Tear Trough Lumps/Nodules
77 · · Last reply 🌐 繁中
Hello everyone, I’m looking for advice from the experts on this forum or anyone who has had a similar experience...
I previously went to a clinic to have my tear troughs filled with Princess Hyaluronic Acid (HA), but now I have obvious lumps/nodules under my eyes. They look like two caterpillars, and my face looks incredibly stiff when I smile 😭.
I originally thought that injecting hyaluronidase would solve the problem, but I’ve already visited two clinics to try dissolving it, and the lumps/nodules haven't gone away at all! The doctors told me it might be due to capsule formation or the characteristics of the product, but I really don't want to live the rest of my life with these two lumps...
I would like to ask everyone:
Has anyone experienced ineffective Hyaluronic Acid (HA) dissolution? How did you eventually get rid of them? (Surgical removal? Or some special laser treatment?)
I am begging for recommendations for authoritative doctors or clinics in the Greater Taipei area (or anywhere in Taiwan) that specialize in "aesthetic medicine filler revision"?
I feel devastated every time I look in the mirror. Thank you all in advance for your help! 🙏
3 Replies
Dr. Ta-Ju Liu · Board-certified dermatologist🌐 繁中 Doctor
Hello, I am Dr. Liu. I have encountered cases like this, and they are not uncommon.
Direct Answer: If hyaluronidase was injected twice without resolution, the next step is not to blindly inject more hyaluronidase, nor is it laser therapy. Instead, you need to use high-frequency ultrasound to clearly see what is inside before deciding on the treatment approach.
Possible Causes to Differentiate
When two caterpillar-like bumps appear under the eyes after tear trough Hyaluronic Acid (HA) fillers, and the stiffness worsens when smiling, common causes include:
1. Superficial placement
2. Product aggregation or migration
3. Swelling due to Hyaluronic Acid water absorption
4. Subsequent fibrosis or encapsulation
The skin around the eyes is inherently very thin, so even the slightest unevenness will be visibly prominent.
General Treatment Directions
- In some cases, residual Hyaluronic Acid is indeed still present, and they simply require more precise dissolution, possibly even Ultrasound-guided hyaluronidase injection.
- In other cases, the main problem is no longer the Hyaluronic Acid itself, but fibrosis, encapsulation, or a chronic inflammatory reaction. In such instances, hyaluronidase alone will have limited effectiveness.
- Lasers are usually not the primary treatment for this type of Hyaluronic Acid lump/nodule.
- First, determine whether it is residual Hyaluronic Acid, fibrosis, or other tissue issues, and then decide whether to proceed with precise dissolution, local medication, or Pinhole Extraction. This prevents you from heading in the wrong direction with subsequent treatments.
When to Seek Medical Attention Immediately
If the swelling, redness, heat, and pain under the eye rapidly worsen, if the skin turns pale or purplish, or if there are changes in vision, do not wait—seek medical attention immediately.
This online response is for general health education purposes and does not constitute a diagnosis, nor can it replace an in-person consultation and ultrasound examination.
Anonymous🌐 繁中
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Anonymous🌐 繁中
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