LAM FACIAL PLASTICS

Hi Dr. Lam,

I am writing to get your advice because you seem to be the only doctor that understands fillers/botox and the possible side effects. Exactly 4 months ago, I had restylane injected in my hollow tear troughs (I had no bags) and botox - 20 units in my forehead, 10 in each crows feet and 2 units under each lash line. It was a first for me for a filler and botox. I am living a nightmare ever since. Immediately, I could tell I had been overfilled with the restylane under my right eye and had immediate bruising on that side. 10 days post procedure, the physician used a small amount of hyaluronidase to dissolve some of the restylane. It looked good for about 5-6 days, then the puffy bags reappeared under my eyes. 30 days post procedure I went back in and asked that all the restylane be removed. He used a lot of the hyaluronidase on this day. I am now 120 days out. I have a huge puffy bag under my right eye (the eye that received the obvious overfill) and a small bag under my left. My tear function has been effected by the botox around the eyes and I have discomfort (throbbing/pressure/burning) under both eyes, but most often around the right eye. Not sure if this is due to the botox or restylane/hyaluronidase.

I will be thrilled if the bags and discomfort are due to the botox around the eyes. Botox wears off, however I am terrified that permanent damage has been done by either the restylane or the hyaluronidase. I have been to the top plastic surgeons in my area for a consult but none seem to have any answers for me. They do not perform restylane around the eyes and do not advise it. I wish I had done my research prior to this procedure. I went in for laser treatments around my eyes and was talked into the restylane and botox by the physician. I am desperate for answers and where to go from here. I am 35 years old and did not need any of this done. I would do anything to take it all back. Thanks for your sharing your knowledge.

although i have not seen you, i would most likely venture that everything you are describing is temporary in nature. what you are experiencing could be a byproduct of all of the above procedures, i.e., both restylane/hyaluronidase and botox. although i have never seen it, i can say at least that botox is temporary but so are restylane/hyaluronidase. hyaluronidase over can over dissolve your natural collagen which can take weeks to months to fully restore it especially if a large quantity was applied. for all of those reasons, hopefully everything will be restored over the next few months. this is why i really only use microcannulas around the eyes for restylane. it really helps me achieve virtually bruiseless and smooth filler results.
best,
sml

Thanks so much for your response. This has been a frightening experience for me. There are so many women online talking about restylane and/or hyaluronidase causing permanent under eye bags and permanent damage to the lymphatic system as if it was common knowledge. I was hoping that this was not the case. As you stated, both restylane and botox are not permanent. I'm a little over 4 months out. Hopefully, the bags of fluid will slowly disappear as the botox continues to wear off.

i hope that all will be well with you.
best,
sml

Hi Dr. Lam,

Just one other question. I have been so focused on the new bags under my eyes post botox (5 months ago) that I did not until recently notice that one of my cheeks is flat and the jowl is huge on that side of my face. Will this too correct itself? This was my first time having botox - 20 units in forehead/20 crows feet and 4 under eyes = 44 total units, 35 years old. At 5 months post botox, I am still suffering from dry eyes and under eye bags. Just wondering when I might start seeing a light at the end of the tunnel

Simply put I have never heard of such a thing after treating thousands of patients over a decade. Sometimes you can experience facial changes when you become insanely stressed. Try to let go of your anxiety and sometimes your face comes back from that alone.