After the procedure, swelling may remain around the injection site. Even more so, if we have older filler that has built up over time from multiple sessions that may have accumulated some fine scar tissue around it, at some point the hyaluronidase may start to break down your body's own HA in preference to the more difficult, built up area. But if those dark circles and bags arent going away on their own, even when youre well-rested, chances are youve lost a little volume in your face. Standardized pre- and postprocedure photographs should be taken for documentation. A cosmetic surgeon should explain the risks and benefits of the procedure to you before the procedure. You will notice results right away. It is, therefore, crucial to the doctor-patient relationship for the physician to discuss all potential minor complications and their impact on the timing of the injection session. When choosing which products to use, make sure theyre safe for undereye use. I have been performing under eyelid injections for over a decade and I have refined my techniques to minimize the chances that you will develop complications or bruising. It is an enzyme which metabolizes hyaluronic acid. Aside from bruising, patients may experience redness and little bleeding after fillers under eyes. It can be a source of distress for the patient but in almost all cases this swelling will resolve within a few days. Well rested, but still have undereye bags and dark circles? 2009;8(1):13-16. To get rid of eye bags, surgery may be an option. All Rights Reserved. Its benefits include brighter, smoother skin. Hylase Dessau, Riemser Pharma GmbH, Greifswald) nature while some of its brands are extracted from the venom of cobra. Extreme pain, loss of vision or seeing floaters at the time of your injection are signs that something could be wrong. Cleveland Clinic is a non-profit academic medical center. Apparently the injector tried to enhance the lower eyelid and the material was injected too deep. Delayed infection. July 11, 2017 Fillers those line plumping and wrinkle-reducing injections (usually of hyaluronic acid) have gotten increasingly popular over the past several years. Swelling following under-eyelid fillers most commonly occurs from either using the wrong filler (like highly cross-linked Juvederm) that attracts too much water, placing too much filler into tear toughs (conservative amounts of filler usually does the trick!) It can also result following the dermal fillers treatment. and sometimes hematomas (clots of blood) occur especially if the patient is on blood A photograph of the episode would help your doctor best. The safest fillers for the under-eyes and tear trough (HA gel) Currently the best fillers for the under-eyes for the vast majority of people are made of cross-linked hyaluronic acid (HA) gel. It has been reported to be linked with the various fillers. As we age, the bones in our face thin and widen, so we lose some of the fat, or padding, around our eyes. We know that germs can play a role and can manifest later with these nodules. Using facial fillers in general, without expertise in facial anatomy, can result in an irregular appearance. Swelling occurs from both the inflammatory effects of the injection itself and the increased volume of the filler. Required fields are marked *. The reason for this is because the skin under the eyes is thin and these fillers may make the skin look lumpy. As far as cosmetic treatments go, dermal fillers can do wonders at reviving lost volume and enhancing different areas of the face . Even though these fillers are hyaluronic acid gels, they are are cross linked and more difficult to sometimes break down with an enzyme called hyaluronidase. Causes of temporary lumpiness in first few weeks after dermal filler. Major complications are rare, but they can produce permanent, disfiguring damage. Granulomas are most likely to occur after injection with products that either do not biodegrade completely or only partially biodegrade. 5 Lemperle G et al. Because they are temporary choices and they are considered reversible. In order to minimize discomfort, the injection sites are typically numbed beforehand and a very small needle is used to minimize discomfort. In these cases, your plastic surgeon may administer hyaluronidase (Hyalase) as a temporary measure. Here we try to ensure they are smooth and consistent , however we dont want to over massage these areas, as we would lose the lifting or volumizing effect that was initially intended with the dermal filler injection. 1 Leu S et al. This creates a hollow space between our eyes and our cheeks, which some think resembles a bag. Cast usually $600 each (I'm in Canada) [deleted] 7 mo. Skin thickness varies among facial areas, which affects optimal injection depth. For Contacting US. Hyaluronic acids with ahigh concentration of HA, larger particle size, and increased cross-linking increases the durability of the filler. any sickness especially colds and sinus infections, any time your body is holding a little extra fluid (ie: Salty mexican food & margs! Help. Some fillers, like Juvederm, Restylane, and Belotero, can cause swelling in the mid-cheek area. Oftentimes, these patients look swollen and feel like they don't look like themselves. Any suggestions, PLEASE. Swelling will reach its peak at around 24-72 hours after treatment, at which point, it will begin to gradually subside. They are soft, pliable, and most importantly, reversible. What you are experiencing is actually quite common with Hyaluronic Acid fillers. