over now, but I am left with a loss of volume in my cheeks and bags and creases under my eyes when I smile.

What is the best permanent solution for my eyes? Do I need to remove some of the skin or add volume? Lower Blepharoplasty, Laser resurfacing or Fat Transfer?

Doctor Answers 7

Treatment for bags under the eyelids

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As you unfortunately developed a complication from a filler, it would be helpful to know exactly what the filler was to gauge the reaction you had and determine, if possible from this information, what filler you might obtain without a similar reaction. It is impossible to evaluate the lines and bags under your eyelids from these photos. It should be felt by the examining physician. Loose skin and a retatined product would be treated by different means.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Permanent solution for bags and excess skin under the eyes

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We do not recommend fat transfers into the lower lids because they will inevitably leave irregularities in the lower lids, which will accentuate the preexisting asymmetries. In the pictures, it indeed looks like you have extra skin in the lower lids, which can be removed through a pinch technique in the lower lids. This is an incision placed at that mascara line on the outside of the eyelid. Any periorbital fat in the lower lids can be removed through a transconjunctival approach with a traditional lower blepharoplasty. The loss of volume in the cheeks can be augmented with small cheek implants.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Correction of lower eyelid skin excess.

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Yikes! What a reaction! Correction of this now stretched out skin might be possible with a "pinch and peel." Provided there's enough skin elasticity (and in youthful skin there usually is), a lower eyelid skin-pinch to remove the excess skin followed by a Jessner & TCA peel about three months later might make a nice improvement.

I'm curious what bogus filler was used, though. Incredible (and unfortunate)!

All the best,


David C. Pearson, MD
Jacksonville Facial Plastic Surgeon

Treatment of eyes

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Given your reaction to a filler, it makes it difficult to recommend any fillers for you. Your crow's feet would benefit from the use of botulinum toxin but I am not certain that you would want it injected into the lower eyelid. This would best be treated with surgery for the long term correction. You lack of lines at rest make me hesitant to recommend a peel or laser resurfacing as advised by the other surgeons.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Botox, laser, surgery, include upper lids

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This is difficult problem. Find someone with a lot of experience. Botox would help in the crows feet area, but is temporary-4 months.

I would start with laser resurfacing in an attempt to tighten the skin without pulling you eyelids down. I'm a fan of removing excess skin. This must be done very carefully by supporting the eyelid at the same time, suturing the muscle to the bone. Unfortunately you probably won't ever get your eyelids as smooth as you would like without having serious complications.

 I would also suggest trimming some skin from your upper eyelids. That would give you very attractive eyes.

E. Anthony Musarra II, MD
Atlanta Plastic Surgeon

Severe Adverse Reaction to Counterfeit Filler Product in Lower Eye Lids

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Hi Iggy,

Sorry to hear about your unfortunate experience with a counterfeit filler product under your lower eye lids. At this point I would treat you initially with CO2 laser resurfacing. If you still have redundant skin after healing from the laser treatment, I would then perform a very precise lower eye lid skin pinch procedure.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Lower eyelids

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You are not as hollow as you think. What probably will make the biggest difference is Botox for the dynamic wrinles you have when smiling. Laser resurfacing or chemical peel will also help with the static wrinkles.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.