Discoloration Under the Eyes After Juvederm
Hi,
I had juvederm in sept07 for some dark circles. Dr. told me to fill the hollow and it would get rid of the shadow. One month later there was an imperfection on one undeye(dent) so she talked me into filling it with restalyne. She hit a blood vessel on the l eye and I had a black eye for 5 wks. When it cleared, there was still a very dark mark where the black yey had been It did not get lighter and she said it was a hemosidirin stain and lets try to laser it. She laser it 2x and it helped lighten the bottom but there is still a discoloration I never had before. The other eye strated to get a discoloration under it also. It became worse than the other side. It looks like 2 dark lines that where drawn from my eye to the side ofthe nose. They are MUCH more noticable than any dark circles I used to worry about. They are VERY distinct in photos and I look like an exhausted mug shot. I reviewed all my photos prior to the injections and you cannot see any darkness or distortions under my eye. I guess the dark circles bothered me in the mirror but they were nothing compared to what I am dealing with now. I look terrible in photos and it is quite noticable in person. There is a slight bump on the right side but I can live with bumps. Its the discoloration (darkbrownish) that has me terrified. I am afraid I ruined my face. All over a little dark circles. I would give anything to have my face back. Any ideas? The 2 syringes of juv were 9/07 and the resty on top of it was 11/07.
Thank you for your help!
hi
sorry - i was on vacation
the discoloration that you are describing is a rare but really disturbing side effect of injecting restylane or juvederm under the eyes. i'm not sure why it happens - probably the filler becomes visible through the skin (it is clear, but looks blue under the skin). did your doctor inject deep, next to the bone? if she injected too superficially, it is possible that the filler becomes visible like this.
the filler is still there, so i would dissolve it with hyaluronidase enzyme if i were you. if your doctor is injecting under the eyes, she should be familiar with the enzyme. it will remove the filler and your eyes should go back to normal.
cheers
posted by Dr. Alexander Rivkin at
1:33 AM
23 Comments:
From on the ground experience (I'm not doctor; just an experienced patient!) I have to say I disagree somewhat with Dr. Rivkin's analysis here. I had exactly the same thing happen to me: Had Restylane injections under eye about 10 months ago. Doctor hit vein(s) and I ended up with two horrible black eyes for about 10 days. After black eyes resolved, I was left with a darkish, brownish "stain" under each eye. Several docs concurred that this was not Restylane peeking through, rather the stains were hemosederin -- essentially iron deposits left over from the bleeding.
Hemosederin stains are deep under the dermis. Most people think cannot be adequately reached with most lasers.
It has been 10 months for me now, and most of the staining seems to have disappeared. (The process has been slow; it has taken almost a year.
In an admittedly bold move, I actually had another practitioner inject Juvederm under my eyes again yesterday! Having done about 500 of these types of under-eye injections, she inspired great confidence (unlike the plastic surgeon who did my eyes before). Lo and behold, this second time around has been great. No bruising whatsover. The hollowness under my eyes is filled in quite nicely.
September 27, 2008 at 10:53 AM
you are absolutley right - this is the other possible scenario and i should have mentioned it. hemosiderin deposition after bruising is a definite possibility. it is fairly rare, though.
most of the cases that sound like this are tyndall effect - i would have to see the situation to know for sure one way or another.
the other point is that, yes, there's not much that can be done for hemosiderin. it gets better over time, but its slow and one just has to wait.
this is why i am extremely careful about bruising and, fortunately, have not seen more than 1 or 2 cases in my practice.
September 27, 2008 at 3:07 PM
I have this too. Both eyes. They were injected in April. It's now January. The discoloration does not seem to be improving but rather getting worse. My new derm in La Jolla has not heard of this (she is a bit clueless). What do you suggest? Should I be worried?
Thanks in advance...
January 5, 2009 at 12:14 PM
I had juvederm filler injected under my eyes in May 2008.
I have a soft pocket under each eye now,it looks like I have bags under my eyes.
My doctor said too much was injected by his assistant, and only TIME would eventually cause the bags to disappear. He said it would be too dangerous to inject me w/something that can "eat up" the excess juvederm. His he right, and how much longer should I have to wait??? Is there anything else that can be done???
Thank you,
North Carolina
February 10, 2009 at 6:43 PM
to answer the second question first - your doctor is incorrect. the enzyme - hyaluronidase should be injected to bring down the swelling. it will bring your eyes back to normal in one day and it is not dangerous. i do it every week and the results are just fine.
discoloration is a more difficult question. you can always have the juvederm removed with enzyme and then the discoloration will disappear. i tell my patients that the bluish color can be covered up, whereas an indentation cannot, so its a good trade off.
