Tear Trough Lumps/Nodules

劉達儒醫師 Doctor

Hello, I have encountered cases like this, and they are not uncommon. After getting **Hyaluronic Acid** for tear troughs, if you develop protrusions under your eyes that look like two caterpillars, or if your face feels stiff when smiling, common causes include: injecting too superficially, product aggregation or migration, swelling due to the **Hyaluronic Acid** absorbing water, or subsequent fibrosis or encapsulation. The skin around the eyes is naturally very thin, so even the slightest irregularity becomes very noticeable. If you have already visited two clinics for hyaluronidase injections without significant improvement, the next step is usually not to inject blindly again. Instead, you should first use high-frequency ultrasound to clearly visualize the situation inside. In some cases, there is indeed residual **Hyaluronic Acid** that simply requires more precise removal, potentially under **Ultrasound-guided** conditions. However, in other cases, the primary issue is no longer just the **Hyaluronic Acid** itself, but rather fibrosis, encapsulation, or a chronic reaction; in these instances, hyaluronidase alone will have limited effect. As for the laser treatment you asked about, it is generally not the primary method for addressing these types of **Hyaluronic Acid** lumps. What is truly important is to first distinguish whether the issue is residual **Hyaluronic Acid**, fibrosis, or other tissue problems, and then decide whether to proceed with precise dissolution, local medication, or minimally invasive revision. If you are in Taipei or Kaohsiung, you are welcome to come to LIUSMED for an assessment. We will first use ultrasound to clearly examine the internal structure to determine the exact nature of the problem, ensuring that subsequent treatments do not continue to head in the wrong direction.