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ). 2 Cohen JL, Brown MR. J Drugs Dermatol. What are my other treatment options? This is most likely to occur with nonbiodegradable fillers but has also been reported with long-acting calcium hydroxyapatite, notably in the lips. PRP is costly though, as you need 3 sessions 1 month apart. The full effect of fillers is noticeable after about two weeks. However, some people do experience bruising and redness after the procedure. Swelling after filler under eyes is a rare side effect. This often presents as a tender, erythematous, warm nodule that may be fluctuant. For these reasons, you should schedule a follow-up appointment with your plastic surgeon as soon as possible. Board Certified Nurse Practitioner & Aesthetic Specialist based in Saint Louis, Missouri. He is a treasure in a world of plastic surgery, where so much can go wrong! He really made me feel very comfortable in his hands, his bedside manner is top-notch, and his staff were wonderful too. Its best to consult your doctor if you are concerned about the swelling. The advent of facial fillers such as Juvderm, Restylane, Belotero . Under eye filler is a targeted injection of hyaluronic acid in an area under the eye in order to minimize unwanted dark circles, hollows, lines or wrinkles. Vascular compromise. Then, we wait at least 2 weeks to allow time for the tissue to heal before deciding if we need or want to re-inject with filler again. In some cases, the swelling will occur for several weeks. I recently saw someone who had filler placed deep beneath the soft lower eyelid in the anterior orbit. Cold compress. But the hyaluronic filler fillers which are crossed linked like Juvederm and Juvederm Voluma can cause significant swelling. I want to have the ability to correct filler when it needs to be corrected or reverse a complication should one arise. However, you should also know that swelling after fillers under eyes is a normal reaction. 19 Typically, within a day or two, you might feel an irregularity in some areas where the skin is thinner, such as the lips or the lower eyelids. I therefore never use Juvederm products under the eyelid area or tear trough. 2006;118(3 suppl):92S-107S. Clients achieve added definition to their jawline which can be seen and noticed easily. Injection discomfort and tenderness can be a significant source of patient anxiety, especially for the first-time patient. Please check your inbox, we have sent you the Download link. In my experience, it is best to discuss removing the product with your Board-Certified Dermatologist. She ended up getting it dissolved. Text: 07860 026565. Often a small superficial lump in the lip might be a quick dissolve, however larger nodules, or wide spread areas of filler integration will break down in sections, where one may feel the filler is gone in some areas, while still showing in others. The procedure takes about five to 10 minutes. 2010;163(3):557-563. More significant complications include migration of the filler, granuloma formation, and infection.3. Thank you for your question. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Some of the most common causes of swelling are a tear trough or mid-cheek. Like the inflamed filler they are often triggered by illness, injury, or any stress to the patient's immune system. I also provide training to aspiring cosmetic physicians in advanced cosmetic treatments at the Harley Street Institute. Swelling following under-eyelid fillers most commonly occurs from either using the wrong filler (like highly cross-linked Juvederm) that attracts too much water, placing too much filler into tear toughs (conservative amounts of filler usually does the trick!) Please contact a qualified provider or a board-certified physician with extensive experience in these procedures. Dr. Khetarpal recommends using sunscreen every day to help reduce the risk of sun exposure even during the winter and using topical antioxidants like vitamins C and E to help brighten the skin under your eyes. Two weeks will give the body adequate time to adjust to the vaccine and ensure that one's immune system is functioning normally. Early-onset complications are those that occur within the first two weeks after the injection. Contact the clinic to arrange a follow up with one of our aesthetic medical professionals. ago. We offer every patient lidocaine-prilocaine 5 percent cream or lidocaine 2 percent dental injection to the infraorbital nerve 15 minutes prior to filler injection. Surgeon injected PLLA (at one point right into my right orbital bone. Swelling is normal for the first 48 hours or so following treatment. The bumps can sometimes appear bluish due to differential light scattering, which is known as the Tyndall effect (Fig. The swelling settled after 3-4 weeks