I have had my tear troughs done. Is this normal? Will they improve over time? (photo)

Question

what Can I do about it x I have had my tear troughs done injector used Redensity 1 at first and then a top up 4 weeks later I wasn’t happy so he put in rendenisty 2 it’s been a week but my under eye bags look worse

Mitesh Kapadia, MD, PhD · Answer

I have no experience with redensity but this definitely does not look normal. I would recommend dissolving the filler you have now, as it is unlikely to improve much more after four weeks. Under eye filler injections are very difficult - make sure to see a doctor who is experienced in treating this area if you decide to try the procedure again. I like using Restylane and Restylane Silk under the eyes but there are other options that work well.

Vilma Di Maria, MBBS · Answer

thankyou for your question.
Swelling in tear troughs isn't that unusual.
The are multiple causes: the product was injected too superficially , too much product or its affecting lymphatic drainage. The  tear trough area is tricky and for this reason in Australia we try to treat it indirectly. 
You will need to return to you injector and have some of the product dissolved .
good luck

Chad Pfefer, MD · Answer

Hi Wissy 0580 and thanks for the question.  Many of the providers in the U.S.  don't have experience with Redensity and neither do I, but I can tell you that your results are not typical.  Tear troughs are one of the most difficult areas to inject correctly and unfortunately it's not uncommon to see either(improper technique and/or type of filler injected.  The results of which will typically give the appearance that your photos are showing.  My recommendation would be to get the filler dissolved and get a second opinion from a different provider that is properly trained/certified and with excellent reviews.

Jean M. Casello, MD · Answer

I have no experience with redensity however looking at your photos this is not the results I would expect 4 weeks after injections into this area.  Typically I do advise patients that there will be some swelling and bruising but it should be improving at this time.  My guess is that the product was injected too superficially in this area and pulled in fluid.  I would talk with your provider about having the product dissolved.

Richard Ort, MD · Answer

I would recommend that you see a different injector and consider having the filler dissolved.  Injections under the eyes should be made with a filler such as Restylane which does not swell as much and the filler should be placed below the muscle.  Injection technique is everything.Regards,Dr. Ort

Anteneh Roba, MD · Answer

No your results are not what I would expect after treatment. It is  hard to determine the exact cause, but it maybe that you had the redensity injected to superficially and since redensity contains hyaluronic among other things like antioxidants, vitamins, minerals and amino acids, it absorbs water and if the injection site is too superficial it can cause swelling that you see under your eyes. I’m not familiar with redensity which seems to be a cross between a filler and mesotherapy, I’m not sure if this out come is to be expected. You may consider hyaluronidase, for the hyaluronic component of the redensity you were injected. That might help.

Robert Whitfield, MD · Answer

No that is not a normal appearance after a tear trough injection.  The product should be injected deep to the muscle. That appearance is probably secondary to filler being to superficial.

Ramtin Massoudi, MD - Account Suspended · Answer

Hi Dear Wissy0580 from United Kingdom
Sorry to hear about the mishab 
The FDA has not approved Redensity in United States, and I never used it but what I can talk about is that why we get Tearthrough and how we can treat it.
After age of 25-30 not only we lose collagen but also we lose fat. the most common areas we lose fat is temporal area and mid face. And are skin falls like pendulum from lateral side of our face to medial side of our face as result causing the teartrough.
So what I don't do is actually I don't fil the teartrough first.
I start filling the temporal area first so I can lift the muscle in teporal area first and basically lifting everything from lateral side of the face as much as possible. then I work my way through by filling and lifting the muscle in zygomatic arch. This way I have send back the pendulum back to the lateral side.
Another important technique is that I do not fill superficially and place the filler on bone so I can lift the muscle also.
This way I have addressed the cause of the issue at source of the problem. I get very natural look.
Another procedure that like to do is Ultherapy or laser to tighten the skin and muscles around the eyes before I do fillers, so I get the best result possible.
I hope these information help you.
Sincerely,
Ramtin Massoudi, MD

Alexis Parker, MD - Account Suspended · Answer

Rendensity contains hyaluronic acid.  Hyaluronic acid is hydrophilic, "loves water, so it is holding too much water.  An injection of hyaluronidase, an enzyme that dissolves hyaluronic acid, should help.  If your injecting doctor cannot do it for you, ask for a referral to an expert familiar with this problem.  All the best to you.  Alexis Parker MD

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