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Discoloration Under the Eyes After Juvederm | Westside Aesthetics: Rhinoplasty Los Angeles Fraxel, LA Non-Surgical Nose Job

September 2, 2008
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
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

60 thoughts on “Discoloration Under the Eyes After Juvederm | Westside Aesthetics: Rhinoplasty Los Angeles Fraxel, LA Non-Surgical Nose Job”

  1. Anonymous says:

    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.

  2. Dr. Alexander Rivkin says:

    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.

  3. Anonymous says:

    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…

  4. Anonymous says:

    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

  5. Dr. Alexander Rivkin says:

    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.

  6. Wildflower & Free says:

    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!!!!

  7. Dr. Alexander Rivkin says:

    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.

  8. mariapsytrance says:

    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.

  9. Dr. Alexander Rivkin says:

    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.

  10. Anonymous says:

    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

  11. Anonymous says:

    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?

  12. Dr. Alexander Rivkin says:

    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.

  13. miris85 says:

    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.

  14. Anonymous says:

    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

  15. Fab40 says:

    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!

  16. Priti says:

    Hello Dr. Rivkin,
    Like many others on this site, I had juvederm injected underneath my eyes, with terrible complications. I wanted a slight correction of my hollows, and never had any under-eye discoloration (at least none that was significant) -could easily go out w/out make up. Now after the juvederm, the correction blends my eye with my cheek, it looks terribly unflattering (to me), as it flattens my cheek and overall appearance, making me look more guant, I feel. Also, I have discoloration underneath the eye, which my doctor is unsure if it is tyndall or hemosiderin deposits. I have sought out a second opinion, and there continues to be a lack of consensus. I am dark/tanned skin (of South Asian heritage), which may be why doctors are somewhat less experienced with ethnic skin.

    My questions are as follows: (1) are there definitive ways to tell between tyndall vs. prolonged bruising vs. hemosiderin staining? 2) how do I now correct my face/ the eye/cheek interface? how long will the discoloration last? 3) will this permanently damage me in the sense that I was never looking for something I wanted to “maintain,” just temporarily rejuvenate and let fade out. Will this now be something I have to permanently maintain since the skin may be stretched out or corrected more than I had ever intended?
    Thank you very much for you time.

    1. Dr. Rivkin says:

      hi priti,
      i will answer your questions first.
      1. hemosiderin comes about after a severe bruise only. if you did not have bad bruising in the areas of discoloration, it is probably tyndall effect.
      2. you need to be injected with hyaluronidase to dissolve some of the juvederm – you should do this and not wait for the juvederm to dissipate by itself because it lasts 3 years or more in the area under the eye.
      3. i do not think that this will stretch out your skin permanently – skin is very elastic.
      it would help if you sent me pictures – that way i could advise you more specifically.
      its unfortunate that this happened to you – this kind of thing does happen with juvederm in the tear trough, but, fortunately, the enzyme will always dissolve the material.
      cheers,
      azr

  17. Judi says:

    Hi, I also received juvederm for under eye circles and got good results. Don’t really have complaints because my circles were pretty deep. The only issue is a vein on my right eye. I think she hit in during the injection process as i did have a black eye for a week, but the vein is still visibly enlarged. I can almost feel it protruding out of my face. I got this done in January and am wondering if this is anything to worry about. It does stick out quite a bit and didn’t before. When i asked doctor she said we will have to watch out for it next time. Anything I can do in the meantime?

    1. Dr. Rivkin says:

      hi,
      that is unfortunate – your options are a bit limited, but there is one way to fix it.
      the juvederm is probably under the vein, pushing it up.
      you can dissolve a bit of the juvederm, but then you may get a bit of the hollowing back.
      ultimately, i would try dissolving just a bit with hyaluronidase (less than 0.02cc) – that should bring the vein down.
      if the under eye area is too hollow afterwards, you can always refill with juvederm.
      hope that helps.

  18. Ray says:

    Please can you tell me how to correct Malar bags. I have one under my right eye since having a filler to correct hollowness. it causes me terrible distress and I really need some advice. Thanks

    1. Dr. Rivkin says:

      it sounds like you need to have that filler dissolved. it is easy to do with hyaluronidase

  19. courtney says:

    hello dr.. you might have answered this question already, but I had juvederm put under my eye as the doctors idea to get rid of dark circles. Well under my right eye, it has been a year and a half now, and it is still extremely dark and puffy. Will this ever go away? it looks horrible.. how much does the hyaluronidase cost?

    1. Dr. Rivkin says:

      hyaluronidase is cheap – i charge about $100 and its never too late to do it if you are still seeing puffiness and dark coloration

  20. Mano says:

    I am waiting for my turn to be answered as I am desperately distressed about my eye bags after hyaluronidase on the right side. It has been almost 21 days since I dissolved my misplaced filler with hyaluronidase and I still have the puffiness. I did cold compresses and took serratiopeptidase tablets but nothing worked. How can I vet rid of them.

