Alexander Z. Rivkin M.D. is a Yale trained facial cosmetic surgeon and UCLA faculty member who has focused his practice exclusively on providing his patients with the latest in non-invasive, non-ablative cosmetic treatments in Southern California. He understands that no one relishes the thought of “going under the knife,” and believes modern medical technology can provide today's patients with superior alternatives to invasive, painful surgery that requires a long recovery time.

Monday, July 14, 2008

Blue under the Eye due to Juvederm? Use Enzyme!

Hello Dr. Rivkin,

I have been getting filler under my eyes to fill hollows for about two years, first restylane and most recently juvederm. About nine months ago when I went for a touch-up, I bruised quite a bit under my right eye only. Since then, I have a purplish discoloration under that eye that can be camoflauged with concealer but is still very distressing to me. Because it is dark under that eye, it still looks under certain light as if I have a hollow.

The nurse injector said that sometimes blood will get trapped inside the filler itself and that if this is the case, I would need to let the filler completely dissipate so that the the blood can be untrapped. This is not a good option to me because I don't want to have one eye with a hollow under it. Or, she said I could try a laser treatment, but she said that might cause the filler to dissolve as well.

My question is two-fold. Have you heard of blood getting trapped inside the filler? If so, would a laser treatment cause the filler to dissipate? If it does, is it immediate?

Thank you very much for your time.



hi,
you know, that's quite a long time to be walking around with a purple eye, especially since there is an enzyme that is easily obtainable that can dissolve the juvederm under your eye in less than 24 hours! if she really thinks that there is blood trapped in the filler (and there really isn't - its the filler itself that has been placed in too superficial a plane that is probably causing the discoloration - you're seeing it through the skin - its called a tyndall effect), then she should have used hyaluronidase (the enzyme) to dissolve the filler when you first noticed it.
people who are injecting filler under the eye should really not be doing so unless they are comfortable with using the enzyme - my personal pet peeve.
in any case - you should get the juvederm dissolved with enzyme from your right eye and then start over under that eye, taking care that the injector injects into a deep plane.
hope that helps

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