Thank you for your question!
You submitted photos with a description of having undergone Restylane injection under
your eyes and you’re concerned about swelling and bruising and irregularities.
And you had it done the day before you submitted the photos.
Well, certainly I can assist you with this question.
I’m a board certified cosmetic surgeon and fellowship trained oculofacial plastic and
reconstructive surgeon.
Rejuvenation of the eyes is a big part of my practice.
I do a lot of injectable treatments including the use of Restylane for the treatment of
under eye rejuvenation so I can certainly give you some perspective as to the areas
of concern that you have.
To begin with, although you have submitted this question, I would strongly encourage
you to speak directly to your doctor.
Your doctor is the one who performed the treatment.
Your doctor knows what went on during the treatment and should be able to answer these
questions very clearly.
Now that being said, I can tell you that there are a few things that you should be aware
of when you ask a question like this.
Number one, first question I would have is how did you like the way it looked once it
was done?
Did you feel like it looked good?
And the reason I say that is when you do any kind of filler, there is always a certain
amount of swelling that occur immediately.
There is a certain amount of swelling that occurs later.
In our practice, it is routine to see our patients two weeks after we do an injectable
anywhere on the face because it allows that much time for things to settle down.
The eyelid is a very vascular area.
It’s very easy to create a bruise.
So I would say that certainly what you show in your photos can be certainly described
as within the range of normal but you’re describing also an adjacent area which looks
hollow.
Just to give you an overview of what I look at someone’s face when they want under eye
rejuvenation, what I think of.
The reality of aging is that it doesn’t occur in isolation.
When I look at someone’s under eye concerns, I also look at it in relation to the cheek.
And by looking at the eyelid or eyelid to cheek junction and in the cheek itself, I
describe for the patient the areas that could also probably benefit with volume in addition
to the relative hollow under the eye.
It is very common for me to see people who got an injectable placed directly under the
eye and to feel like there’s a worm or a swelling that doesn’t look very good.
So they come to me to actually dissolve the material which is convenient because there’s
at least an enzyme that we use called hyaluronidase that’s able to accomplish that but I think
a lot of times, they don’t realize that if they also restore volume in the cheek that
there can be a better continuity.
You know, we do a procedure where we do structural volumizing of the cheek bones that will blend
very nicely with the under eye area.
So, it’s my philosophy to try to create a volume correction that’s more global and
helps the person look more youthful rather than chasing hollows and lines.
There’s always a role for that but that’s just one thing to maybe ask yourself.
Were you aware that the cheek looks relatively flat beforehand or do you notice that now
that there’s a volume correction and now there is contrast.
Now, as far as the most important concern when you worry about something immediately
after a procedure of excess bleeding or infection, the photos you submitted did not appear to
reflect anything like that.
So I think that, what this situation, without interfering with what your doctor is advising
you, I would say that you are probably dealing with something that may be normal for you
and will probably get better on its own.
But at the same time, your doctor may guide you to do some massage or to have you come
in to re-evaluate you.
I think that one of the traps that people fall into, and I’m not saying that this
is specific to you, is that they shop fillers.
They think that the filler under eye is a generic procedure.
I promise you, it is an art.
And what I explain to my patients is developing a relationship with the doctor and having
that doctor know you and know your anatomy in a way that is more familiar with continuous
ongoing care is a lot more effective in the long run than people jumping from doctor to
another to get injectables.
I see these patients all the time and I always find out that they bounce from one place to
another.
And so, I would just advise you that if you like this doctor and you are comfortable with
this doctor, work this way through with your doctor to achieve the goals that you ultimately
want to achieve.
At this point, it’s probably best to just continue contacting your doctor.
Understand that there is some volume there from the filler.
There’s some swelling from reactive swelling.
There’s a little bit of bruise . So in summary, I would say that just to review, there is
some volume in there because of the actual filler from reactive swelling, from the bruise
and just some irregularities from all those factors overlapping.
So, the question is whether it’s normal or whether it is unusual, I think really relates
to what you look like before the procedure, what did you experience immediately after
the procedure and this ongoing relationship and communication with your doctor as to what
to do moving forward.
Twenty four hours is not a long time.
So you probably, maybe over interpreting although it’s certainly reasonable if you feel concerned
about the way your eye appears.
So I hope that was helpful, I wish you the best of luck and thank you for your question!