Thank you for your question.
You submitted your question with one photo.
And you stated in your question that you had Restylane Silk placed under your eyes to treat
wrinkles.
And you state that now there’s a hard lump and this is again 3 days after and you want
to know if this is normal.
Well, I can certainly share with you how I counsel my patients after getting fillers
in the same area as well as other areas in order to understand what the process is.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
Helping people with their under eye area is a very significant part of my practice both
using injectables as well as surgery to help people with under eye bags.
And so when it comes to this particular area, it is important to understand what the process
is when you use a hyaluronic acid filler and particularly something that’s on the thinner
side like Restylane Silk.
So to begin with, it is important that you maintain communication with your doctor.
And I can tell you that in my practice, after doing any injectable filler or even Botox®,
I routinely see my patients after two weeks.
I think it’s very important, although it is not that common for my patients to have
significant bruising, this is based on different techniques, but I would say that the timeframe
that it takes for a filler to integrate and soften, essentially stabilize, is reasonable
at about 2 weeks.
I notice that in your right eye, there appears to be a slight bruise.
Now it is difficult to say whether that bruise is contributing to any significant amount
to that feeling of hardness.
When people describe something as being a hard lump, it can simply be a reflection of
the viscosity and thickness of this material which is now a foreign material that is now
in your body that may feel like it is very hard as opposed to something that is more
of a hard rock-like feel.
Typically, a filler will feel firm but it will not feel like it’s that strong like
solid.
And generally speaking, just talking, moving and with the advice of your doctor, you can
consider massaging as well as a warm compress.
The most important thing is to ask your doctor because your doctor recalls how the procedure
was done and what they expect routinely from this type of process.
For example in our process, we routinely do fillers for the under eye area.
And when we do fillers under the eyes, I use a technique using blunt cannulas.
When I use blunt cannulas, I generally find that I can minimize the amount of bruising
as well as minimize the relative trauma to the skin because of the strategic placement
of entry points.
This way, if I get a call or my patients sends a photo that my staff asks me to review, I
know the circumstance in which that procedure was done so I can then advise them accordingly.
We do a procedure called Structural Volumizing.
Again, it’s a technique of placing a material using blunt cannulas under the muscle or between
the muscle and the bone.
Again, this is also something that we’re very familiar with and it is something that
I would know how to counsel my patients if they have any concerns in the first 48 hours
or 72 hours.
And of course, I also leave the door wide open.
I always tell my patients, even though you’re scheduled to come in at 2 weeks, you should
come in just for any question or concern where an examination probably will be more productive.
You know, when patients send you photos, photos can be somewhat challenging to interpret because
they’re two dimensional representations of a three dimensional life.
And when you also describe something through the phone or even using video conference type
of methods, once you’re actually in the presence of the doctor, the doctor can actually
examine you and say, “Okay, this feels right.
It looks right.”
It might help manage any concerns you have about what is actually going on especially
if this is the first time you’ve had a filler done or filler done in this area, it might
just be best, for peace of mind to just see your doctor in person.
So I think that’s worth considering as you learn about what to expect having the procedure
done this way by your doctor.
So I hope that was helpful, I wish you the best of luck and thank you for your question.