Swelling at the injection site is normal in the weeks after your procedure. If there's still swelling after several weeks, notify your doctor immediately. If you experience malar edema, it's important to work with your doctor for the best treatment option. “Treatment is individualized based on the patient’s lifestyle and history, and geared towards reducing the worsening or recurrence of fluid retention,” says Dr. Parsa. “We may remove old hyaluronic acid fillers with dissolving agents, or utilize radiofrequency technology to promote lymphatic drainage, de-puffing and tightening of the skin.”
Make sure you’re getting hyaluronic acid fillers.
Most doctors use FDA-approved hyaluronic acid dermal filler for the tear trough, especially if it’s a patient’s first time. You should ask during your consultation what they will use. “The only type of filler that should be injected under the eyes is a hyaluronic-acid-based filler. Other types of fillers like poly-l-lactic acid (Sculptra) and calcium hydroxyl-apatite, or Radiesse, should never be injected in the undereye area,” registered cosmetic nurse Kristina Kitsos explains. “Hyaluronic acid is an ideal filler material because it is safe and effective and can be dissolved easily with an enzyme called hyaluronidase.”
Hyaluronic acid is popular for its ability to replicate soft-tissue texture and eliminate fine lines. Most commonly used for lip filler, it is found naturally in your body, so it dissolves gradually over time. “HA binds to water, making it an ideal product for correcting wrinkles and folds, as it binds with the skin’s own water,” explains dermatologist Sheila Farhang, MD. It generally lasts from 6 to 12 months depending on the individual and the product used.
Juvéderm comes from the Allergan Aesthetics family and has a few different variations meant to plump different areas. Juvéderm Volbella XC is the smoothest and thinnest of the family. “It is a really nice filler for very subtle hydration of the lips and is now used to soften undereye circles, which is my favorite area to use,” says Kian Karimi, MD, founder of Rejuva Medical Aesthetics.
Restylane is an HA dermal filler Galderma made to correct a wide range of concerns. It’s the second most popular HA filler on the market and has very similar uses and results to Juvéderm. According the brand, Restylane Eyelight targets the tear trough area and minimizes the appearance of dark undereye shadows.
Undereye filler can last anywhere from 6 to 18 months.
According to Kitsos, undereye filler lasts anywhere from six months to a year, or possibly even longer. “Because the area doesn’t get a lot of movement—unlike, for example, the mouth, which talks and eats and moves quite a bit—it’s one of the areas that holds on to filler the longest,” she explains. “The less movement, the longer it lasts.” But of course, everyone’s body metabolizes filler differently.
Undereye filler is reversible, but that can be a long and painful process.
While hyaluronic fillers can be reversed with hyaluronidase, Moran points out that it can be a painful process that will likely have to be performed over the course of a few sessions.
