How to reverse dermal filler under the eyes?

Longterm filler problems include migration, edema, and nodularity. Filler migration and permanence is a very common problem because there are many different types of HA fillers on the market and each is specified for a specific part of the face. Use of highly cohesive fillers on thin skin may cause swelling and nodularity. If patients have filler migration or nodules, we recommend a combination approach of filler reversal with enzymes Hylenex and Hyaluronidase in different strengths to dissolve the filler. We may also need to add Kenalog to the mix in order to reduce fibrous tissue. If the filler does not dissolve, it either means the filler is not HA material or we need more enzyme. The HA reversal can be combined with other lasers and skin treatments at the same time, and it usually (usually) does not affect adjacent tissue.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Hi Zen. Hyaluronidase (Vitrase, etc.) works well for reversing injection treatments as long as the original product injected is made with Hyaluronic acid.  Products such as Restylane, Juvederm, Lyft, Voluma are made from Hyaluronic acid.  As long as you know that an HA product was used, the reversal should be straight forward.  To see an example of an under eye reversal, click on the link below.  

Yes hyaluronidase injections can certainly help.  Some fillers respond better than others. May require several treatments to correct.