Injectable Fillers - I was seen by a different doctor and had a filler injected for my tear trough and later that day I developed a big lump only on one side. It’s been a year and it’s still there. What can this be and how can I get rid of it?

You’re describing a hematoma which is a collection of blood underneath the skin. If you were taking blood thinners around the time of the injection or after, it may have contributed to it. Most go away by themselves but some can in fact solidify and may need to be surgically removed.

I was told that Botox can’t be done for my upper eyelid wrinkle. What else can be done?

Sometimes laser resurfacing can help. Also, as an off-label indication, I have carefully injected thin fillers sparingly underneath these lines with good results, but swelling and bruising are big concerns, although temporary. There is also a possibility of lumpiness seen more readily here than other areas because of the thin skin. Therefore, I only use hyaluronic acid fillers such as Juvederm and Restylane in this area so if there is excessive swelling, or overcorrection or lumpiness, it can be dissolved by injecting hyaluronidase.

If I am going to have fat injections, how long should I expect to have swelling and bruising?

Depending on the level of fat placement and how many areas will be treated, you might have up to three or four weeks of bruising and four to five weeks of swelling. This is especially when the muscle is injected. Usually, in my practice, the fat is injected into the subcutaneous compartment and maybe under the muscle but not in the muscle so there is less duration of swelling and the bruising may be minimized by vitamin K topically, and Arnica by mouth.

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