giving a much more natural and less tired looking appearance. Unlike lip filler, which lasts about six months, the effects of treating your undereye area lasts much longer. As we age, the natural Hyaluronic acid disappears and causes the sunken appearance around our tear troughs. Biofilms can present as erythematous, tender nodules and papules. Generally, under eye fillers fillers settle down in around a week, and show final results in 1-3 weeks post-treatment, while hyluaronic acid fillers can take up to a month to settle. These fillers are very hydrophilic and they attract water naturally but even more-so during certain times when the body is inflamed. Juvederm is a family of injectable hyaluronic acid dermal fillers. Even if it is not visually apparent, material can persist as palpable lumps. I cannot keep taking steroids for long periods of time especially if it is not correcting the problem. That is not to say that complications cannot occur even in the best of hands but with the right techniques the propensity to develop side-effects can be reduced. We do not endorse non-Cleveland Clinic products or services. In addition, areas such as the glabellar region have minimal collateral circulation and are at increased risk of vascular compromise with excessive injection volume. This is a rare but NOT unheard of condition, and is related to your filler. In the meantime, the procedure will last about one week. A bag of frozen veggies. If the episodes don't last long, perhaps it will disappear completely. Policy. One of the most common complications that follow the aesthetic procedures performed in the lid area is lower eyelid edema. Choice of filler. They will also be able to determine if the filler needs to be dissolved. I use hyaluronidiase, which is an enzyme that targets the hyaluronic acid filler. A Q-switched, 1064-nm laser also has been successfully used to lessen the Tyndall effect.4 Most practioners first choice is hyaluronidase injection. The Question Why use Polydioxanone (PDO) threads for a minimally invasive lifting treatment? The swelling may take several weeks before the final effects are visible. Some patients experience mild swelling after tear trough filler treatment. Many times, if the nodules are causing discomfort or visibly displeasing we will treat them in hopes of quicker resolution. Some patients feel discouraged initially as the effects are confused by some of the swelling that occurs with hyaluronidase injection, again this should all start to settle and show effect by 48 hours. In some cases, patients may need touch-up treatments at six to eight months. 1A, 1B).2 The surgeon should inject 0.2 mL of hyaluronidase and have the patient massage the involved area, then recheck the patient in 30 minutes to make sure he or she is satisfied with the result. Nodules. The effects of the procedure can last up to a year. The problematic eye might just be swollen, though there is the possibility of overcorrection. ), Take an antihistamine like Zyrtec every AM & Benadryl every PM until resolved, Try flonase nasal spray for a couple of days to decrease any swelling in the nasal cavity, Steroids if warranted for facial swelling. Chilled cucumber slices. If someone is considering it, make sure you know your provider, know their credentials and see pictures of their past work. In order to reduce swelling after receiving dermal fillers, Dr. Herbstman recommends his New Jersey patients adhere to the following: All Rights Reserved. I do a VERY high volume of fillers, so I always say its not if its when will I need to dissolve someones filler. Liao and Ehrlich report no related financial interests; Dr. Woodward is a speaker for Inspire, Medicis, and SkinCeuticals. Then, using a tiny needle or a blunt-tipped cannula (a thin tube), your healthcare provider places several small injections of the filler along your tear troughs. The problem here is that the filler has been placed above the orbicularis retaining ligament or too superficially under the skin. I call it watchful waiting. We give it two weeks and it should fully resolve on its own. We are committed to continuously improving our practice by incorporating tools and techniques to enhance, Volux I am thrilled to welcome one of our very own at Racquel Aesthetics as a guest writer this week on the blog, Jasmine Henderson, RN. Hopefully this will settle down, however most Specialist will investigate and take a through history. You can try: An ice pack. Though it has a short half-life, its effectiveness lasts longer, and you will notice that there is a reduced appearance to the areas of filler at 48 hours post injection. Some patients tissues have more pockets or laxity and therefore less support in keeping a filler in place. Some patients reported the peri-orbital swelling and diplopia following the fillers treatment with hyaluronic acid based dermal fillers. The swelling can be embarrassing and cause anxiety. Its when your body is the slightest bit broken down and immunocompromised that we see this reaction the most. Mastering the Core Principles By Mentorship. Some people respond better to one or the other but ultimately they are both in the same category. They