-When I first started getting filler about eight years ago,
I didn't really do my research.
If you go to someone who's really not as experienced,
you can get the wrong product under the eye,
and I think, really, that's what happened to me.
I didn't even know that I had filler migration.
I just thought that I just needed to get more filler.
I'm Rachel, and I'm getting my under-eye filler
dissolved today.
I started getting filler under my eyes
at the age of 23.
People would always ask me like,
"Rachel, did you sleep well? Are you okay?"
I decided to finally just do something about it
to feel more confident.
I was actually really happy,
and it was something that I was maintaining.
But in the last few years, every time that I would do it,
my under eyes would actually start to look worse,
that the bag would appear bigger.
It's very purple.
It's actually because the filler's migrating.
So today I'm here to dissolve my under-eye filler.
-I'm Dr. Kay Durairaj.
I'm a facial plastic surgeon in Los Angeles, California.
My practice is Beauty By Dr. Kay,
and I specialize in artistic treatment of faces.
If you've had a dry filler
and you can see a blue discoloration under the eye,
kind of like a venous lake, that is called the Tyndall effect.
So if you can see your filler
and you look more tired and more blue,
you should probably get it fixed.
Rachel, it's so nice to see you again in the office.
We had talked before that you felt puffy,
swollen, and noticed that your old filler
was looking really prominent under your eyes.
The types of filler that you had in here were gel fillers.
One of them is very hydrophilic.
It sucks a lot of water content into the tissues,
and that can create this long-term swelling issue.
That filler should be adjusted and softened or dissolved.
We're going to start with
just something to make you more comfortable.
This is a topical numbing cream.
It's a triple antibiotic.
And the injection stings a little,
so this just numbs the skin surface.
It also has the benefit of making things
look a little juicy, swell-y,
and it makes that little area that we have to treat.
It protrudes, and I can see it just right.
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As part of my preparation, I will palpate and outline
the area where the filler feels like it's conglomerated.
And now we are going to give you the Hylenex shot,
and this is just, like, a little miracle
'cause really instantaneously you can start to see
the dissolver working.
We will draw up and inject the hyaluronidase very carefully,
with attention to avoiding
the vascular and neurologic structures under the eyes
and with care taken to avoid bruising as much as possible.
This can be somewhat stingy for the patient,
so we treat the patient very quickly.
Stinging subsides within a minute.
Hyaluronidases are enzyme
that dissolves the filler virtually instantaneously.
It's very fast-acting.
Fifty percent of the product is dissolved instantly,
and the half life of the enzyme is two minutes,
so it works super fast.
The remaining of the dissolving process occurs
gradually over two weeks.
When we dissolve the filler and take the filler out,
it's going to alleviate so many problems.
It takes away blue discoloration,
it takes away puffiness and bulging.
It leaves you with a mild hollowing
when the filler is adjusted, but we can fix that later.
All right, you can see that, already,
it's looking improved.
-Oh, yeah. Amazing.
I'm shocked that this is the result now.
I can't imagine what it's going to be like in a couple weeks.
-In 24 hours, it'll start to look even better.
You're going to do lymphatic massage,
where you start in the middle and milk swelling out,
morning and night.
You can use my really awesome eye cream for that.
At two to three weeks, we'll see you back.
-I'm really happy. Thank you.
I feel so much better.
I already see a big improvement,
and it's only been like 20 minutes,
so I'm really eager to see what it's going to look like
when it's fully dissolved in a couple weeks.
I really wasn't sure how I was going to look after
because I didn't know how much of the puffiness
was actually the anatomy of my eye
and how much of it was the migrated filler.
So I'm actually really happy that the majority of it,
I believe, was the filler,
because this eye, without the bruising, looks pretty flat.
-It's so important to do your research
when you are looking for someone to work on your tear troughs.
Please realize that, currently,
there are no FDA-approved products
for use in the tear trough area.
So all of us have been placing filler in under eyes
because of our experience.
And if we have years of clinical experience,
we can place it with accuracy, precision, and safety.
And for people who are seeing someone
who's an inexperienced injector, who really is just dabbling
and doesn't do this on a regular basis,
you can expect to have problems, and you need to be so careful.
This is your eyesight.
-I have no makeup on under my eyes.
I removed my concealer.
And I have a little bit of bruising on this eye,
which is totally normal, so I'm not worried about it.
Going forward, I think I'm going to do a little bit more research
on, you know, the product that I want to use.
And, of course, I would recommend using a doctor
that you really trust, who's super knowledgeable.
Just do your research and be safe.
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