I have a question regarding Juvaderm injectables. I had fillers put in early October, under my eyes. They looked great for 2 weeks or so and then they started to look like sacks under my eyes. I believe my doctor actually took some of hylaronic acid out or put some saline solutions in. They looked good for several weeks. For some reason I have alot of water in my face and you can see bags or sacks under my eyes. I don't know if I should just have the fillers removed or hope my face goes back to normal.
Do you have any idea why my fillers would look good for 3 mths and then all of a sudden look like tear drop sacks under my eyes? Could there be an infections in my face? Could it be that my body is rejecting the fillers?
I really loved the way my face looked for the first few months, now I hate it, I look like I have these water bags under my eyes.
What could it be?? What should I do??
Anxiously waiting your recommendation,
erin
Answer:
Dear Erin,
First off, since I have not seen or examined you, make sure you follow up closely with your doctor to make sure there is nothing acute going on.
From your story, Im not sure if you had good results for just 2 weeks or a few months. Regardless, swelling and a baggy look under the eyes from filler injections can be due to several factors. The Hyaluronic Acid fillers like Juvederm or Restylane are hydrophillic and they attract water molecules to the area. This could be what you are experiencing or at least part of it. If the injections are not done right on top of the bone and if you have thinner skin then you may notice this more. If too much injection is done then you may notice this more. Im hoping your doctor did not inject saline at the 2 week point when you went back. That could certainly make it worse. Most likely she injected the enzyme, Hyaluronidase, to dissolve some of the Juvederm Molecules. There is also a phenomenon known as the Tyndall effect which some patients can see with Juvederm. (You can google Tyndall effect and read more about it).
If the swelling and baggy look is due to any of the above issues then you can have the molecules dissolved with Hyaluronidase or better yet just wait for it to dissolve on its own if its not that bad.
Again, without seeing you and examining you I cannot give you any advice other than see your doctor or another experienced doctor and take it from there. I have seen patients come to me from other doctors in your situation who ended up doing way too much to the area to try to solve the problem. That can make things worse as well.
4.5 years ago, I had Restylane injected in the undereye/top of cheekbone hollow, and ended up with terrible results. The eye hollow skin was permanently discolored (darkened/blueish). I am still faced with that discoloration, along with an assymetrical lumpiness 4.5 years later!
I am now considering Perlane to lift up my cheeks a bit, and I watched your video on YouTube. Is it likely that I will have the same bad reaction to filler in my cheeks, or was my awful undereye experience a result of thinner skin, veins closer to the surface, or poor technique (or a combination)? Bottom line - because I had a problem with undereye injections, should I avoid injections uniformly? I have had Botox injections for a number of years with much success, but I am terrified of ending up with blue skin and moving lumps in my cheeks! Additionally, will the cheeks require as much recovery time as the undereye area? I was horribly swollen and black and blue for a good ten days, with an exceptional amount of pain and almost flu-like symptoms following the undereye Restylane procedure.
One last question- is there anything to be done about the discoloration and solid undereye lumpiness? I try to hide it with makeup...any other suggestions?
Thanks in advance for your help!
Answer:
Hi,
Sounds like you had a very rough experience with the lower eyelid tear trough Restylane injection. Your results may have been a combination of poor patient selection and poor injection technique. Patients with very thin skin in that area should avoid injections. The injections should be in small amounts directly on top of the bone and not into the muscle or fat or skin itself. There may be small bruises but considerable bruising and pain equals a rough injection technique.
Your lumpiness at 4.5 years cannot be restylane. Its most likely scar tissue or otherwise. I would suggest seeing a good Oculoplastic surgeon and seeing what he/she suggests.
The bluish discoloration may be from permanent bruise tattooing or from what is known as the Tyndall Effect which is an optical phenomenon.
Here is the midface fillers technique you referred to that my video shows:
In this technique the filler is in an area with much thicker soft tissue overlay and with the use of a safe filler and good technique, the risks of lumps and bumps and discoloration is much less than the injection under the eyelids. But again, its technique dependent.
First I want to say that I love your website! It is very informative and I appreciate the fact that you take time to answer questions online.
I am a 31 year old female who is considering using a dermal filler (juvederm or restalyne) under the eyes/ tear trough. My skin has fared well considering I work outdoors daily. While I have some sun damage(mostly on the sides of my nose) I don't have any wrinkles, at least not yet:)
Sometime around my 29th birthday I begin to notice darkness under my eyes and the line running from the inner corner of my eyes looked more defined. I have read that the under eye hollowness comes from losing volume and thinning of skin as you age. I have also read several reviews(some good and some bad) about treating the tear trough areal with a dermal filler to restore volume. The "after" photos I have seen are very impressive and seem to look very natural but the horror stories of lumps and bags forming beneath the eye have made me concerned.
My question is... Is there a particular filler that works best for this problem? Also, how do ensure I get a good result? Are Plastic Surgeons a better bet than say a dermatologist? and lastly the average price seems to be around 600-700 dollars, which while pricey would be ok if lasts the 9 months to a year that I've read but if it absorbs in 2 or 3 months it wouldn't seem worth it. Do you find the tear trough injections last that long or are worth the money?
I guess that turned out to be more like 4 questions! I appreciate your response to any or all as well as your time. Thanks Again!
K.
Answer:
Hi K,
Thank you for your nice comment. I try to make this as educational as possible without any sale's pitch!
Tear troughs are treated with fat injection, fillers, implants and fat transposition surgery.
Fillers work very nicely when injected properly by experienced doctors.
Plastic Surgeons know the anatomy much better than Dermatologists but I have seen very nice and very poor results achieved by both types of doctors. I have seen nice results from nurse injectors and bad results from them. It all depends. Knowing and seeing the anatomy helps surgeons know where to inject but having patience and a good artistic sense also is key.
Juvederm and Restylane are the only 2 fillers that should be used there. Either is fine. The injection should be right on tip of the bone. Bruising may occur. The filler should last 6-12 months in that area (as opposed to the lips that last much less) and the cost of $600 is an average cost per syringe and most patients dont need more than one syringe.
Lumps and bumps should be avoidable but baggy swelling can occur in rare cases due to the hydrophillic nature of Hyaluronic Acid fillers.
Im Ali and it has been two years I'm performing lip enhancement procedures .I have done up to 200 lip augmentations with fillers and also I'm doing botox injections as well.
Actually,I'm seeking for a short term training or observation courses that I can atend and became familiar with recent changes in procedures and new methods.
It would be so kind of you telling me if there is any courses and how can I register in?
Answer:
Hello
I am not sure what courses are available in your area. The Facial Plastic Surgery Academy, the Plastic Surgery Society and the Dermatology Academy hold many yearly courses. You can do a google search for such courses.
Here are some websites where you can do a search. Good luck.
Dr. Naderi is a true Specialist Cosmetic Surgeon with distinguished Facial Plastic Surgery practices in the Washington DC area dedicated to Rhinoplasty, Revision Rhinoplasty & Facial Rejuvenation using Botox and Dermal Fillers. Learn More about Dr. Naderi
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