    1. Dr. Rivkin says:

      hyaluronidase will dissolve the material if it was hyaluronic acid that was injected. if you are still having edema and swelling, it may be a inflammatory reaction and a brief course of oral steroids may be the way to go. i usually use a medrol dose pack in this situation (although this situation is very rare), which is a five day tapering dose of oral steroids.

  21. Mano says:

    Thankyou for the reply. It was a hyaluronic acid filler. And 0.1 cc hyaluronidase was injected on the fifth day after filler and then 0.2 cc injected on the 8th day. Filler is dissolved as it seems a soft cystic swelling which worsens when I can’t sleep well at night or may be its just my impression.

  22. tricia says:

    Hi Dr Rivkin, I too got juvederm under the eye’s and it’s not good.I went to this doctor to ask about getting rid of celulete he talked me into getting juvederm for under my eyes and radisse for my cheeks and botox for my forhead. Being a model i thought if i could get rid of the dark circles under my eyes it would be great for my career. So i got it done it’s been over 12 days and i have brusing under my right eye which will hopfully go away and i have these raised indentations under both eyes right under the dark circles. NOT GOOD! So i went back just 2 days ago He suggested Hyaluronidase to disolve it but i am very weary of having him do it cause i’m thinking if he did the juvederm wrong then how can i be so sure he is going to know how to do the hyaluronidase right? My face is how i make money. That being said. What do i do? The lumps are not going away and i’m scared to death to have him do the Hyaluyonidase. Plus do i ask for a refund on the juvederm? It was his suggestion to do it not mine. He is the one who said it will make me look ten yrs younger. Right now all i see is my future in modeling going down the tubes.Can anything go wrong if i opt for the Hyaluronidase. Should i wait for it to just go away? Cause time is money for me. Sincerely, Scared to death.

    1. Dr. Rivkin says:

      hi tricia,
      hyaluronidase should be safe to reduce the juvederm. i understand what you mean about the trust factor. i have to say, that a bit of irregular contour is common to see. it sounds like you have more bumpiness than would be expected, though.
      the most important factor in terms of doctor choice is experience. if there is someone else in your community who is experienced with hyaluronidase you may want to speak to him or her, just to get another opinion. of course, if you are in the area, i would be happy to see you myself. no, i do not think you should wait to get this taken care of. let me know how it goes.

    2. Dr. Rivkin says:

      sorry for the late reply. hyaluronidase really works well, but you need to go to someone experienced in its use. getting a second opinion is never a bad thing to do. hyaluronidase should be injected in small quantities, although i do not think that there are side effects from it, you always have to be conservative and careful under the eyes. i’m afraid i can’t advise you on the refund – you may want to bring up your concerns with your doctor and see if the two of you can come up with a reasonable solution.

  23. Isabel says:

    I did not read all the post, but I searched the page for some key words and believe that no one posted the information I’ll share.
    For the black stains due to iron deposits because of bruising, an Vitamin K cream helps a lot to dissolve that iron and make it disappear or become much lighter. One example is a gel called Auriderm.
    I’ve used it myself and the stain got much lighter, but needs to be applied twice a day for months.
    Hope this helps.

  24. Mano says:

    Hi doctor. What dose of medrol should I use for my tear trough swelling one and a half month after hyaluronidase. You mentioned earlier that a five day course would be enough. What strength should I take I mean how many 5 mg of prednisone tablets. And in what fashion should I taper off the dose. Will aspiration help.

    1. Dr. Rivkin says:

      Medrol is sold as a pack of 21 tablets (4mg each), where 6 tablets are taken on day one, 5 are taken on day two, 4 on day three, 3 on day four, 2 on day five, and one on day six.
      however, I would try the hyaluronidase again first and make sure that it is not expired. The enzyme usually works very well to reduce the swelling. I do not think that aspiration helps.
      the other possibility is kenalog injection into the area of swelling if there is a possibility that a material other than hyaluronic acid was used. i would start with kenalog 10 and only go to kenalog 40 if no resultas are seen from the 10

  25. Mano says:

    Thankyou dr for the nice reply. In the meantime I did try deltacoetil tab. Though I can feel the swelling which is very soft and cystic, hA diminished now. Still I can feel it ESP when one side is having more darkness than the other meaning the swollen one. Now they feel uneven. One with smaller circle and the other with a longer one. Though I agree with you to go see the doctor again. Will inform you later about any progress. The filler injected was fortelis which is not for tear trough.

  26. You you should make changes to the blog title Discoloration Under the Eyes After Juvederm | Westside Aesthetics: Rhinoplasty Los Angeles Fraxel, LA Non-Surgical Nose Job to more specific for your content you make. I loved the the writing withal.