February 10, 2009 at 7:15 PM
Dr. Rivkins:
My Ophthalmologist also stated that I have to wait at least 2 to 3 months to receive an injection of hyaluronidase - to get rid of the puffiness & lump under my right eye (which was injected with Restylane).
Is this true or should I find another Doctor?
Thank you!!!!
June 3, 2009 at 4:34 PM
hi wildflower,
i do not think that this is true. i have injected hyaluronidase to correct swelling from restylane and juvederm as early as 2 weeks after the procedure. it works just fine.
June 4, 2009 at 10:48 AM
I had a restylane injection on my forehead almost 2 months ago and I have noticed a discoloration that I would describe as a dark stain.At first it was red and quite swellen with some small dark stains.Then my doctor suggested that I should massage the area and after doing that the dark stains spread and now it's a larger stain,more full and more obvious.Is this a side effect similar to the ones caused after having restlylane under the eyes?I had restylane on the forehead twice before and none of these happened.Although the doctor insists that it has nothing to do with the resylane and it's caused by the sun ( I live in a really sunny area) I disagree because I'm always carefull with sun protection and the dark stains appeared after the injection follwing the shape of the swelling.The discoloration is getting worse and I would really appreciate your advise. Thanks in advance.
June 5, 2009 at 10:14 AM
hi
it sounds like you experienced bruising followed by deposition of pigment in the area of the bruise. its called a hemosiderin deposit. sometimes this resolves by itself with time, but it sounds like it is not getting better. lasers or peels can help, depending on your skin color. we would use ipl or yag laser for lighter skin color patients or vi peel for darker colored patients.
June 5, 2009 at 11:39 AM
Thank you Doctor but I can't have any kind of peeling or laser at the moment because of a very sunny summer.I have to wait until September.Do you think the dark stain is gonna keep growing? If it resolves by itself with time that would be in weeks or months? Massaging the area makes it worse? Is there anything else I can do? Thanks for your time
June 5, 2009 at 12:14 PM
Dr. Alexander. I had Perlane injected underneath my tear troughs, and received nasty side effects. I had incredibly swollen cheeks, and hemo, (the bluish color that tends to stand out from the product), and of course the infamous lumps on both side of my cheeks. I went to my doc, and he said that I was crazy, and looked beautiful, but I know what looks normal, and what looks like a nasty plastic surgery horror story, as was in my situation. I waited over 2 years, because I have heard that injecting hyaluronidase was dangerous, and could cause interference with our natural hyluranin, our bodies "magic glue". Since the injection seems to break down collagen tissues, it could interact in our natural production. Well, I went ahead and found a doc, who is experienced and said that i was crazy thinking that it would effect my own tissues. She said the hyluranidase acid only eats up the product, nothing more. 4 weeks later, my lumps are gone, but now I'm left with indentations, and what seems to be some pigmentation of a reddish shallow color. Like a little bit of sagginess from where the injection was placed at. What happened?
June 11, 2009 at 10:34 AM
hard to say without seeing you.
when i do hyaluronidase, i try to go really slowly. bringing people in for several sessions is better than risking reversing it too quickly and risking that the skin does not bounce back.
it sounds like you could benefit from restylane or juvederm in the area, just not as much as you had before. make sure that the person doing it is very experienced.
June 11, 2009 at 10:43 AM
Hi, it's me again. Referring to the injection sight of where my perlane was placed, and since it was soo bumpy and lumpy, I decided to get hyluranidase injections where the lumps and the inflamed cheekbones were at. I'm 24, and do not need more cheekbones. I just needed it under my tear troughs because of my insomnia condition, which has caused me to have really bad darkness under my eyes, but the perlane was horrible; leaving me worse off than i was before. It was soo embarrassing. My doctor placed the hyluranidase acid where the problematic areas were at, the lumps are gone, and the cheekbones have gone down a bit, but another situation happened. I could see the place where the hyluranidase was injected. My skin is indented, and have noticed that it is more transparent. I can actually see my veins under my cheeks in that area. It is scaring me a bit, because my doc said that it should not effect my natural hyluranin production, and that it would only eat up my perlane injection, but I don't see that here. I actually do think it is effecting my natural production of hyluranin production, which is our natural "magic glue" that connects the rest of our tissues and collagen together. I didn't seem to have an allergic reaction to it, she tested it on my forearm, and everything was fine. Is this just a phase and a process that the hyluranidase is going through, or is this permanent? I don't know what to do. i'm scared.