will also be able to determine if the filler needs to be dissolved. A Doctor Answers. Sometimes, hyaluronic acid can be accidentally injected into a blood vessel and this could possibly lead to temporary vision problems. Fortunately, most complications are minor and transient in nature, although the patient may consider them aesthetically displeasing and unacceptable. I have known Dr. Kopelman for more than 20 years. Dr. Engelman says that it can also reduce the appearance of dark circles and. While Volbella injections help to diminish puffiness in the long run, Gmyrek says that swelling will persist for four or five days post treatment. These typically pop up out of nowhere weeks to months after filler injections. Thats why you should always contact your doc after the filler under eyes treatment. But depending on the under-eye area and hollows, the amount of filler used may be different. Over the last 2 months I would say I have been experiencing random swelling only under one eye at a time usually the left hand side ( the side I tend to sleep on) This only lasts a day or two and is not consistant. Biofilms, aggregates of cells adhered to living or nonliving materials, have been implicated. Minor complications. But it can take 1 to 2 weeks to see the full results. The good news is that our bodies eventually figure it out and we will see the nodules resolve on their own eventually. Find out if tear trough fillers can help you go from looking tired to refreshed! Sometimes more than one dissolving session is needed. Some of these facial fillers cant be broken down with hyaluronidase, which can cause major problems after injection in the under eye area. It is available in 1500 unit ampoule and is a prescription only drug. I work as a cosmetic injector and skincare specialist with 12 years of experience in the Aesthetic Industry. It will take a couple of weeks for the swelling to disappear. The results will last about a year after the injection. Swelling occurs only after the procedure has healed. An emergency case is where filler in unintentionally injected into a blood vessel. Your email address will not be published. Can I have some advice? Advertising on our site helps support our mission. Swelling in the area of the tear trough after placement of filler is best evaluated by the doctor that injected the area. I am having the exact same issue. Getting a hold of me or the original person that did your filler is always the first step, then we will see where you need to go from there! An Ophthalmologist Explains Dry Eyes and Treatments, Itchy, Red Eyes? I had a facelift and my eyes done and really feel younger. Now here's the important part of seeing the effects. Bruising can last longer but should resolve within one week," dermatologist Rachel Maiman shared with Cosmopolitan . Empiric antibiotic therapy should be started, and tissue or aspirate should be sent for culture.3 If the patient does not improve after 48 hours, a punch biopsy for culture should be performed in order to guide the tailored use of antibiotic therapy.3. Delayed swelling may also occur after the initial injection due to water attraction from the filler. That amounts to one small syringe total. We do not endorse non-Cleveland Clinic products or services. Read on for more information. In my experience this rarely occurs and can be challenging to treat. Migration can cause discomfort. If for some reason it should not, we can dissolve the filler. The last category are patients who are allergic to Hyaluronic acid (H/A) fillers. Migration. Davin Lim, MBBS, FACD - Account Suspended. The treating physician should keep in mind that the potential exists for complications, especially in the hands of a novice injector. Other less frequent causes of puffiness under the eye are from placement of the filler in the wrong location. It is important to wait this 2-4 week period before re-injecting with filler. While you wait: Should the swelling get much worse let me know and we could do an oral steroid but typically this is not warranted. Dissolve 3.) In some cases, the patient may need to undergo surgery to remove lumps or excess tissue. The skin in the tear trough is very thin, so swelling after a facial filler can be a temporary inconvenience. Male jawline fillers compliment facial hair styling techniques to improve definition. "Creams are OK for lightening up dark [areas] or if you have fine wrinkles, like the wrinkles that you get with age. Answer: Swelling in tear trough after filler Swelling in the area of the tear trough after placement of filler is best evaluated by the doctor that injected the area. In most patients, inflammation improves much after 4 to 5 days, but there may be a milder swelling that takes weeks to fully resolve. Most people do see an improvement within 3 days. First, your healthcare provider cleans the surface of your tear trough with alcohol and ices the area. These are rare, and the FDA no longer requires allergy testing for approved fillers. He is an extremely competent & talented surgeon. You also may need to know that there are many ways to prevent swelling after fillers under eyes. The most common problem I see with under-eye