Voluma and Teosyal Redensity 2. Seriously considering dissolving them - My eye bags look worse than ever. (Photo)

It looks like you have significant clumping of filler near your nose. I would recommend dissolving this part of the filler with hyaluronidase as I think you will look much more natural.

Dear veronicamessi,

Thank you for your question and the images provided. The
question is a great one as you have already answered what will help you most –
facial volume restoration. This can be performed with off the shelf fillers or
with autologous fat transfer (fat from your body). The differences are
convenience (off the shelf), natural appearance (both can do this), longevity
(fat wins), and excellent changes in the overlying skin that make it more
youthful and vibrant (fat transfer does this). Unfortunately the Voluma that was placed is more of a “lifter”
than a “filler” for the region. It is hard to determine which filler is in
excess along the tear troughs, but there is excess filler in the region. I
would recommend conservative reduction in your filler.

Be healthy and be well,

James M. Ridgway, MD, FACS

I suggest you reverse the fillers.  There are some patients that can get excessive swelling.  Fraxel and Venus legacy can help improve the appearance after the fillers are dissolved.  Consider another type later with cannula.  Best, Dr. Emer.

Hi Veronica. I think the issue here is that you had too much of an inappropriate filler placed in your tear troughs. Voluma is great for the cheeks, but is too bulky a compound to place directly into the tear troughs. At this point I would go ahead and have the filler dissolved with Hyaluronidase. Best of luck.

Maybe you got too much filler injected and now that area has some water retention and swelling, there are many factors that can increase the swelling in that area, like to much salt intake, heat, hormonal changes with the menstrual cycle, sun exposure, etc. You will need to have some hyaluronidase to dissolve some of the filler to reduce the volume on that area. For that area is important to not correct it completely and to use a low hydrophilic filler like Belotero soft or Juvederm Volbella,

In looking at your pre-procedure picture I feel the concept of filling the hollow under the lower lid (often called the "tear tough") was a good plan for you. But it appears that you got too much of a good thing! First, using Voluma in that area is a poor choice because it is very dense. It is only FDA approved for the central cheek where the skin and subcutaneous tissue are thick. While virtually everyone uses these products in areas that are "off label", I wouldn't use Volume near eyelid skin or under lips for fear of noticeable lumps. Second, why did you get a second injection in that area? Was it to try to conceal visible lumps? I assume you crossed over to Canada to get the Teosyal. Your present results will probably last for at least several more months possibly longer. Voluma is promoted as lasting "up to two years". I have no experience with Teosyal. Fortunately these fillers can be reversed. You may "luck out" and get partial reduction of material to end up close to your desired result. However, you have two materials of different density and slightly different chemical composition which will probable dissolve differently so you may have to have the material totally dissolve. These materials work but you are not just buying a commodity, the experience and skill of the injector is very important to the final result. If you chose Voluma because you wanted long term results you should consider  fat transfer which will last for many years, even decades if performed properly. Please see link for examples. 

Where did you have your injections performed? To best of my knowledge, Teosyal in not FDA approved for use in United States. Also, did you have your treatments done by a board certified dermatologist, occuloplastic, facial plastic or general plastic surgeon? If not, that may be part of the problem. Tear trough injection required a great deal of experience and expertise and should only be performed by a qualified physician. I would recommend allowing the filler to resorb and not use the enzyme around the eyes as it dissolves endogenous as well as exogenous Hyaluronic acid.

Under eye filler in the tear trough area is often a difficult area to inject. It's important to see someone who has experience with this particular area. You want to see someone who injects every day and has been doing so for a long time. Skill comes with experience as the anatomy of every person is slightly different.  I started out 10+ years ago using Restylane for that area. As new products come out, I've also tried Juvederm, Belotero, Volbella and for me, I find that Restylane gives me the most predictable and consistent results. The anatomy is somewhat complicated in that it can be difficult to put the product exactly in the compartment and place where you want it. I think this comes with experience, understanding product(filler) limitations, and knowing the anatomy in detail. The eye area has several (what I call) "compartments" and if the product is not injected exactly into the particular compartment, it can create a line like appearance of the filler in that area. Some patients may not be the best candidates and it's difficult to tell from pictures, although my best guess is that you are a good candidate. It looks a bit too low, but that would have to be based on safety and your bone anatomy. I always do a test to determine if the filler can be placed on the bone and also in the depressed area. Occasionally I'll get a patient that appears as though they would be a great candidate, when in fact they are not. In that case, I will use platelet-rich-plasma. Fat transfer is also another great option(which I don't do). Looking at your pictures, I would consider dissolving the filler with hyaluronidase and exploring other options.
I hope that helps!