    1. Dr. Rivkin says:

      thanks!
      i will try that

  27. Cheryl says:

    Dr. Rivkin,
    I too had juvederm injected in the tear troughs exactly 1 year ago. I know the technique was done improperly. She did not inject deep enough-it was very superficial like laugh lines. Now I have two really large “pillows” under my eyes. My right one is worse than my left and now my husband is telling me how I look like I like someone punched me in the eye some days. I wish I had never done it and will not do it again. So, I though after a year the product would dissolve and it would get better-no such luck-it is really getting worse every day. Help! I am so self-conscience about the giant pillows under my eyes.

    1. Dr. Rivkin says:

      you really need to get to an experienced injector (usually a physician) who can use hyaluronidase to dissolve your juvederm. it is a simple injection procedure and the material is gone in 24 hours. hyaluronidase is a safe, reliable medication that really works. i use it all the time.

  28. Linda says:

    Dr. Rivkin, I’m so confused about the proper use of hyaluronidase for dissolving Juvederm in my tear troughs. I have consulted with a few doctors; some say it can and SHOULD BE dissolved in small increments; perhaps not having to dissolve all of it. However, one doctor I’m considering 100% disagrees and says “The dissolution of the Juvederm is total and cannot be done incrementally.” When I questioned him further, he said “You cannot quantitate dissolving this in increments!” I’ve already lived with puffiness and discoloration from an obvious over-fill of Juvederm in my tear troughs and want to dissolved; I was hoping to retain some of it where my eyes might look “normal” and nice. I’m so afraid of making matters worse by having it dissolved incorrectly. Please give me your opinion. Can and should the Juve be dissolved slowly and increments, or is that not possible like the one doctor said?

    1. Dr. Rivkin says:

      yes, i always dissolve slowly and in increments.
      it just involves injecting small amounts of the enzyme and seeing you again 2 weeks later.
      although he is right, that you cannot predict exactly how much will stay and how much will dissolve, it does not mean that you cannot try to do it incrementally.

  29. naz says:

    I have had restylane over-injected in my tear troughs for over two years..I have had improvement but I still have the dark stain, bumpy skin, and blue hue under both eyes.I have lost all hope to have a normal face. Any suggestions???

    1. Dr. Rivkin says:

      yes, you need to go to someone experienced in using hyaluronidase – an enzyme that dissolves the restylane. even after this much time, you should get significant improvement within 24 hours.

  30. Marian says:

    Hello, I had Juvaderm XC done in August and I have never had any problems with Juvaderm, Juvaderm Ultra but as quick as the surgeon injection the XC above my upper lift, I had white raised up puffs. There are still as visible as they were the day of the treatment and was this caused by injecting too close to the skin? I did also have some injected under my eye and there was also a white puff there. He used hyaluronidase and thank goodness it worked under my eye. I still have bruising and some lumps but those are not as noticeable as the white raised up puffs above the lips. Will the Hyaluronidase work above the lip area as well? I have researched this since August and have called Allergan and not anyone could help me but after reading your comments, I am beginning to fill much better. Also as I was reading one of your comments you were saying Dr. Rivkin, that possibly the discoloration is the XC showing through the skin and by injecting Hyaluronidase, this would resolve this problem. I respect your work as you did this slowing as not to reverse the entire treatment. Thank you, Marian

  31. Elsa Reyes says:

    I had juvederm under my eyes and I hate the results. Can I have it dissolved without having to use hyaluronidase. I am scared because I have heard horror stories that it leaves bigger bags, holes and double bags. Is this true?

    1. Dr. Rivkin says:

      hyaluronidase works really well and, as long as it is used carefully, should not have any side effects. i inject small amounts at a time and bring the patient back after a week to check the results. if they need more, i put more in at that time. i would get your juvederm dissolved with a doctor who is experienced at using hyaluronidase.

  32. BellePierce says:

    Had restylane injections under my eyes by my dermatologist 4 weeks ago and then more 2 weeks ago. I have awful bags inder my eyes under the dark circles that he wanted to get rid of. Looks like I have circles down in my upper cheek now. I trust him but he says he has never had to do a reversal on anyone. He has wydase(sp?) and can if he needs to, however he would not be experience if he has never done it before. I have no idea how to find someone to do the reversal and am scared to death that anything done will only make matters worse. It has aged me 10 years and I would just love to have my dark circles back in exchange for these bags. HELP!

