Treating Hollow Under Eyes: Temporary Swelling and Bruising, and Importance of Cheek Volume


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!

5 thoughts on “Treating Hollow Under Eyes: Temporary Swelling and Bruising, and Importance of Cheek Volume

  1. I wish that I lived in your area! Your work looks amazing and I love your videos! You have a fantastic way of explaining things!!!

  2. Thank you for your great video, I hope you can suggest or help me as I recently had tear trough filler (2 weeks ago, I went to a very good cosmetic surgeon in London and unfortunately during the first injection on my right eye I got a bruise and the surgeon decided not to proceed or continue any further as my under eye started to swell quite quickly and I gained a black bruise the next day. It is now 2 weeks the swelling and the bruise has gone but I am now left with a brown mark under my right eye. Not much filler was placed under this eye and the shadow doesn’t look like a bruise to me anymore. (Unless the bruise last more than 2weeks). I now have a dark shadow which looks worse than I originally started as I wanted to disguise my dark circles in the first place. Can you tell me if this shadow be permanent or will it fade and What can I do to get rid of the brown mark in the tear trough area, .Many thanks

  3. I had Restilyne about 3 weeks ago and I am going through the same thing. After the treatment I look as if I have bags under my eyes, something that it was never an issue before. I will go back to my Dr. in a few days for evaluation, hopefully he can correct the problem. That is too bad that you are not in my area and really too far away from where I live because I really like your work. Thank you for the information.

  4. hai. i am saran 22 year old. i had an microdermabration treatment. That caused bruising around my eyes. so please just tell me how to cure that naturally. ??

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