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Dermal Fillers
Puffiness and dent 4 days after tear trough filler? Practitioner has assured me it is swelling, but it's not getting better.
Tear trough filler is notoriously finicky and can take several weeks to settle down. As a general rule of thumb, I recommend waiting at least 2 weeks before additional intervention. If still present at that time, you can consider dissolving a little bit with hyaluronidase. Unfortunately hyaluronidase is not as precise compared to the initial placement of filler and the amount dissolved in one session can be variable, depending on the rheology of the product used. Since the tear trough is a delicate and unforgiving area, it's typically best to under-correct and add more filler as needed.
Clinical Context
Puffiness under the eyes after filler can come from lingering swelling, filler sitting slightly high, or normal muscle movement when you smile or squint — these can look similar. A provider will often check how the area responds to gentle pressure and to smiling before deciding on next steps. Skin thickness and symmetry also affect how a dent looks. Because early swelling often fades on its own, many providers wait several weeks before dissolving, so they don't remove filler that would have settled naturally.
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