June 11, 2009 at 11:51 AM
Hi, Dr. I'm writing from Mexico, I had teartrough restylane injections. As far as the volume i'm very pleased, but I also ended up having horrible dark marks under the eye exactly where the product was injected, as if they were really bad dark circles, so, my question is that if I decide to get the enzyme to dissolve it, the stains will go away immediately at the same time that the products is being dissolved?
Look forward for your answer :)
Thanks in advance
June 11, 2009 at 8:21 PM
Hello Dr. Rivkin,
I had Juvederm for my undereye hollowness in Dec 2008. I had a fairly good result on my left side - no bluing but was left with a faint yellowish fluorescence toward the inner corner of both my eyes. My right side has a more perceptible blue-green cast, although it can be easily covered my makeup. In addition, I also ended up with a slight malar bagging in the same general area which I've never had before. In a few months, I will be due for a "refill" but I'd like do a thorough research about proper procedure or technique so I can ask the right questions of my prospective injector. From your experience in using fillers in the tear trough area, can you say that the tyndall effect (and malar bags)is altogether avoidable? Can you comment on technique? Thanks for your insight!
June 13, 2009 at 10:42 PM
Dr. Rivkin;
Please help..I am desperate. Had juvedeerm 6 months ago and like the others have brown "stains" and bags under both eyes. I don't believe it is the Juv though because it is below the tear trough area that was injected; So I don't believe hyaluronaidase would benefit. I have seen 3 dr's and no one knows what it is or what to do. I have had Vitrase, Thermage and laser recommended and don't know what to do.
I am getting depressed. Please help
August 13, 2009 at 8:00 PM
Hi i had juverderm put in under my eyes to fill up the valley i had under my right eye..it has been about 3 month since the injections and i still have what looks like a terrible bruise.. from what ive read online im not sure if its a bruise or the juvederm showing..iv read other peoples stories saying that it has been between 12 and 18 months and they still have this discolaration.. if some one has experienced this and has had it dissolved my quuestion is did the discoloratiohn completley go away after the jevederm had dissolved.and how long did it take?
thanks
November 3, 2009 at 2:24 PM
Dr Rivkin,
I had Restylane injected in September of 2009 and experienced the probably Tyndall effect of blue color to my smile lines. Would having the hyaluronidase injected still help or is it a lost cause? There is no longer any product that I can feel in the tissue?
S.M. in Texas
May 26, 2010 at 11:55 AM
`Hello Dr Rivkin, i just had a quick question im 20 years old and recently got dark circles under my eyes like 2 weeks ago. I sometimes do get stress and depression, so idk if thats the reason. i was thinking about getting a Restylane injection, or using a Bleaching cream to get rid of it. What do u think about that? also i can send u a picture to ur email- if that will help? thanks alot
March 7, 2012 at 6:51 PM
I have not seen these comments, so I apologize for not answering - I thought that all of this blog migrated somewhere else.
@Nick Shanes: Restylane is only if there is volume loss under the eyes. It really will not help much if it is only dark discoloration. Feel free to send me an email at arivkin@westsideaesthetics.com with pictures and I can tell you for sure.
May 24, 2012 at 4:57 PM
As long as you can see a Tyndall effect (bluish discoloration of the skin caused by a clear filler like Restylane or Juvederm being injected underneath thin skin), you can inject Hyaluronidase. It's OK if you can't feel the filler. Don't forget, that Restylane will last for years in the tear troughs. The enzyme will be effective.
May 24, 2012 at 5:00 PM
I had Restylane injected under both eyes 16 months ago after finishing chemotherapy for breast cancer, which left me with dark circles and a hollowed-out appearance. I actually had it injected on two occasions, a month apart, because I didn't feel like the first round made much of a difference. They used one syringe total on each eye. Within a few months, I did not like the way I looked in photos. I did not look like myself. I decided I'd just let it 'wear off'. Well, here we are 16 months later and it has 'worn off' to the point where I have some pretty noticable pouches (bags) under both eyes that I did not have prior to treatment. Is it too late to try the hyaluronidase to get rid of the pouches?
February 15, 2014 at 2:20 AM
Hi andi,
its not too late, but go to an experienced injector. the person should know how to use hyaluronidase.
good luck!
February 17, 2014 at 2:36 PM
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