How to reverse dermal filler under the eyes?

Question

I had a dermal filler 3 weeks ago and it created bags under my eyes . Will hylaronidase help ? Can you recommend any other solution?

Raffy Karamanoukian, MD, FACS · Answer

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

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Harold J. Kaplan, MD · Answer

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.

Philip Solomon, MD, FRCS · Answer

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

Jason Emer, MD · Answer

Yes, this can be reversed with hyaluronidase. It may take a series of treatments. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Faiyaaz Kalimullah, MD, FAAD · Answer

Thank you for your question.  I'm sorry to hear that you are unhappy with the results of your under eye filler treatment.  Do you remember which product was injected under your eyes?  Assuming you were treated with a hyaluronic acid product (Restylane, Belotero, or Juvederm products), hyaluronidase should be able to effectively dissolve your filler.  It may take more than 1 session to fully reverse the effects of your filler, but it can be done.
That said, the under eyes are also particularly prone to swelling after filler injections.  While this swelling typically resolves within 2 weeks for most patients, I have seen a handful of patients who have experienced swelling for longer periods of time (sometimes up to 4 weeks or so).  I would recommend following-up with your injector to discuss your concerns.  Best of luck!

Robert Whitfield, MD · Answer

Yes you can have this dissolved.  I have done this for patients who have been referred or have come into the office on their own after a bad experience.

Alan M. Engler, MD, FACS (retired) · Answer

If the filler was an HA product (hyaluronic acid, such as Juvederm, Restylane, Belotero) then hyaluronidase is likely to help reverse it.  There are several different companies that manufacture the product, which is known as Vitrase or Hylenex.  There may be others also.  You should see a board-certified plastic surgeon or comparable specialist near you.  The person who injected the filler should be able to help you but if not seek a second opinion/consultation.  I hope that this helps and good luck, Dr. Alan Engler, Member of #RealSelf500

How to reverse dermal filler under the eyes?

Answers (7)

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