The Women with Blue Eyelids

As the use of fillers becomes more widespread and sophisticated, more physicians, and some non-physicians are trying their hands at it. Originally collagen was used as a wrinkle filler and, while there were occasional side effects, for the most part they were limited to some assymetry with the more serious problem of interference of the circulation to the lower mid forehead skin occurring only rarely.

Now the collagen fillers have been replaced by new families of fillers that bring with them new potential problems. The most commonly used fillers are the hyaluronic acid fillers, such as Restylane or Juvederm that, when placed beneith thin skin, can produce a bluish discoloration.

The change in the use of fillers from wrinkle improvers to facial sculptors, replacing facial volume lost with aging, has resulted in the need for more skilled injectors and increased the variety and risks of complications.

This past week I saw a woman who was quite upset about the blue bubbles just below her lower eyelids. She was most unhappy about the unevenness of her skin, but she also did not like the areas of blue visible through her skin. When I told her that the best option was to dissolve some of the poorly placed filler, she stated that it had cost her a lot of money to have the filler put in, and she did not want it removed. I ended up doing nothing, and she planned to go back to the person who injected the filler and have more put in to even things out. She said she could always cover the blue discoloration with makeup.

The next day I saw another woman who had presented with the identical problem several months before. When she returned home after her initial injection, her husband told her "I don't know what you had done, but something went terribly wrong." She allowed me to dissolve some of the filler, and she's been extremely grateful subsequently. Although they were having a "buy one, get one free" sale in her town, she had driven over one hour to see me. She thought that she needed more filler under her eyelids but, in fact, more of the misplaced filler had become visible, and she needed more dissolved.

The take home message is that you should not let price be the major determinant in choosing where to have a cosmetic procedure done, any more than you would choose a heart surgeon because they were the cheapest. Although they are uncommon, there are significantly worse outcomes than blue skin bags that can occur after fillers are injected. Some injectors are prepared to deal with this. Some are not. Your best bet is to choose someone who has been doing this for a while and who has a good reputation in your community.

Gerald N. Bock MD

California Skin & Laser Center

Stockton & Lodi, CA

Comments

[johnvictor]

Thank you for sharing your experience with all. Really fillers give very good result for wrinkles.