I had Restylane Refyne placed in my tear troughs last week. One eye seems misplaced. (Photo)

Thank you for your question and I appreciate your concern. Even when a cannula is used in the tear trough, there is a chance of swelling after the treatment. It is possible this is what you are seeing. My recommendation is to schedule a follow-up if you hit the two-week mark and do not see any improvement, as this likely means the area was overfilled and a portion of your filler will need to be dissolved. Rest assured that this process will not cause bagging under the eyes. Always work with a very experienced, board-certified injector to ensure the best possible results from your treatments.

Undereye filler is super challenging.  The goal is to add to the area and avoid a puffy appearance.  The filler should be placed at the junction between the lower lid fat and the cheek (this typically corresponds to the orbital bone).  In your case it appears (difficult because of pics) that too much filler was placed (could be swelling).  In some cases, filler can be resorbed by the body quickly, particularly in patients with aberrant metabolic rates.  Best Dr. Anil Shah

Thank you for sharing your question and photographs.  I see your area of concern and this is either residual swelling from treatment or an over accumulation of dermal filler.  I would allow at least another week to pass, with gentle pressure applied to the area of fullness to note continued improvement.  If after this time the fullness remains, consider having the material dissolved.  Hope this helps.

Dear sadelili,
Thank you for your question. While your photographs may show that the filler may have been placed superficially in the tear trough area, it is difficult to make an accurate assessment and recommendations based on photographs alone. That is great to hear that you already have a follow-up visit in place with your provider, as I would have recommended re-evaluation by them. In the meanwhile, it does not hurt to ice or massage the area to see if the area evens out, especially if it is mainly due to post-injection swelling. The filler can be reversed without issue with hyaluronidase. Should you consider repeat filler treatments to the tear trough areas, there are good thinner filler options such as Belotero when injected conservatively that can achieve good results. 

I agree something is not quite right in the photo. However, I cannot tell exactly what the issue is by looking at your photos. I suggest you see your injector for an exam and diagnosis. Best wishes, Dr. ALDO 

I agree with you, the filler was not injected smoothly. I would dissolve. There was too much injected in one area. It should be spread out more diffusely. I am a fan of injecting above and below the muscle in some cases. I think this was above the muscle in too large a quantity. Only a small amount should be above the muscle.

Hello Sadelilli, not sure how you are doing since you last posted your question. I have seen this before when the filler is injected using a retrograde technique (when injected the needle is pushed in the filler is pushed as the needle is taken out, it usually happens as the needle is being pulled out and the filler deposits on a higher plane than the rest of it) 
I usually use a cannula or i inject deep at the level of the bone and it will softly lift the entire area. 
if you wish, you could post updated pictures, we will be happy to answer and guide you 
hope this helps 

Restylane refyne is an option for tear troughs.  It is a common off label use (ie not the FDA approved 'on label' indication) both in the USA as Restylane Refyne and abroad under its prior name Emervel Classic.  One week after treatment this could still be swelling or it could be excess product.  The great thing is that you can have is dissolved and retreated if needed (usually separated by a week).  And filler does not stretch out the skin so you are not left with any more loose skin than you had before (if any).  You can swell or bruise from any injection including hyaluronidase (the enzyme used to dissolve HA fillers like the restylane products).  So never fear -- your physician can get this better.  I hope this answer was helpful.  Best wishes.

Yes, this swelling can happen with Refine or any filler under the eye.  The great thing is this is easily treatable.  We always have patients return in 2 weeks after a undereye filler treatment for a fine tuning.  Sometimes we add little bit more and sometimes we will take down with hyaluronidase.  You should end up just fine.

Hi sadelili,We've had great experience with Restylane Refyne using both needle and cannula. From the photos, you can still be suffering from residual swelling which is unfortunate because Refyne produces the least swelling among fillers and natural-looking results.If it doesn't subside, you would need to dissolve with hyaluronidase but don't expect it to be fast or to be done in one sitting. Refyne is made using new technology - and would take a bit longer to dissolve.I don't think you will end up with baggy eyes. Relax.All the best,Justin Harper, M.D.