Restylane in tear troughs NOT dissolving years later. Any suggestions? (photos)

Restylane in the tear trough areas such as yours need to be dissolved with Vitrase.  I am sorry for your problems but I believe that your problem will be resolved.  Best, Dr. Green

Dear productjunkie27,

Thank you for your clinical post and
photograph. From the photograph it is
evident you do have a kidney bean shaped swelling in the outer aspect of your
eye which is typically not the tear trough, but may well have been injected
with Restylane at the time of your intervention. Restylane and most HAs do not last years
although there are certain reports of Restylane stimulating a host collagen
response and the swelling you experience may not be the Hyaluronic acid gel
anymore, but rather your collagenous hypertrophy around the previous location
of the product. A bluish discolouration
is generally attributed to the Tyndall effect of an HA when injected
superficial or in large quantities, however, the HA has disappeared the bluish
discolouration may be simple venous engorgement. It does appear you have other veins under the
lower lid, which may contribute to the bluish discolouration over the
swelling. At this point an aggressive
injection regime of both Hyaluronidase diluted with a mild steroid can often
reduce the swelling. Other percutaneous
techniques using small laser fibre radio frequency probe can reduce swelling
due to fibrous enlargement and camouflage techniques with other fillers can
help hide the bulge. A bulge in this
location is occasionally the upper reaches of a festoon or lymphatic collection
and there are some percutaneous thermal techniques that help eliminate this. Fibrous reactions to soft tissue
fillers that don’t resolve and that are located in this area of the orbit can
sometimes be removed as a last option through a lower lid blepharoplasty
incision.

I think you have a lot of options to
try and improve this area of aesthetic concern and visiting a very experienced
and certified plastic surgeon or facial plastic surgeon that has experience
with soft tissue fillers with the complications of soft tissue fillers and also
performs blepharoplasty and surgical procedures if necessary will give you the
full breadth of options to improve or eliminate this aesthetic concern.

I hope this information is of some
assistance and best of luck.

To find out more, please visit the
link below.

R. Stephen Mulholland, M.D.

Certified Plastic Surgeon

Yorkville, Toronto