    1. Dr. Rivkin says:

      get it reversed with someone who has experience with hyaluronidase. you will have to call around to the docs in your area and find who has the experience

  33. Shelli says:

    Hi,

    I had Juvederm injected in the fine lines on my cheeks by my eyes 18 months ago. Laugh lines. I liked the results from that, however, the nurse took it upon herself without my consent to inject the remaining syringe in both lower corners of the bottom portion of my under eye dark circles. I NEVER wanted my dark circles injected. Now I have this discoloration in both chunks of the bottom of my dark circles. It is so noticeable with and without makeup. Probably worse with makeup. I have put up with this for 18 months. I’m so devasted. I don’t know what this discoloration is. A couple weeks ago I went back there and had a consultation with the doctor. He’s a reputable physican. Board certified etc. I wanted to try that syringe that dissolves Juvederm, however, the physician states after 18 months there is no Juvederm left under my eyes and that hyaluronidase will not work. He said give it more time and come back in six months. I think he’s just trying to wait until the statue of limitations runs out. I’m so embarassed by this discoloration and it is so noticeable. Should I try the hyaluronidase anyway or some type of laser procedure. I just don’t want to make it worse but I want it gone. The nurse did this I didn’t and I told the physician that!!

    1. Dr. Rivkin says:

      the physician is probably incorrect. there is probably still hyaluronic acid in there. you should try the enzyme. if that doesn’t work, you can try laser, but i would do the enzyme first.

  34. Julian says:

    Hi,

    I had Perlane injections in the tear troughs 5 months ago. After a few days from the injections these dark marks appeared under the skin, and have still not gone away. It looks like the muscle that runs from the corner of the eye, which follows the orbital rim is showing through the skin. It depends which light i am in as to how bad it looks. It does not seem to have faded at all in the last 5 months. What are the main possibilities that this could be, and how long for each possibility could it take to go? Can it be a permenant marking now? Thankyou for you time.

    1. Dr. Rivkin says:

      it sounds like what you are seeing is the perlane through the thin skin of the eyelid area. this is called a tyndall effect and is quite common. the only way to reduce it is to dissolve some of the perlane with an enzyme called hyaluronidase. just make sure that the doctor you choose has lots of experience with injecting hyaluronidase

  35. shelly says:

    Dr.,
    I had Juvaderm Ultra injected under the eye because I had mild bags and dark circles. It looks weird. First he injected way under the dark circle and I guess that is common for people with volume loss but I dont have that there but he did it anyways. Now I have a raised area under the circle. This raised area only makes the dark circles adjacent to it look much worse. He tried to “move it up” by injecting again and again. $2000.00 and 5 appointments later I still look weird. I wanted to ask why my skin looks much lighter after injection? I am not talking on the dark circle because that is still very much there, but beneath it where he made the puffy bags it is bright white and I am olive tone. He said the skin is smooth and so light is reflecting but I dont buy this. It is distinctly much lighter than all the surrounding skin. I am very frustrated because I went to a well-known derm in Manhattan and came out looking like a weirdo. Im exhausted and unhappy to say the least. Why is it white where he injected and is the filler not supposed to go in the dark circle?

    1. Dr. Rivkin says:

      tough to tell without a picture, but i would get a second opinion. make sure that the second doc does this procedure all the time and is skilled in the use of hyaluronidase – the enzyme that dissolves the juvederm. i would be happy to help, but i need pictures.

  36. ceejay says:

    Hello, had juvederm in tear troughs 15 months ago, have crepey eye bags, worse still this flourescent yellowy orangey discoloration in the bags, my local physician thinks its too late for the enzyme, but has no answers for this discoloration, thankyou for your input

    1. Dr. Rivkin says:

      i do not think that it is too late for the enzyme. it certainly does not hurt to give it a try. it will not dissolve your natural tissue.

  37. ceejay says:

    HI Doctor, thanks so much for your reply,do you have any opinion on this flourescent discoloration that I still have in the lower eye bags it seems to cast a shadow beneath the eye sockets? I notice ” Fab 40 ” question 15 has this same problem, much appreciate your opinion, thankyou

    1. Dr. Rivkin says:

      this is called tyndall effecgt
      it is the filler under the skin
      to get rid of it, you would have to dissolve the filler, at least partially, with hyaluronidase

  38. Nice, put on reddit ;)

  39. Hi Dr Rivkin says:

    I had Juvederm Ultra injected into the lower part of my eye bags or tear trough. Its been 3 months and the lines around my mouth are getting worse and worse it seems each week. I am so worried what it will look like once it’s worn off. I have been assured it only lasts 1 year at most. And am using Galvanic twice a week for massage too. I’m nervous to dissolve it, and have been told its better to let it go naturally. Is it possible it can stretch your skin and weight your skin down to sag faster than the aging process?

    1. Dr. Rivkin says:

      not sure what you mean. you had juvederm injected under your eyes, but your area of concern is the lines around your mouth?
      the injections you had should have no effect on the lines around your mouth.
      dissolving juvederm is safe and will not make your skin sag. if you are talking about your tear troughs, juvederm lasts for years in there and will not go away unless you dissolve it.
      i hope that helps and feel free to email me via the website if you have further questions.

  40. Cool story. Pity that in my location there’s no results what so ever around me.

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