Thank you for your question.
You’ve submitted some photos and you stated in your question that you had Juvederm on
the under eye tear trough area a week prior, and you have swelling and bruising, and you’re
asking if this is normal.
Well, certainly this is a question easily answered by the doctor who performed the procedure
for you, but I’ll share with you a little bit about my perspective and take this opportunity
to maybe provide you with some additional information that may be helpful.
I’m a Board-certified cosmetic surgeon, and I am a specialist in oculofacial plastic
and reconstructive surgery, practicing in Manhattan and Long Island for over 20 years.
Cosmetic and reconstructive procedures of the eyelids and the face is something we do
everyday, and the use of fillers for the tear trough area is also something that we also
do very commonly.
It often amuses me, if you will, when patients who have fillers complain of bruising and
swelling a week after a procedure.
The reason why it’s a little ironic is that often people don’t want to have surgery
because they’re concerned about the bruising and swelling after surgery, amongst other
things.
In fact, in our practice, we have patients who we’ve done transconjunctival lower eyelid
blepharoplasty, obviously to address the puffy bags under the eyes, which people are looking
to treat non-surgically with fillers, and they can come back after a week and have almost
no bruising or no bruising at all.
So the paradox, and why I used the term “amused”, is that people will avoid surgery and get
injectables and still have bruising and swelling.
Basically, it’s important to understand, that a procedure where there’s a needle
involved is, by definition, invasive.
So it may not carry the term “surgery”, but it is something where you are getting
something done through the skin and under the skin.
Which means that, automatically, you can hit a vessel or a capillary, and you can get bruising.
No doctor is immune from that and it’s important to factor that in when you have these injectables.
Swelling can also be a significant factor, because of the trauma of doing the treatment.
The filler itself, anything in the hyaluronic acid family, will expand a little bit because
of a variety of factors, and because by nature the material is hydrophilic, which means it
likes water, it pulls water in.
It can be swollen as a part of the natural transition period after this injectable is
done.
Now, for a lot of people, less is more, and we’ll often do a little bit and see how
they do, and then add upon that later on.
We see our patients routinely after two weeks when we do an injectable treatment.
Now, with the photo you submitted, it’s difficult for me to ascertain, but it appears
that you have puffy under eye bags, which may have become accentuated from the injectable.
If you have a significant amount of fat prolapse, it might be worthwhile discussing this with
your doctor, about the possibility of undergoing a cosmetic procedure to address the fat prolapse.
As far as the bruising and swelling and the term “normal” is concerned, the answer
is yes, it is normal to have bruising and swelling a week after the procedure.
This is part of the normal healing process, and so it’s very important that you communicate
this with your doctor, and if you haven’t arranged a follow-up visit, make sure you
do that and see your doctor and show the doctor how you look.
As a physician, it is important for me to see how my patients respond to the way I do
a treatment.
A lot of times patients come to us and they state that they had a “bad experience”
with name any filler, and often they feel that the filler was not good for them.
I explain that it’s really a combination for factors.
It may be that the filler is too viscous, too thin, whatever it is, but it’s also
a lot to do with technique, and style, and artistry, and approach to doing this.
I always tell my patients that I approach fillers the way I approach surgery—we take
our time, we have a real process, we do it very very methodically.
It’s not like a lot of offices where the doctor will come in, see you for a second
and do a quick injection and the run out.
I think the obsessive quest for the ideal result requires time when you’re doing these
things.
But that’s a separate issue.
Again, I think it’s very important that you speak with your doctor and discuss how
you appear, and I’m sure your doctor will appreciate the feedback on how you responded,
and it will probably help the doctor make note of what your reaction was or response
was with this treatment.
The more data, the more communication, the better.
So, I hope that was helpful and I wish you the best of luck.
Thank you for your question.