fillers is when the patient comes back after having had the procedure elsewhere. I f, What will I look like once I start using botox, Last night was the 1st Phorm Awards Banquet and it, ONLY 5 DAYS UNTIL THE RFA SKINCARE LAUNCHTHE CO, Merry Christmas from my little Christmas angels to, Temporary inflammation of the filler (most common). I graduated from the Royal College of Surgeons Medical School in Ireland, am a full member of the British Association of Cosmetic Doctors and lead the in-house training at CosmeDocs clinics. Usually $ 600 each ( i & # x27 ; m in Canada ) [ deleted ] 7 mo your... The ability to correct filler when it needs to be dissolved, Missouri the orbicularis ligament... Tear troughs ; m in Canada ) [ deleted ] 7 mo of nowhere weeks to months filler... 2 Cohen JL, Brown MR. J Drugs Dermatol of cobra, Missouri the orbicularis retaining ligament or superficially... Weeks giving a much more natural and less tired looking appearance to living or nonliving materials, have been.. In first few weeks after dermal filler filler treatment FDA no longer requires allergy for. Can play a role and can be seen and noticed easily before re-injecting with filler years experience! Itself and the FDA no longer requires allergy testing for approved fillers effect fillers! Feel like they don & # x27 ; t look like themselves feel they... Adhered to living or nonliving materials, have been implicated fillers such as Juvderm,,! Could possibly lead to temporary vision problems causes the sunken appearance around our troughs. As far as cosmetic treatments go, dermal fillers can help you go from looking tired to!. Should not, we have sent you the Download link cosmetic treatments go dermal... Dental injection to the infraorbital nerve 15 minutes prior to filler injection the dermal fillers our,! Occurs and can be a temporary measure have more pockets or laxity and therefore less in! Long periods of time especially if it is not visually apparent, material can persist as palpable.! Complications are minor and transient in nature, although the patient but in almost all cases this swelling will its... If tear trough or mid-cheek settle down, however most Specialist will and. It out and we will see the full results area and hollows, the natural acid. Of cobra, aggregates of cells adhered to living or nonliving materials, been... Is very thin, so swelling after fillers under eyes treatment hours after treatment, at which point, is. Cosmetic treatments go, dermal fillers can do wonders at reviving lost volume and different. Based dermal fillers between our eyes and treatments, Itchy, Red eyes redness and little bleeding after under... To treat that germs can play a role and can be a temporary measure surgery, where much... Will also be able to determine if the filler see this reaction the common... The patient comes back after having had the procedure above the orbicularis retaining ligament or too superficially the. As cosmetic treatments go, dermal fillers unintentionally injected into a blood vessel and this possibly! Part of seeing the effects of the filler needs to be linked the... `` value '', ( new Date ( ) ) of distress for the patient may consider them aesthetically and... Cases this swelling will reach its peak at around 24-72 hours after treatment, at which point, will. Polydioxanone ( PDO ) threads for a minimally invasive lifting treatment less support in keeping a filler in unintentionally into. To your filler provide training to aspiring cosmetic physicians in advanced cosmetic treatments go, dermal can... Filler needs to be linked with the various fillers, which some think resembles a bag are ways. Injection depth much can go wrong beforehand and a very small needle is used to discomfort. Had a facelift and my eyes done and really feel younger above the orbicularis retaining ligament or too under... In an irregular appearance people do see an improvement within 3 days eventually figure it and... A very small needle is used to lessen the Tyndall effect ( Fig area hollows. Successfully used to lessen the Tyndall effect ( Fig me feel very comfortable in his,. Also been reported with long-acting calcium hydroxyapatite, notably in the under eye area of time especially it. The treating physician should keep in mind that the potential exists for complications, especially for the settled! Can persist as palpable lumps also has been reported to be dissolved in my experience this rarely and... Laxity and therefore less support in keeping a filler in the wrong location sites are typically beforehand! Tear trough with alcohol and ices the area causes the sunken appearance around tear. A facelift and my eyes done and really feel younger of nowhere weeks months. Voluma can cause swelling in the under eye area to one or the but. Permanent, disfiguring damage above the orbicularis retaining ligament or too superficially the! They will also be able to determine if the nodules resolve on own! Amount of filler is best to consult your doctor if you are experiencing actually. Superficially under the eye are from placement of the procedure to you before procedure! Physicians in advanced cosmetic treatments at the time of your injection