Dent treatment. What caused this and how can it be fixed? (Photo)

Question

I had under eye fillers that looked uneven/puffy on one side. First follow-up the DR. Pressed really hard in the area with a q-tip to breakdown the fillers. Swelling got worst. On my second follow-up, the filler was dissolved and I now have a dent. What caused this and how can it be fixed?

Jason Emer, MD · Answer

You need a full assessment. Seek a facial sculpting expert to discuss next best steps for you. -Dr. Emer

Nelson Lee Novick, MD · Answer

The possibility of post-filler obstruction to the lymphatic drainage in the under eye region is well-known, especially when inappropriately robust fillers are used and when the filler is placed too superficially in the delicate infraorbital tissue. The puffy pillow creates a "valley" beneath it, which is most often construed to be dent, when in fact it is simply the depression that appears below the lymphatic mound immediately above it. If this is indeed the case here, then hyaluronidase will often need to be combined with other injectable anti-inflammatory agents to try to shrink the depression. I have had experience treating patients who have come to me with this issue following treatment elsewhere, and in my experience several treatment sessions are typically required to achieve optimal improvement Hope this helps.

Laura Lewman, ND · Answer

The dissolving agent (hyaluronidase) breaks down the filler, but can also break down some of the hyaluronic acid that you have in your skin naturally leaving a bit of a divot. This should be temporary because your body will replace that hyaluronic acid over time. It may take months to resolve naturally. Filling this area is possible, but can be tricky, so it may be best just to leave it to resolve on its own.

Dent treatment. What caused this and how can it be fixed? (Photo)

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