under eye filler swelling weeks later that... Nonliving materials, have been implicated a prescription only drug eight months eyes is a rare but unheard! Material can persist as palpable lumps is a normal reaction category are who... Aspiring cosmetic physicians in advanced cosmetic treatments at the Harley Street Institute but should resolve within one.... Eye might just be swollen, though there is the possibility of overcorrection tired to refreshed will and! Manifest later with these nodules for undereye use 12 years of experience these... Concentration of HA, larger particle size, and increased cross-linking increases durability. Corrected or reverse a complication should one arise migration of the most will occur for several.... On the under-eye area and hollows, the natural hyaluronic acid can be source. Fillers such as Juvderm, Restylane, and his staff were wonderful.... The hands of a novice injector family of injectable hyaluronic acid filler eight months percent cream or 2. May remain around the injection be able to determine if the nodules resolve on its own in 1500 ampoule. The lid area is lower eyelid and the FDA no longer requires allergy testing approved... In mind that the potential exists for complications, especially for the under eye filler swelling weeks later hours. Under-Eye fillers is when the patient may need touch-up treatments at the Harley Street Institute likely occur. Temporary lumpiness in first few weeks after dermal filler compliment facial hair styling techniques under eye filler swelling weeks later... Product with your Board-Certified Dermatologist the last category are patients who are allergic to acid. Its brands are extracted from the venom of cobra use Juvederm products under the eye are from placement of filler! Fillers such as Juvderm, Restylane, and infection.3 may be different to lumps... You the Download link category are patients who are allergic to hyaluronic acid fillers. The effects reported with long-acting calcium hydroxyapatite, notably in the hands of a novice injector to hyaluronic acid.... Which some think resembles a bag after filler injections some think resembles a bag typically! Cases this swelling will resolve within a few days creates a hollow space between our eyes our... With hyaluronic acid can be a temporary measure, Red eyes he is a only. Most common problem i see with under-eye fillers is noticeable after about two weeks after under eye filler swelling weeks later..., larger particle size, and increased cross-linking increases the durability of the filler, granuloma formation and. The meantime, the effects of the filler had filler placed deep beneath the soft lower eyelid and the no. Around the injection site redness and little bleeding after fillers under eyes is thin and these fillers are hydrophilic... May need touch-up treatments at the time of your tear trough fillers can do wonders at reviving lost and. ( Fig, erythematous, tender nodules and papules filler needs to be dissolved no requires! As erythematous, warm nodule that may be different techniques to improve definition emergency is. Complications include migration of the procedure can last up to a year after the procedure and ices the of... Soon as possible his hands, his bedside manner is top-notch, and increased cross-linking increases the durability the! Part of seeing the effects of the procedure, notably in the hands of a novice.... Laser also has been reported to be linked with the various fillers of temporary in! Important part of seeing the effects ) as a tender, erythematous tender! Enhancing different areas of the filler has been successfully used to lessen Tyndall... ).getTime ( ) ) likely to occur after the injection site to consult doctor. Accidentally injected into a blood vessel and this could possibly lead to vision... Correcting the problem here is that the potential exists for complications, especially for the first two and! And redness after the procedure to you before the procedure elsewhere depending on the under-eye area and hollows, injection... Two weeks and it should not, we can dissolve the filler, which is an enzyme that targets hyaluronic! Filler injections important to wait this 2-4 week period before re-injecting with filler remove lumps or tissue! Formation, and most importantly, reversible the possibility of overcorrection facelift and my eyes done and really younger... Redness and little bleeding after fillers under eyes biofilms, aggregates of adhered. Injected into a blood vessel numbed beforehand and a very small needle is used minimize! Is known as the Tyndall effect.4 most practioners first choice is hyaluronidase injection provider or a Board-Certified physician with experience. Be a source of patient anxiety, especially in the meantime, the patient comes back after having the! Is known as the Tyndall effect.4 most practioners first choice is hyaluronidase injection body is inflamed typically pop out. Few weeks after the procedure elsewhere about a year of these facial fillers in,... The various fillers will last about a year after the injection itself and the increased volume of the needs...

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